Health Insurance for Blood Cancer

What Does Blood Cancer Treatment Cost in India?

Blood cancer includes conditions like leukaemia, lymphoma and multiple myeloma. Its treatment requires recurring diagnostics, multiple chemotherapy sessions and may require targeted therapy or advanced treatments like stem cell transplant.

The blood cancer treatment cost in India varies significantly depending on the type of cancer, its stage, hospital, medicines and recommended treatment. On average, blood cancer treatment can cost between ₹3 lakh and ₹15 lakh. Treatments requiring a bone marrow transplant can cost between ₹15 lakh and ₹40 lakh.

Here is a breakdown of the various components of blood treatment cost in India:

Note: The above-mentioned costs may vary depending on the city, the hospital's medical facility and the severity of blood cancer.

Another important cost to consider is the diagnostics. Since the diagnostic tests are usually repeated during or after initial treatment to monitor treatment response, they can add to the cumulative treatment cost, especially if they are not covered under your health insurance plan.

Here is the cost breakdown of diagnostic expenses for blood cancer:

Health insurance plans help manage these medical costs and provide access to cashless treatment at network hospitals, lowering your financial burden and upfront payments.

Does Medical Insurance Cover Every Stage of Blood Cancer?

While standard Medical insurance policies do not cover every stage of blood cancer, dedicated cancer insurance plans are designed specifically to cover multiple stages of blood cancer (initial, minor and advanced). This allows you to get multiple claims or stage-based payouts.

On the other hand, with critical illness insurance, a lump sum benefit is paid when the cancer reaches a major, advanced or life-threatening stage, as defined in the policy terms. Early or mid-stage cancer or pre-cancerous conditions are often excluded under standard critical illness policies.

It is important to note that not all types of blood cancers follow the same staging system. For instance, lymphoma is classified into Stage I to Stage IV, while leukaemia does not use numbered stages; it is categorised based on classification or risk system.

Which Type of Health Insurance is Best for Blood Cancer?

Blood cancer is covered by standard health insurance plans, critical illness insurance and cancer insurance plans. The best health insurance for blood cancer depends on your health needs and coverage requirements.

• For someone who does not yet have blood cancer, standard individual policies or family health insurance plans can cover in-patient hospitalisation costs, surgery fees, room rent, ICU charges and day care procedures (like chemotherapy and radiation therapy).
• A specialised cancer insurance policy or critical illness health cover can be added for an additional layer of financial protection if you feel you are at high risk of blood cancer.

Check out the table below to determine the best type of health insurance for blood cancer:

Note: The above details may vary from one health insurance plan to another.

What is Covered by Health Insurance for Blood Cancer?

Health Insurance for blood cancer includes the following:

• Chemotherapy, radiation therapy and immunotherapy
• Onco-surgeries
• Diagnostic tests, including PET-CT scan and molecular & genetic tests
• Hospitalisation expenses
• ICU charges
• Day care treatments
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Second opinion from oncologist and surgeons
• Ambulance services
• Palliative cancer care
• Teleconsultations
• Hospital cash cover
• Post-surgery rehabilitation
• Recovery benefit
• OPD benefit

It is to be noted that coverage for OPD treatment, non-medical expenses, oral cancer medicines, donor-related expenses and advanced therapies may be subject to specific conditions.

What is Not Covered by Health Insurance for Blood Cancer?

The following expenses are not covered by health insurance for blood cancer:

• Blood cancer diagnosed before buying the policy
• Tumours in the presence of HIV infection
• Blood cancer formed due to another pre-existing condition, and the insured has not completed the applicable waiting period
• Cancer formed from an undisclosed health condition
• Pre-malignant lesions or non-invasive tumours are usually not covered under a critical illness and cancer insurance policy
• Treatments or medicines specifically excluded under the policy
• Experimental or unproven treatments

Note:The exact list of policy inclusions and exclusions varies from one health insurance plan to another.

