Health insurance

There are different types of health insurance policies. The main ones are:

  • private medical insurance
  • employer health insurance.

If you have health insurance, a cancer diagnosis can trigger a payout. This may be a lump sum, a monthly income, continuing payments on your behalf or reimbursing the cost of private treatment. There is usually a time limit on claims. Try to claim as soon as possible if you are eligible. Insurers make careful checks after a claim and you may be asked to have a medical examination.

If you do not already have health insurance, it could be harder to get if you have cancer. You may be asked questions about your health or the health of family members. Insurers use this information to assess if you are likely to make a claim. This is called underwriting.

If you are recovering from cancer, your insurance may exclude claims relating to your illness. But conditions that develop after you have taken out a policy do not usually affect your cover.

What is health insurance?

Health insurance can help cover medical costs or repay the cost of private treatment. Some health insurance policies may include payments towards wigs and prosthetics if you need this.

If you are recovering from cancer, your insurance may exclude claims relating to your illness. But unrelated conditions that develop after you have taken out a policy do not usually affect your cover.

If you do not already have health insurance, it could be harder to get if you have cancer. The insurer may ask you questions about your health or the health of family members. They use this information to assess if you are likely to make a future claim.


Types of health insurance

There are different types of health insurance. The main ones are:

Private medical insurance (PMI)

This usually pays the cost of private treatment for acute medical conditions that start after your policy starts. An acute condition is a condition that is likely to respond quickly to treatment, or a condition that you are more likely to fully recover from. Some policies may cover medical conditions that started before the beginning of your policy. So it is important to check.

Some policies may also pay you a set amount if:

  • you need to spend the night in an NHS hospital
  • you are admitted as a day patient for chemotherapy treatment.

Private medical insurance is annually renewable. This means that premiums and continuing cover have to be agreed with the insurer every year.

Employer health insurance

Some employers arrange health insurance for their employees. This means all their employees can get health insurance cover. The employer chooses the insurer.

If you join an insurance scheme through your employer, you are usually covered up to a set amount of money. This should not be affected by any health conditions you already have.

Contact your human resources (HR) department at work to find out whether your employer offers any health insurance schemes that you can join or are included in automatically.


Buying health insurance

Before you buy health insurance, an insurer will assess how likely it is that you will need to make a claim. This is called underwriting.

Insurers can underwrite health insurance in two different ways:

Moratorium underwriting

This means that the policy does not cover claims linked to health conditions you have, or have recently had, at the time you take out the policy.

This exclusion usually lasts for the first 1 or 2 years of the policy. This is called the moratorium period.

Some insurers use the moratorium period to help you get cover in the future for a health condition you are recovering from. You will not have to provide details of your medical history.

If a claim is made after the moratorium period, the health condition is covered as long as there are no more related symptoms, medical advice or treatment (including taking medication) during the moratorium period.

Full medical underwriting

Full medical underwriting means you will need to provide details of your medical history. This assessment is usually used for:

The insurer may ask for your full medical history. This includes information about your health, your lifestyle and the health of your close family members. They may do this through questions and medical reports.

Based on this assessment, they will decide:

  • whether to offer you cover
  • what premium to charge you
  • any other special terms or limits to include.

Health conditions that develop after you have taken out a policy do not usually affect your premium or cover. But they may affect the terms you are offered if you wanted to switch to a different policy.


Claiming on health insurance

Private medical insurance (PMI) covers acute medical conditions. There can be confusion about whether cancer is an acute medical condition or not.

Macmillan Cancer Support has 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. 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. If you do not, the insurer may refuse to pay.

There may be arrangements for the insurer to pay the bills directly. Or, you may need to pay your medical bills first. You can then collect receipts and send them to your insurer to claim a refund.

If your work provides your private medical insurance, contact your human resources (HR) department for guidance on making a claim.

Back to Insurance

Cancer and buying insurance

Insurance protects your finances against unexpected events. Cancer can sometimes affect buying insurance.

Life insurance

Life insurance policies pay out money when you die. Having cancer may affect the life insurance you can get.

Protection insurance

Protection insurance can pay out money if you become too ill to work or are diagnosed with a serious illness such as cancer.

Car insurance

Your car insurance should only be affected if the cancer makes it difficult or dangerous for you to drive.