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Difference between cancer insurance and critical illness insurance

Team AckoNov 8, 2024

If you have stumbled upon this article, we assume that you want to prepare for tough times. Yes, health insurance is the answer you are looking for to get a financial shield against life-threatening diseases like cancer or other critical illnesses. Health insurance for these diseases is quite different from a regular mediclaim policy. Here the payout is more as the seriousness of the diseases is higher. Let us help in understanding what all is covered under these policies, while explaining the differences between cancer insurance and critical illness insurance.

Contents

Cancer insurance vs. critical illness
When is buying cancer insurance helpful?
Inclusions and exclusions of cancer insurance
- Inclusions
- Exclusions
When is critical illness insurance helpful?
List of illnesses and services covered under critical illness insurance
Services offered under critical illness insurance
- Takeaway
Frequently asked questions

Cancer insurance vs. critical illness

Here’s an in-depth comparison between critical illness and cancer cover.

Parameters	Cancer Insurance	Critical Illness Insurance
Purpose	Health insurance that specifically covers treatment expenses for cancer.	Health insurance that specifically covers treatment expenses for listed critical illnesses.
Extent of coverage	Covers all the stages of cancer, i.e. early, major and advanced stages of cancer.	Covers limited but serious illnesses as specified in the insurance plan.
Exclusions	May vary from policy to policy. However, in general, skin cancer, cancer due to pre-existing diseases, and cancer through sexually transmitted diseases may not get covered here.	May vary from policy to policy. However, cases like self-injury, health issues due to the influence of alcohol and drugs, etc., may not get covered here. For cancer, the cover may be available only for advanced stages, depending on the policy terms.
Survival Period	Cancer patients must survive for 7 days after the diagnosis for a valid claim.	Depends upon the policy. However, in general, it is around 30 days.
Stages of cancer covered	All the stages of cancer are covered in this policy.	Only advanced stages of cancer are covered in this policy.
Future premium waiver	Depends upon the policy. However, companies usually offer a future premium waiver for 3 years in case of cancer diagnosis.	Depends upon the policy. However, in certain cases, companies may offer waivers of all future premiums while in other cases, premium waivers can be availed through riders and add-ons.

When is buying cancer insurance helpful?

A cancer health insurance policy; is structured to mitigate the risks associated with cancer. It relieves you by providing financial protection against exorbitant medical treatment costs of cancer.

If your family members have already been diagnosed with cancer, there are chances that you or other family members may contract it in the future. Therefore, if this is your case, then you should consider opting for cancer care cover.

Also, advancing age increases the chances of being cancer positive and also suffering from specific cancer ailments. As per the statistical data from NCI’s Surveillance, Epidemiology, and End Results (SEER), in India, the median age for cancer diagnosis is 66 years.

For most of the specific cancer ailments, the median age revolves within the brackets of 60-70 years.

Type of cancer	Median age
Breast cancer	62 years
Colorectal cancer	67 years
Lung cancer	71 years
Prostate cancer	66 years

Even if the median age is beyond 60 years, cancer is quite unpredictable as many people in lower age groups also suffer from this disease. It is also true that medical technology is advancing at unbelievable rates and cancer is curable in most cases that are detected at early stages. Here, financial preparation with health insurance can be a key to living a cancer-free life.

Also, read: Critical Illness Insurance Cover for the Self Employed

Inclusions and exclusions of cancer insurance

Your cancer insurance policy may have the following inclusions and exclusions.

Inclusions

1. A comprehensive cancer insurance policy is adequate, whether cancer is at an early or advanced stage, and may include.

Stomach Cancer

Lung Cancer

Prostate Cancer

Ovarian Cancer

Breast Cancer

Other cancer types as specified in the policy document

This list is indicative.

2. The coverage starts right from the beginning when the cancer is diagnosed and continues till the entire treatment. The policy may provide a lump sum payment to the insured person or fixed payouts at regular intervals to support the treatment, depending on the policy terms.

3. In order to ease the financial distress of the insured person and their family during the treatment, the policy may also provide for a premium waiver for specified years till the treatment continues. This comes as a great relief to the already escalating medical costs.

Exclusions

While a comprehensive cancer insurance policy covers most of the expenses associated with the treatment of cancer, the following are the exclusions that are common to them.

Cancer resulting from sexually transmitted diseases (STDs).

Cancer is caused by the consumption of intoxicating substances like alcohol, drugs, or tobacco.

