In addition to Mediclaim and critical illness plans, there are health insurance plans that cater to one or more specific ailments such as cancer cover plans or heart & cancer plans.
Having a health insurance policy for self and family members is considered to be the first step in financial planning. However, they are primarily an indemnity plan and therefore, only reimburses the medical cost incurred during hospitalization. But, what if a critical ailment strikes?
In order to cover financial risks arising out of critical ailments, there are Critical Illness plans to choose from which are basically defined-benefit plans in which the entire sum insured is paid on the diagnosis of the specified critical ailments.
In addition, there are special health insurance plans that cater to one or more specific ailments such as cancer cover plans or heart & cancer plans. As lifestyle diseases are on the rise, heart and cancer plans are getting its importance and deserve a place in one’s health insurance portfolio.
There are several such disease-specific insurance plans and Edelweiss Tokio Life Insurance is the latest entrant in this segment with the launch of a ‘Heart and Cancer insurance’ plan called ‘Health Shield+’. Depending on their needs, one can opt for a cover only for Cancer or only Heart or both the ailments. The Health Shield+ provides cover for all types of Cancers and 17 cardiac conditions and it comes with a unique feature called Term Trigger benefit.
One may choose any of the three options in the Health Shield+ plan:
Option A – Cancer Cover: Covers early stage and major stage cancer
Option B – Heart Cover: Covers minor and a major heart condition
Option C – Cancer & Heart Cover: Covers early stage and major stage cancer, and minor and major heart.
How it works
Health Shield+ offers a fixed payout on diagnosis of minor and major conditions of Cancer and Heart disease, and a waiver of premium for 5 years from the date of diagnosis of both, the first and second minor condition of these ailments.
Term Trigger benefit is an optional feature available under the Cancer variant of the plan. In case of detection of a major condition of cancer, the insurer extends a term cover to the policyholder, in addition to the lump sum payout. In a way, there is the accelerated benefit of the term cover which is the death benefit is paid on the diagnosis of the final stage of cancer. If someone already has adequate term plan coverage, this variant may not be opted for.
Another unique feature is the Return of Premium, which allows the policyholder to recover all unclaimed premiums from the insurer on maturity. This benefit can only be selected only with Option A – Cancer Cover. However, it can not be selected if Term Trigger Benefit is selected.
Increasing incidence of cancer
According to a recent report, the survival rate of cancer patients while promising in the first year post late stage detection declines drastically following 5 years of diagnosis. While 45 per cent of patients survive post one year of diagnosis of a major condition, only 11 per cent live beyond 5 years. The study also showed that cancer care can cost anywhere between Rs. 4 lakh and Rs. 14 lakh, depending on the stage of detection. More importantly, a whopping 75 per cent of patients are either uninsured or inadequately insured to meet these treatment costs. Also, as per the report, with incidences of cancer likely to rise by about 25 per cent over the next five years, a disease-specific insurance plan is essential.
What to do
Different insurers may define early stage and final stage of cancer in a different way and the payouts, therefore, may differ. Give a close look at not only the exclusions but also the restrictions and waiting periods in any Heart and Cancer plan that you wish to buy. Do not merely look a the premium but choose a simple to understand plan with minimum conditions and restrictions as it helps at the time of claims.