Do you need cancer insurance?
Miscellaneous / / October 05, 2023
Few people know about these interesting VHI policies.
What is cancer insurance
Cancer insurance is a type of VHI policy that covers oncology treatment, unlike regular VHI. Many insurance companies have such oncopolicies.
According to the policy, insurance companies either transfer money to the patient or organize and pay for treatment. The second is usually more convenient, because often the patient does not understand how to act after diagnosis, he is confused and scared. And such policies are cheaper.
Why do you need cancer insurance?
Because cancer, unfortunately, is still common and very expensive to treat.
By according to WHO, cancer is one of the leading causes of death in the world. In 2020, it claimed the lives of about 10 million people—almost every sixth person who died died from cancer. In 2022, the incidence rate of malignant tumors per 100 thousand population of Russia made up 428,4. In the same year, more than 624 thousand cases of malignant neoplasms were identified for the first time in the country.
On average, the cost of paid oncology treatment in Russia starts from 500 thousand rubles. Further, the price varies depending on the drugs, the severity of the disease, duration and methods of treatment, and the patient’s location.
Treatment abroad is even more expensive and can start from 100 thousand dollars.
Therefore, for the sake of treatment, many sell cars and apartments and take out loans. The situation is further complicated by the fact that when people fall ill, they temporarily lose the opportunity to work, which means they cannot receive money.
Of course, the insured event may not occur. Or it may happen, then the patient will remain in a financially advantageous, invulnerable position.
Why you shouldn’t rely only on compulsory health insurance
Cancer treatment is included in compulsory medical insurance - this is true. But there are many but.
Most people with cancer require diagnosis, medications, a range of medical procedures, psychological and surgical care, and in some cases, implantation.
But in most cases, compulsory medical insurance does not cover all the costs of treating cancer, since the budget allocated by the state is usually limited. So the patient one way or another has to pay extra for certain services.
The second problem is that under compulsory medical insurance the patient often has to wait his turn: for examinations, for hospitalization, for medical procedures. And with cancer, time plays a very serious role.
Thus, quotas for complex high-tech operations usually have to wait up to several months. In addition, there are not enough quotas for everyone: they may run out before the end of the calendar year. Therefore, if you are unlucky, you will have to pay for the operation at your own expense.
The third problem that may arise with compulsory medical insurance is the lack of necessary drugs. If for some reason we did not have time to purchase the necessary medications, then even with them there may be interruptions. And most patients have to buy expensive immunobiological drugs and targeted therapy at their own expense.
With cancer insurance, you don’t need to apply for or wait for a quota—you can get an appointment and examination without waiting in line: the insurance company pays the clinic directly.
In addition, the patient is not tied to his registration, as is the case with compulsory medical insurance, and can receive help in another region, including the capital. And if this is insurance with international coverage, then abroad.
There will be no problems with medications. With insurance, you can even buy rare and expensive, but necessary medications in another country and bring them to Russia.
In addition, depending on the tariff, insurance provides assistance with relocation, a nurse, implantation, and genetic tests. At the same time, the company helps the patient in everything: in selecting hospitals and laboratories, delivering medications, choosing a doctor. This removes a lot of moral burden from the patient.
How much is insurance
Differently. So, you can pay about 5-10 thousand rubles a year for the simplest truncated treatment option, which will not cover all stages. Or you can buy insurance with international coverage for about 60,000 per year.
The price of insurance depends on several parameters:
- amount of insurance coverage - how much money can be spent on treatment per year;
- countries of treatment - Russia or abroad;
- list of diseases: there are insurances only for oncology, and there are those that include the treatment of cardiovascular diseases;
- conditions for extending insurance: there are insurances that can be extended and treatment continued if the insured gets sick, and there are those that are valid only for a certain period.
By the way, it is important to understand that in some insurance companies, when an insured event occurs, the price of the tariff does not change. If the treatment is not completed, the patient renews the policy, pays the same money and receives the same sum insured. When applying for a policy, it is very important to pay attention to this condition.
But in general, all cancer insurance programs in Russia are quite similar and have approximately similar characteristics, insurance amounts and prices.
Who can get cancer insurance?
