Moving with the industry trend, Apollo Munich Health Insurance Company has launched its cancer-specific health insurance plan, named iCan. Any person between the age of 5 and 65 years can buy this policy, and is eligible for lifelong renewals even after there are claims. There are six sum insured options – Rs 5 lakh, Rs 10 lakh, Rs 15 lakh, Rs 20 lakh, Rs 25 lakh and Rs 50 lakh. The policy has two main variants – Essential and Enhance. Under Essential Plan, only MyCare benefit is available, while in Enhance Plan, along with MyCare benefit, CritiCare benefit and FamilyCare benefits are also available.
MyCare Benefit: It provides conventional treatment for cancer, which include chemotherapy, radiotherapy, organ transplantation, as part of cancer treatment and surgeries for excision of cancerous tissue or removal of organs/ tissues (onco-surgery). MyCare benefits also include pre-hospitalisation coverage for 30 days and post-hospitalisation coverage for 60 days, expense for emergency ambulance up to Rs 2,000 per hospitalisation, up to Rs 3,000 twice a year for follow up care post treatment and optional benefit of advanced treatment, which includes proton beam therapy, personalised & targeted therapy, hormonal therapy or endocrine manipulation, stem cell transplantation and immunotherapy, including immunology agents e.g. interferon, TNF etc.
CritiCare Benefit: In addition to MyCare benefit, this benefit is available with Enhance plan, in which on being diagnosed with cancer of specified severity (excluding Stage-IV), the policyholder will get 60 per cent lump sum payout of the sum insured, over and above the base sum insured. For example, if a person has taken Rs 10 lakh cover, he/she will get Rs 6 lakh as lump sum and can still use Rs 10 lakh to cover his/her treatment expenses.
FamilyCare Benefit: Also available under Enhance Plan, FamilyCare benefit will provide lump sum payout of 100 per cent of sum insured to the family of policyholder, on first diagnosis of stage IV or recurrence of cancer.
The CritiCare and FamilyCare benefits are available for insured of 18 years or age and above and is payable only once in a policy lifetime.
Other features: The insured would have an option to request for a second opinion, on first diagnosis of cancer. This would be provided through Apollo Munich’s panel of medical practitioners who would have access to artificial intelligence, deep analytics and cognitive software. The initial waiting period is of 120 days.
Exclusions: The iCan plan has following exclusions –
• Any Treatment other than for Cancer.
• Pre-existing condition for cancer for which insured had existing signs & symptoms, and/or was diagnosed, and/ or received consultation, investigation, treatment or admission anytime prior to the date on which the policy was issued.
• “AIDS” (Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human Immunodeficiency Virus) including but not limited to conditions related to or arising out of HIV/AIDS such as ARC (AIDS Related Complex), Lymphomas in brain, Kaposi’s sarcoma, tuberculosis.
• Non Allopathic treatment
• Prosthetic and other devices which are self-detachable /removable without surgery involving anaesthesia
• Treatment availed outside India or at a healthcare facility which is not a hospital
• Congenital external diseases, defects or anomalies
Premium: For premium purpose, the proposers for iCan has been divided into four categories – non-smoker male, non-smoker female, smoker male and smoker female. At lower age, the premium is very nominal. For example the premium for sum insured of Rs 25 lakh for a non-smoker male of 36-40 years of age, the premium is Rs 3,274 (exclusive of GST) for Enhance Advance plan which covers advanced treatments and has both hospitalisation and lumpsum benefit.