Health Insurance for Breast Cancer: 6 Important Things that You Must Know

What is Breast Cancer?

Breast cancer refers to a malignant tumour in the breasts that can spread to other parts of the body. It occurs when the cells of the breasts start mutating and grow uncontrollably. Most breast cancers occur in milk ducts or ductal carcinomas and about 10% occur in milk glands or lobular carcinomas.

Some of the most common symptoms of breast cancer are:

• Changes in nipples
• Discharge from nipples
• Pain, itching or pain in breasts
• Change in skin texture like dimpling, puckering, etc.
• Redness or inflammation in the breasts
• Skin pigmentation
• Flaky skin or peeling off

When it comes to breast cancer, early detection is the key to getting cured. The survival rate of a patient reduces by 3 to 17% if the breast cancer is detected at a later stage. Moreover, the treatment for breast cancer involves surgery, chemotherapy, radiotherapy and hormone therapy.

However, breast cancer treatment is costly. In India, the average cost of breast cancer surgery is somewhere between Rs 1.9 lakh to Rs 4.2 lakh. If you get your breast cancer treatment done at a private hospital, the overall cost of investigations, surgery and radiation may go up to Rs 5-6 lakh. Similarly, six-cycle chemotherapy may cost up to Rs 20 lakh in India. Therefore, buying health insurance for breast cancer is highly recommended.

6 Things You Must Know About Health Insurance for Breast Cancer

Most insurance companies in India offer health insurance plans that provide coverage for breast cancer. They cover the cost of the surgery, radiotherapy, hospitalization, chemotherapy, ICU charges, pre-hospitalization, diagnostic tests, etc. depending on the scope of the policy.

Here are a few things that you must know before buying a health insurance policy for breast cancer:

1. Breast Cancer is Covered Under Critical Illness Insurance

Breast cancer is usually covered by critical illness insurance plans and not under regular health insurance plans. This is because breast cancer is a critical illness and most regular health plans do not provide coverage for critical illness. At the most, they would provide coverage for hospitalization expenses.  

On the contrary, critical illness insurance plans are designed to cover critical illnesses. Such plans will pay you a lump sum amount as soon as you are diagnosed with the disease, irrespective of the actual treatment cost. You can take care of all medical expenses incurred on breast cancer treatment with this amount.

2. Critical Illness Rider for Regular Health Insurance Plans

Although most regular health plans do not cover breast cancer, they may come with a critical illness rider. You can opt for this rider under your policy to avail coverage for critical illness without buying a critical illness insurance policy separately. However, this rider will be available for an extra premium amount.

3. Waiting Period Applies for Breast Cancer

Whether you buy a regular health insurance policy or a critical illness insurance plan, a waiting period will apply to avail coverage for breast cancer. During this period, you cannot raise any claim as it will get rejected. All critical illness insurance plans will cover breast cancer after a waiting period of 90 days. Similarly, most regular health insurance plans will cover breast cancer after a waiting period of 2 years.

4. Survival Period Under Critical Illness Insurance

Along with the waiting period, all critical illness insurance plans come with a survival period of 30 days. The woman diagnosed with breast cancer needs to survive the survival period to avail insurance coverage. In case the insured woman dies from breast cancer within the first 30 days of diagnosis, then the insurance company will not be liable to honour the claim.

5. Out-of-pocket Expenses May Be Incurred

While availing treatment for breast cancer, you may incur some out-of-pocket expenses that will not be covered under your regular health insurance policy. For instance, money spent on travelling to chemotherapy sessions, medical tools & appliances, diet plans, etc. will not be reimbursed by the insurance company.

This, however, may not be the case for critical illness insurance plans as you have the liberty to use the lump sum amount paid by the insurance company to pay your out-of-pocket expenses.

6. Free Preventive Health Check-ups May Be Available

Some health insurance plans may offer annual free preventive health check-up facilities. Opting for a plan with a free annual preventive health check-up benefit is recommended as it will help in the timely detection of your breast cancer. Besides, breast cancer screening is expensive and availing free check-up facilities will help you save lots of money.

In a Nutshell

Breast cancer is the most common type of cancer among women today. Given the high treatment cost of breast cancer, buying a critical illness insurance policy is recommended. Just make sure to keep the above-mentioned things in mind before buying the good health insurance for breast cancer. Also, undergo a breast cancer screening every year to detect the disease at an early stage.