Anyone can potentially take out insurance. But there are some stopping factors. Before registration, the client accepts the terms of a special declaration - this is a document consisting of several points, with the help of which the client confirms that he, for example,
- has not undergone a heart transplant;
- does not use drugs;
- does not drink alcohol in quantities of more than 20 ml per day in terms of pure alcohol;
- does not smoke more than 20 cigarettes per day;
- does not suffer from diseases caused by AIDS;
- does not currently suffer and has not suffered during the last 10 years from cancer or precancerous conditions, etc.
Of course, formally, the insurance company cannot check how many cigarettes a client smokes daily. But this is a certain message to the insured, a certain measure. If he agrees with the declarations, he will not have problems with insurance.
And if at this stage at least one item does not apply and the user cannot agree with the declaration, then he is asked to fill out a more detailed and extensive questionnaire about his health. Then the tariff is individually recalculated for him or some risks are excluded from the policy. For example, if a patient suffers from gastritis or other severe gastrointestinal diseases, stomach cancer may be excluded from the policy, since this is an increased risk.
Every time the insurance company looks at the client’s age, medical history, and family history of illnesses. Of course, if there is a serious medical history, great age, a rich medical history in the family, the insurance company will individually decide how much such a policy will cost and what will be included in it. In rare cases, a patient may be denied insurance.
Remember: insurance must be taken out before the onset of illness! Very often, patients want to apply for it as soon as they are diagnosed with cancer. Unfortunately this is not possible.
So it is better to buy a policy as early as possible. Moreover, the insurance begins to be valid only 3 months after registration. That is, a disease discovered during this period will not be considered an insured event. This is done so that a person who already knows about his diagnosis cannot deceive the insurance company.
How insurance works
Usually, if something starts to bother a person, he goes to the doctor and undergoes the examination that is prescribed for him. The insurance company is not yet involved here. She will accompany the patient only if a malignant tumor is detected and the oncologist makes a diagnosis.
From the moment of diagnosis, all necessary procedures - additional examinations, medications, chemotherapy and radiation therapy, surgery, and so on - are paid for by the insurance company.
An administrator from the care service is assigned to the patient. It helps to coordinate online with the insurance company all procedures, starting with the selection of a clinic and a doctor.
Insurance companies suggest doctors and clinics based on the type of cancer—there are oncologists who specialize in specific tumors. Experience, patient reviews and territory are also taken into account.
In Russia, the patient is offered a choice of at least three doctors and clinics, mainly in large cities. Basically, everyone is operated on in Moscow or clinics in large regional centers. If the insured person lives in the region, then after the operation in Moscow he can continue treatment and receive chemotherapy and take medications at local commercial clinics unless it requires you to be in a hospital hospital. In this case, medicines will be delivered to the patient from large cities or even from abroad.
If a person has purchased extended insurance with worldwide coverage, he has the right to choose a country from the proposed list. There, the insurance company selects a clinic and a doctor, helps to obtain a visa, buys tickets, pays for accommodation and meals for the patient and accompanying person.
Surgeries, radiation and chemotherapy are carried out under insurance in large public and private clinics.
The insurance also includes tests in diagnostic laboratories, which can be taken regularly.
In addition, plastic surgery after some tumor removals, such as breast implants, may be covered.
What to pay attention to when concluding a contract
The main advice is to read all the terms of the contract very carefully.
For example, the website may write that it is possible to extend the policy during treatment before remission, but if you look at the contract, it turns out that this is not the case. Or they may indicate on the website that there is delivery of medicines from abroad, but again this will not be recorded in the documents.
In addition, you definitely need to look at what exactly the insurance company requires as proof of illness. The fact is that some ask to provide exclusively histological analysis confirming the malignancy of the tumor. But there is oncology, when it is impossible to find the focus or the doctor cannot take histology, for example, with a brain tumor. Such a tumor can be seen on MRI, but it is impossible to assess whether it is malignant or not. It turns out that such cases are immediately excluded by such a policy.
There are also limits on certain services that are included or not included in the policy: a caregiver at home or, for example, breast implants when removing mammary glands. These amounts can vary greatly between insurers.
In short, to avoid getting into trouble, you should carefully study the contract itself, and not just what is written on the website.
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