Cancer due to contamination by any chemical, nuclear or biological substance.

Congenital conditions leading to cancer.

This list is indicative.

When is critical illness insurance helpful?

Critical illness insurance covers the risks of serious and life-threatening diseases like heart attack, renal failure, cancer, etc. Such illness can break you emotionally and financially.

Not only does your life get affected, but your dependents also fall into the pit of uncertainties. Therefore, critical illness cover provides you financial protection against the huge medical expenses incurred to cure such illnesses.

In most cases, a lump sum is paid when the patient is diagnosed with any specified diseases mentioned in the policy document. The claim settlement will initiate after the survival period is complete. Here are a few situations when the critical illness cover can be helpful.

If any family member has a medical history of being affected with any critical illness like cardiovascular disease or stroke, Alzheimer’s disease and arthritis, then the chances of future generations being affected with such diseases increase.

Advancing age when the chances of being affected by the critical illness increases.

List of illnesses and services covered under critical illness insurance

While the extent of coverage is pre-determined by the insurance companies, here’s a list of critical illnesses that are usually covered by critical illness insurance policies.

Coronary Artery Disease	End-Stage of Renal Diseases	Open Heart Replacement	End-Stage Lung Disease	Aplastic Anemia
End-Stage Liver Disease	Terminal Illness	Coma	Motor Neuron Disease	Major Burns
Stroke	Permanent Paralysis of Limbs	Aorta Graft Surgery	Multiple Sclerosis	Primary Pulmonary Arterial Hypertension
Bacterial Meningitis	Deafness	Parkinsons	Speech Loss	Blindness
Heart Valve Surgery	Apallic syndrome	Benign brain tumour	Quadriplegia	Alzheimer’s disease
Muscular Dystrophy	Congenital Disability Benefit	Paraplegia	Paralysis Multi trauma	Hepatoma
Brain surgery	Multiple system atrophy	Cardiomyopathy	Goodpasture syndrome	Creutzfeldt Jakob disease
Major head trauma	Cervical Cancer	Ovarian Cancer	Breast Cancer	Vaginal Cancer
Pneumonectomy	Progressive Scleroderma	Progressive Scleroderma	Pulmonary artery graft surgery	Progressive Supranuclear Palsy
Endometrial Cancer	Fallopian Tube Cancer

This is an indicative list. Please contact your health insurance company to know more about the coverages.

Services offered under critical illness insurance

Services normally covered under critical illness insurance include.

Payout - Payout is done in a full, lump-sum in most cases, upon the diagnosis of the specified critical illness after the survival criteria is met.

Accidental death or disability cover - Critical illness plans also cover accidental death or disability apart from critical illness cover.

30+ critical illnesses covered - It provides protection against more than 30 critical illnesses.

Takeaway

It is essential to stay covered against the major uncertainties of life. Any negligence can cost a fortune and put the whole family in financial distress. Considering the needs and distress of the patients and their families, these policies usually provide a lump sum payment for the diagnosis of the illness. It is not only helpful to meet medical costs during treatment but in case of any adverse event and demise of the patient, it ensures financial security for the dependents.

Frequently asked questions

The following are some common questions related to cancer and critical illness health insurance, but if you have any specific queries then please don’t hesitate to get in touch with us at [email protected]

Does critical illness insurance cover cancer?

Yes, cancer is one of the common coverages that is a part of critical illness insurance. However, it is a good idea to confirm the same with your health insurance company.

Is it useful to get critical illness cover?

If your family has a medical history of certain critical illnesses or you have senior citizens at your home, then critical illness cover becomes important. Thus, getting a critical illness health insurance policy is useful.

What are the various types of cancers covered under critical illness insurance?

Commonly the following types of cancer ailments are covered under cancer insurance.

Breast cancer
Prostate cancer
Basal cell cancer
Colon cancer
Lung cancer
Leukaemia
Lymphoma

Please go through your health insurance policy or contact the insurance company to get the detailed list of coverages.

What is the difference between illness and disease?

An illness is an unwell or unhealthy state of mind and body. The disease is the malfunction of a particular part or organ that needs to be cured.

What is the difference between terminal illness and critical illness?

Terminal illness refers to incurable illness and will ultimately lead to death, while critical illness is a severe but curable illness.

What are carcinogenic products?

Products having the potential to cause cancer are known as carcinogenic products. These commonly include tobacco, alcohol, ultraviolet rays, processed meat, engine exhaust, pollution etc.

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