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Having cancer can influence the decisions you need to make when you are buying health insurance.
There are different types of health insurance, including:
PPI may seem like an easy option because insurers don’t ask for intrusive medical details when you apply for the policy. However those questions will be asked at the point of claim and may make a difficult time even harder. Both MPPI and PPI usually exclude all cases of stress or depression, the former being particularly relevant to people living with cancer, and back/joint complaints. However, these are the major sources of claims for long-term ill health.
With all these types of insurance, the likelihood of making a claim tends to increase if you already have a pre-existing medical condition. When arranging your own insurance, insurers deal with this in one of two ways:
Health conditions that develop after you have taken out a policy don’t affect your premium or cover, provided you stay with that policy. But they may affect the terms you are offered if you wanted to switch to a different policy.
Some employers arrange health insurance for their employees on a group basis. This may be private medical insurance or income protection insurance. Cover up to a set amount is often provided for employees who have joined the scheme, regardless of any health conditions they may already have.
Contact your personnel or human resources (HR) department at work to find out whether your employer offers any group health insurance schemes that you can join.
If you have had cancer or are living with cancer, you usually can’t get any health insurance cover for claims related to the cancer. You need to consider carefully whether a health policy that excludes cancer cover is still worthwhile. For example, with critical illness cover, the most common reason for men claiming is a heart attack, so this type of insurance may still be worth having. But the most common reason for women claiming is cancer. An insurer shouldn’t offer cover if the exclusions are so great that the policy has little value.
Insurers can ask questions about the health of family members. This is because people whose close relatives (for example, parents, brothers and sisters) have had cancer may, in a small number of cases, be at an above average risk of getting the same cancer.
It’s possible to have genetic tests to check if you are at high risk of getting some types of cancer. Insurers can’t ask for or use the results of such tests unless you already have symptoms, because in that case, the test is treated the same as any other type of diagnostic test. If you have a family history of cancer but have had a favourable genetic test result, you may want to tell the insurer about it, and if you don’t have any other health issues you could get cover on standard terms.
For help finding suitable health-related insurance, contact an independent financial adviser (IFA) through Unbiased Ltd|, the Institute of Financial Planning| or the Personal Finance Society|. To find out about the limited circumstances in which insurers can ask to see the results of genetic tests, get the free booklet Genetic tests and insurance: what you need to know from the Association of British Insurers|.
If you’ve been diagnosed with cancer or you’re off work because of it, you may be able to claim against any health insurance policies you already have. Try to claim as soon as possible because there will usually be a time limit (for example, six months) after which claims will no longer be eligible.
Before paying out on a claim, the insurer will make careful checks to make sure the claim is valid. This is likely to include getting medical reports from your GP and cancer specialist. You may be asked to have a medical examination with another doctor.
Paying out on a claim will usually take several weeks. Income and lump sum insurance payouts may affect your entitlement to state benefits.
Check the policy documents for details of how to make a claim. If you used an insurance broker or financial adviser when you took out the policy, they should be able to help you claim. We have advice for if you want to make a complaint|.
If you’re diagnosed with cancer and have a mortgage, you may have mortgage payment protection insurance (MPPI). This should cover your mortgage payments if you’re signed off sick from work. Make the claim as soon as possible.
Make the claim as soon as possible. Usually the payout starts after a waiting period of around 30 days. With some policies, payments are backdated to the start of the period off work. The payout will cover the whole mortgage payment and may provide a small amount of cash as well.
MPPI provides useful temporary help but pays out for a maximum of 12 or 24 months. It’s important to keep up the mortgage payments after that to avoid any risk of losing your home.
Critical illness cover pays out a tax-free lump sum, typically £100,000 or more on diagnosis of a life-threatening condition. It may have been taken out as a stand-alone policy or combined with life insurance.
If taken out in connection with a mortgage, critical illness cover pays off the whole of the outstanding loan. If not linked to a mortgage, the payout can be used for any purpose - for example, to pay bills during a period off work, cover private treatment costs in the UK or abroad, or pay for a holiday.
Not all cancers are life-threatening, so a cancer diagnosis doesn’t necessarily trigger a payout. Check the wording of a critical illness policy to see what cancers are covered. If the wording is unclear, contact the insurer.
Income protection insurance pays out a monthly income if you’re unable to work because of illness or disability. You will have chosen the level of income at the time you started the insurance and hopefully it will be enough for you to pay your bills and carry on with a reasonable lifestyle. You will also have chosen a waiting period, which may be from 4 to 104 weeks.
The insurance usually carries on paying out until you either return to work or reach retirement age, whichever comes first. But some policies pay out only for a maximum term (five years, for example).
If you’re diagnosed with cancer and have a personal loan or credit card, you may have payment protection insurance (PPI). This should cover your loan or card repayments if you’re signed off sick from work.
Make the claim as soon as possible. Usually the payout starts only after a waiting period of around 30-60 days. With some policies, payments are backdated to the start of the period off work. PPI pays out for a maximum of 12 or 24 months.
PPI has been widely mis-sold in the past. If your claim is turned down and you feel that it wasn’t made clear to you when you took out the insurance that claims like yours would not be covered, you should make a complaint, as you may not be eligible for compensation (see our section on sources of advice for financial issues|).
If you have private medical insurance (PMI) - either your own policy or cover through work - it may reimburse the cost of some or all private treatment for cancer. PMI is designed to cover acute medical conditions but not chronic ones. There can be confusion about when cancer counts as acute or chronic. Macmillan worked with the Association of British Insurers (ABI) to make sure PMI insurers have a separate section that explains the cover for cancer using agreed examples. You will need to check the wording of the policy and it may be helpful to discuss it with the insurer.
You must get the insurer’s approval for any course of treatment before it goes ahead, otherwise the insurer may refuse to pay. There may be arrangements for the insurer to pay the bills directly. Alternatively, you will need to collect receipts and claim refunds.
For income protection insurance or private medical insurance provided through work, contact your personnel or human resources (HR) department for guidance on making a claim.
Content last reviewed: 1 May 2012
Next planned review: 2013
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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© Macmillan Cancer Support 2013
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