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Jan 8, 2023

How to Choose Best Health Insurance for Cancer Patients?

Cancer, the very name of the ailments sends shivers down the spine. Be it your close relative or your friends, it is disheartening to know about someone diagnosed with it. But the statistics in India are alarming. It is stated that these number of cases are expected to touch the 15 lakh mark by the year 2025 as described in a report by Indian Council of Medical Research (ICMR). This is a 12% increase from the estimated figures for the year 2020. With such a distressing rate of increase in cancer among people, it is necessary that you have a cancer insurance cover.

What is a Cancer Insurance Policy?

Cancer insurance is a specifically designed critical illness insurance which provides a lumpsum pay-out on the diagnosis of this illness. Cancer insurance plans provide coverage for a range of costs associated with the treatment like hospitalisation, radiation, chemotherapy, surgery and more. With a cancer policy, you can have not only financial, but also mental security since these policies cover the ailment at both early and advanced stages. The pay-out in some cancer insurance plans are paid in based on severity of the diseases in lump sum. This is subject to the terms of your health insurance cover.

What Types of Cancers are Covered by Cancer Insurance Policies in India?

In India, cancer insurance coverage typically covers major types of cancer such as:
  1. Breast cancer
  2. Lung cancer
  3. Prostate cancer
  4. Ovarian cancer
  5. Colon cancer
Some plans may also cover other types of cancer, such as bladder cancer and pancreatic cancer.

What Benefits Do Cancer Insurance Policies Offer?

Health insurance with a cancer cover offers several benefits that can help individuals manage the financial burden of a cancer diagnosis. Some of the benefits of cancer insurance coverage include:
  1. Coverage for expenses related to cancer treatment, including chemotherapy, radiation therapy, and surgery *
  2. Coverage for hospitalisation and medical tests *
  3. Income replacement or disability coverage to help cover lost income during treatment and recovery *
  4. Access to counselling services or support groups for emotional support *
  5. Lump-sum payment for early detection of cancer *
  6. Option to choose a higher sum assured for more extensive coverage *
  7. Flexibility in choosing the policy term and premium payment frequency
By providing comprehensive coverage for cancer-related expenses and support services, health insurance with cancer cover can help alleviate the financial and emotional stress that comes with a cancer diagnosis.

Tips for Finding Affordable Health Insurance for Cancer Patients

Finding affordable health insurance for cancer patients can be a critical task. Cancer treatment often involves extensive medical care, including surgeries, chemotherapy, radiation, and ongoing medications, which can lead to significant financial burdens. For cancer patients and their families, securing comprehensive and affordable health insurance is essential to ensure access to necessary treatments and reduce out-of-pocket expenses. Navigating the complexities of insurance options, understanding coverage details, and exploring available resources can make a substantial difference in managing the cost of cancer care. This guide provides valuable tips to help cancer patients find health insurance that meets their needs and budget. Finding affordable health insurance with cancer coverage entails several crucial pointers:
  1. Comparison: Explore multiple cancer and other illness health insurance plans from diverse providers to identify the most suitable coverage within your budget.
  2. Government Programs: Investigate government initiatives like Medicaid or Medicare, offering tailored coverage for cancer care, potentially alleviating financial burdens.
  3. High-Deductible Plans: Consider high-deductible plans to reduce premiums, supplementing them with health savings accounts (HSAs) or flexible spending accounts (FSAs) to manage out-of-pocket costs.
  4. Employer-Sponsored Plans: If available, leverage employer-sponsored plans for potentially more cost-effective coverage options tailored to cancer care.
  5. Professional Guidance: Seek advice from financial advisors and utilise available resources to ensure informed decision-making, ensuring the chosen plan adequately addresses your needs while managing expenses effectively.

What are Inclusions and Exclusions Under Cancer Insurance Plans?

Understanding distinctions ensures individuals can make informed decisions when selecting health insurance for pre-existing cancer, providing clarity on what expenses are covered and what may require alternative financial arrangements. Below mentioned are the inclusions and exclusions under cancer insurance plans:


  1. Hospitalisation and Inpatient Services: Covering expenses related to hospital stays.
  2. Surgery and Surgical Procedures: Including costs for surgical interventions.
  3. Chemotherapy and Radiation Therapy: Providing financial support for these critical treatments.
  4. Medications and Prescription Drugs: Covering prescribed medications for cancer treatment.
  5. Diagnostic Tests and Imaging: Including expenses for tests to monitor cancer progression.
  6. Supportive Care Services: Such as home health care and hospice care.