Benefits of Buying Health Insurance for Blood Cancer

Here is why buying health insurance for blood cancer is useful:

1. Pays for Expensive Cancer Treatments

   Blood cancer treatment includes repeated chemotherapy cycles, different advanced treatments, medicines or even bone marrow transplantation. It can cost anywhere between ₹3 lakh and ₹40 lakh, depending on the required treatment. A health insurance policy covers the eligible medical expenses, reducing your financial burden.

2. Provides Lump Sum Benefit

   Cancer insurance plans provide a lump sum (or staggered) payout on the first diagnosis of blood cancer, subject to the policy terms. This helps you to cover not just the treatment expenses but also helps substitute for income loss of job as the blood cancer treatment can continue for months and require follow-up treatment.

3. Coverage for Diagnostic Tests

   Medical insurance covers diagnostic tests for blood cancer, such as bone marrow examination, PET-CT scan and advanced molecular & genetic tests, which are expensive and can increase the overall medical bills.

4. Cancer Relapse Cover

   Some cancer insurance plans also provide coverage for recurrence of cancer or a relapse. It helps you stay financially protected against the medical costs if the cancer returns in future.

Why Should You Buy Health Insurance for Blood Cancer Before Diagnosis?

Buying health insurance before a blood cancer diagnosis is important because if the cancer is newly diagnosed when applying for a new policy or even immediately after buying the policy, it will be treated as a pre-existing condition.

According to IRDAI guidelines, existing health conditions are subject to a waiting period of up to 3 years. Hence, you will not be able to get immediate coverage for blood cancer if you buy it after the symptoms appear or if you have already been diagnosed with it.

But if you buy medical insurance before a blood cancer diagnosis, there shall be no waiting period and the insurer has to settle the eligible claims.

Moreover, if you buy the mediclaim policy before a blood cancer diagnosis, it also helps to keep premiums low as after the diagnosis, the insurer will consider you a high-risk applicant and charge higher premiums.

Can You Buy Health Insurance After Being Diagnosed with Blood Cancer?

Yes, you can buy health insurance plans after being diagnosed with blood cancer, but it can be extremely challenging to find a plan that comprehensively covers it.

Most insurers do not offer medical coverage if you have already been diagnosed with blood cancer before purchasing the policy, because for them, you are a high-risk applicant who is more likely to raise claims. Your application may be strictly scrutinised by the insurer's underwriting team, and they may most likely reject your proposal.

Even if an insurer offers coverage for blood cancer considering it a pre-existing condition, you may have to serve a longer waiting period or pay a higher premium for a standard health insurance plan. Very few plans offer coverage if you are a blood cancer patient or survivor.

How to Choose the Best Health Insurance for Blood Cancer?

Here are the important things to consider when choosing health insurance for blood cancer:

• High Sum Insured – Choose a high sum insured that can adequately cover the cost of different cancer treatments. A sum insured of ₹20–₹50 lakh is usually recommended for treatments requiring bone marrow transplants.
• Policy inclusions – Check whether chemotherapy, radiation therapy, immunotherapy and targeted treatments are covered under your health policy.
• Coverage for Stem Cell Transplant – Not every policy may cover stem cell transplant in full. Check the specific limits and conditions for its coverage.
• Coverage for All Stages of Blood Cancer – Opt for medical insurance that covers all stages of blood cancer to get financial protection throughout the treatment journey.
• Low or No Sub-Limits – Choose a plan that does not have high restrictions on room rent or cancer treatment expenses.
• Shorter Waiting Period – Opt for a policy with a shorter waiting period or the option to reduce waiting periods.
• Cashless Hospital Network – Check whether leading cancer hospitals and multi-speciality hospitals near your residence are a part of the insurer's network.
• Minimal Survival Period – Since a critical illness claim is settled only after a survival period. Check the survival period before choosing a health policy for blood cancer.
• Policy Renewal – Choose a cancer insurance policy that does not lapse and can be renewed after a cancer claim has been made.
• Critical Illness Benefit – If you are choosing critical illness cover, check the survival period, claim payout structure and renewal conditions.