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What is Cancer Insurance? |
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Cancer insurance provides benefits only if you are diagnosed with cancer, as defined by the terms of the policy contract. These policies offer limited benefits for the diagnosis and/or treatment of cancer. Most cancer policies provide benefits based upon specified health care costs and expenses incurred in conjunction with the treatment of cancer, though some policies may pay a lump-sum benefit upon diagnosis. Cancer policies that provide more comprehensive benefits and coverages will cost more than policies with limited coverage. In addition, premiums may increase as you get older, or may increase if total claims paid for consumers covered under a company’s specific cancer policy increase beyond the company’s expectations. Cancer insurance is sometimes referred to as a “specified disease” or “dread disease” policy. Typically, policy contract provisions found in this type of coverage are very specific and limit benefits to narrowly- defined covered illness and/or injury. Specified disease policies generally exclude benefits for any disease or sickness that is diagnosed prior to the policy effective date. Examples of other specified disease policies are heart attack or stroke policies. Much of the information in this document may be applicable not only to cancer policies, but also to these other types of specified disease policies as well. |
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Do I Need Cancer Insurance? |
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If you are considering the purchase of cancer insurance, it is a good idea to carefully review your current health insurance policies and determine how much coverage you would receive from your existing health insurance, if you were to develop cancer. If you do not have comprehensive health insurance coverage, you should consider purchasing a more comprehensive health plan prior to purchasing a cancer policy. If you are covered under Medicare and desire additional insurance protection, a comprehensive Medicare supplement policy may provide you with adequate coverage. Medicaid recipients may not need any additional insurance; if you think you might qualify for Medicaid, contact your local social service agency.
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Types of Cancer Insurance Policies |
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Expense Incurred Policy – pays a percentage of expenses for all covered treatments listed up to the benefit or policy's maximum dollar limit.
Indemnity Policy – is similar to an expense incurred policy. It pays for all covered treatments; however, it places a fixed dollar limit on each individual covered treatment, and the benefit amount is not related to the actual expense incurred.
First Diagnosis or First Occurrence Cancer Policy – pays a lump sum upon the first diagnosis of cancer. The benefit under the policy may be any amount, for example $2,000, $5,000, $10,000 or even $100,000. Benefits cannot be denied due to pre-existing conditions if the cancer is diagnosed after the effective date and applicable waiting period. However, they may contain longer waiting periods than traditional cancer policies. Read the policy carefully to fully understand the benefits and policy limitations. |
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Policy Benefits |
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Cancer policies sold today vary widely in cost and coverage. Since benefits can differ from policy to policy, be sure to read the contract carefully and understand exactly what benefits are being offered. Also, be aware that some cancer policies do not cover all types of cancer. For example, some policies may specifically exclude coverage for skin cancer. Also, some cancer or specified disease policies will not pay benefits unless you are hospitalized.
Most cancer policies will provide some benefits for:
- Hospital room and board;
- Treatment by a legally qualified physician;
- Private duty nursing care while hospital confined;
- Surgery and anesthesia;
- X-ray, radiation therapy, chemotherapy and other therapy procedures used in the treatment of cancer;
- Licensed or professional ambulance service to and from the hospital;
- Blood and blood plasma for transfusions;
- Prescription drugs and medicines recognized by the Food and Drug Administration as medically effective if administered during a hospital confinement.
Some newer cancer policies provide benefits for outpatient treatment; however, many older policies do not.
If you have not yet selected a cancer insurance policy, it may be wise to consider one that provides additional benefits for outpatient treatment. Many cancer treatments are now being provided on an outpatient basis, and new outpatient treatments are being developed.
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Policy Limitations |
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Review and study your policy after you receive it. It is important for you to understand your coverages, rights, and obligations. Some common policy limitations are:
- Covering Treatment Received Only in an Inpatient setting – Today, cancer treatment, including radiation, chemotherapy, and some surgery, is often rendered on an outpatient basis. Because the average stay in the hospital for a cancer patient is only 13 days, a policy that covers only inpatient treatment might not meet your needs.
- Increasing benefits After 90 Consecutive Days of Inpatient Treatment – However, since the average stay in a hospital for a cancer patient is 13 days, large dollar amounts for extended benefits have very little value for most patients.
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