  1. Pre-existing Conditions: Coverage may be limited for conditions diagnosed before the insurance policy's start date.
  2. Experimental or Investigational Treatments: Costs for treatments not widely accepted or proven may not be covered.
  3. Cosmetic Procedures: Expenses for aesthetic purposes are typically not included.
  4. Non-Cancer Related Treatments: Medical costs unrelated to cancer treatment are usually excluded.
  5. Alternative Therapies Not Deemed Medically Necessary: Certain alternative treatments may only be covered if considered essential for medical care.

How to Make Cancer Insurance Claims?

It's important to adhere to the timelines and procedures outlined by your insurance provider to ensure a smooth and timely claims process. So let us know how to make cancer insurance claims for health insurance for cancer patients in India: Step 1: Claim Notification The initial step in making a cancer insurance claim is to notify your insurance provider about your intention to file a claim. This can typically be done through various channels such as online portals, phone calls, or visiting the nearest branch office. Ensure you provide all necessary details accurately, including your policy information and the nature of your claim. Step 2: Submit the Claim Form or Evidence After notifying your insurer, you'll need to submit the required claim form along with any supporting evidence. The claim form can usually be obtained from the insurer's website or branch office. Make sure to fill out the form completely and accurately, providing details about your diagnosis, treatment, and any other pertinent information requested. Step 3: Supporting Documents and Examination Along with the claim form, you'll need to submit supporting documents as evidence of your cancer diagnosis and treatment. This may include medical reports, doctor's certificates, bills, receipts, and any other relevant documentation. In some cases, the insurer may also require you to undergo a medical examination to assess the validity of your claim. Step 4: Claim Settlement Once all necessary documentation has been submitted and reviewed, the insurer will proceed with the claim settlement process. If your claim is approved, the insurer will provide the agreed-upon benefits according to your policy terms. This may include reimbursement for medical expenses, lump-sum payments, or other forms of financial support as per your coverage.

What Justifies the Need for a Cancer Insurance Cover?

Here are some reasons that justify the need for a cancer insurance policy:

High Cost of Cancer Treatment:

Cancer treatment can be expensive, and default insurance coverage may not be enough to cover all the costs associated with it. Cancer insurance cover can help fill this gap by providing coverage for medical expenses, including hospital stays, chemotherapy, radiation therapy, and surgery. *

Financial Protection:

Cancer diagnosis can result in a significant financial burden on individuals and their families. Cancer insurance coverage can provide financial protection by covering the costs of cancer treatment and other expenses, such as lost income and transportation costs.

Early detection:

Early detection of cancer can significantly improve treatment outcomes. Some cancer insurance covers offer coverage for cancer screening tests, which can help identify cancer at an early stage.

Peace of Mind:

Knowing that you have cancer insurance coverage in place can provide peace of mind and reduce the stress associated with a cancer diagnosis. It can also help alleviate some of the financial worries that often come with a cancer diagnosis.

Supplement to Existing Insurance:

Cancer insurance can supplement your existing health insurance coverage by providing additional benefits specific to cancer treatment. It can also provide coverage for expenses that may not be covered by your regular health insurance plan In summary, a cancer cover policy can provide financial protection and peace of mind, as well as, supplement existing health insurance coverage.

Here's how you can avail the best health insurance for cancer patients

Undergo regular health check-ups:

The earlier the ailment is detected, the higher are its chances of being treated is what the experts suggest. Hence, regular and periodic health check-up will help in early diagnosis. Further, doctors recommended gender specific tests for females like mammography, pap smear and ultrasound for women above the age of 40. For males above 55 years, ultrasound tests can help in early detection. Since health check-ups are essential for detection, it is advisable to buy cancer insurance in India that supports these check-ups.

Select the Right Insurance Policy:

When it comes to picking a cancer insurance plan among the myriad options, it is essential to buy a policy with adequate sum insured. Since the treatment costs are exorbitant, a sum insured that will be able to cover for these high treatment costs is essential. Generally, cancer insurance with at least 1.25 times the average treatment cost in your city of residence is necessary, depending on several other factors. This way, you can keep up with the rising medical inflation as well as plan for the future. For Family Floter Policies, makes sure to take a higher amount of cancer insurance coverage since it is shared by many beneficiaries at once.

Check co-payment Clause:

Co-payment clause is where you, the policyholder are required to pay for some part of the treatment whereas balance is covered under your insurance policy. Using co-payment clauses can be helpful to lower the premiums but a policy opted specifically for cancer insurance, it may not be advisable since it requires you to pay a huge chunk of the expenditure.

Compare Waiting Periods:

Another critical factor to consider when getting cancer insurance coverage is the waiting period for the policy. Different health insurance plans have different waiting periods and should be a consideration at the time of purchase. A longer waiting period will mean more time until your insurance coverage kicks in for these ailments. These are some crucial elements in a cancer insurance policy. A thorough analysis of the insurance company’s offering will help in selecting the right cancer insurance in India. Further, it is essential to buy such cancer insurance if the risk of cancer runs in your family. This way, you can have a financial backup in case it ever takes you down. Lastly, do note that this cancer insurance policy does not replace your standard health insurance policy, but instead is a supplementary plan for specific ailment. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.

How Do the Claims Process and Payment Work for Cancer Insurance?

Here's a step-by-step breakdown of how the claims process and payment works for a cancer insurance policy:

Submitting a claim:

To start the claims process, you'll need to submit a claim form to your insurance provider. The claim form will typically require information such as your diagnosis, treatment plan, and healthcare provider details. In some plans, the individual may have to be diagnosed with cancer for a specific period, referred to as the survival period, * before they can raise a claim.

Claim review:

Once the claim is submitted, the insurance provider will review it to determine if it meets the requirements for coverage under the plan.

Claim approval:

If the claim is approved, the insurance provider will pay the payout as determined during the purchase of the plan.

Timely submission of claims:

It's important to submit claims in a timely manner to avoid any delays or denials in coverage. Be sure to keep copies of all documentation related to your cancer treatment and claims. Unlike regular health insurance coverage, the claims process for critical illnesses can be a bit different. Be sure to know the claims process before you sign the policy proposal form.


1. Does cancer insurance cover chemotherapy?

Yes, a cancer insurance policy typically covers chemotherapy as it is a common treatment for cancer. *

2. Can I purchase cancer insurance after undergoing cancer treatment?

Generally, no. Cancer insurance is designed to cover the costs of cancer treatment before a cancer diagnosis, so it is typically not available to those who have already undergone treatment.

3. Does cancer insurance cover radiation therapy?

Yes, cancer insurance usually covers radiation therapy as it is another common treatment for cancer. *

4. If I had cancer prior to buying a cancer insurance policy, will it cover my treatment?

No, pre-existing conditions are typically not covered by cancer insurance policies.

5. Who can buy cancer insurance?

Anyone can purchase health insurance for cancer patients in India, although it is often marketed to those who have a higher risk of developing cancer, such as smokers or those with a family history of cancer.

6. What is the highest age limit to buy cancer insurance?

The age limit to purchase cancer insurance varies depending on the insurance provider, but it is typically available to those up to age 75 or 80 years.

7. What is the cost of cancer insurance?

The cost of cancer insurance varies depending on factors such as age, health status, and the coverage amount.Typically, premiums are lower for younger, healthier individuals and increase as they get older or have pre-existing conditions. *

8. How can I determine the coverage I need for cancer treatment?

To determine coverage for cancer treatment, assess factors like treatment costs, preferred healthcare providers' network inclusion, out-of-pocket expenses, pre-existing condition coverage, and policy exclusions. Analysing these factors can help select adequate coverage matching treatment needs and financial capabilities.

9. What are the common types of health insurance plans available for cancer patients?

Common health insurance plans for cancer patients include traditional health insurance, cancer-specific insurance, critical illness insurance, and supplemental insurance. These plans offer varying coverage options tailored to address different aspects of cancer care, from treatment costs to additional support services.

10. What should I consider when comparing different health insurance plans for cancer coverage?

When comparing health insurance plans for cancer coverage, consider coverage limits, network hospitals, out-of-pocket costs, pre-existing condition coverage, and policy exclusions. Evaluating these factors helps in selecting a plan that best fits your treatment needs and financial situation while minimising potential gaps in coverage.

11. How long does it take to settle a cancer insurance claim?

The time taken to settle a cancer insurance claim varies depending on factors like documentation completeness, the insurer's processing time, and claim complexity. Generally, insurers aim to settle claims promptly, but the process can range from a few weeks to several months, requiring patience and cooperation from both parties.

12. Is cancer covered by health insurance?

Yes, cancer is typically covered in health insurance plans, but the extent of coverage varies based on the policy. Coverage often includes hospitalisation, surgeries, chemotherapy, radiation therapy, medications, and supportive care services. However, it's crucial to review policy details to understand specific inclusions and exclusions.

13. What is the best health insurance for cancer patients?

The best health insurance for cancer patients depends on individual needs, preferences, and financial circumstances. Plans offering comprehensive coverage, including cancer-specific benefits, adequate network providers, manageable out-of-pocket costs, and policy flexibility, are generally preferred. Comparing multiple plans helps in finding the most suitable option.   *Standard T&C Apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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