Does Health Insurance Cover Existing Cancer Patients in India?

Does health insurance cover existing cancer patients in India? The answer is Yes! even a person diagnosed with cancer at an early stage can buy cancer health insurance in India. This post will share the best health insurance for existing cancer patients in India in 2024 that covers pre-existing cancer in India.

Does health insurance cover pre-existing cancer?

Can you get health insurance if you already have cancer? The answer is Yes! now in India, here we are sharing the health Insurance company that offers health insurance for existing cancer patients in India. The best pre-existing cancer health insurance policy is offered by Star Health and Allied Services in India. Getting a health policy even after a cancer diagnosis is now possible in India! Thanks to Star Health and Allied Services for designing such a product.

Here at Galaxy Health Insurance Solutions, we will share the complete details of the Insurance policy for existing cancer patients that is offered by Star Health Insurance.

Which is the best health insurance for cancer patients in India?

If you are searching for the best cancer insurance plan in July 2024 that also provides coverage for pre-existing cancer health insurance in India, you should go and buy Star Health Insurance for cancer patients. Star health insurance covers existing cancer patients in India.

What are the Features of Pre-Existing Cancer Coverage Health Insurance?

Star Cancer Care Platinium Policy is the best insurance for pre-existing cancer patients in India. This Insurance Policy offers coverage for persons diagnosed with Cancer. It is one of the best financial weapons to fight cancer and provides indemnity coverage for medical expenses incurred for cancer and non-cancer treatment.

Features of Health Insurance for Pre-existing Cancer Patients in India Offered by Star Health Cancer Care

Feature	Details
Policy Term	The initial policy term is one year and you can renew for a life time.
Type of Policy	The policy is for Individual
Eligibility	1. Proposers must be 18 years or older. 2. Diagnosed with Cancer, aged between 5 months and 65 years.
Sum Insured Options	Section I: ₹5,00,000, ₹7,50,000, ₹10,00,000 Section II: 50% of Section I sum insured (cannot vary)
Pre-Medical Examination	1. No pre-medical tests are required. 2. Previous medical records must be submitted with the proposal.
Installment Facility Available	Payment can be done quarterly, half-yearly, or annually.

What Coverage Does Pre-Existing Cancer Health Insurance Provide to Insured Persons in Star Health Cancer Care?

Star Health Cancer Care Policy Benefits for the person Diagnosed with the Cancer are listed below.

Indemnity Cover Covers treatment for Cancer and Non-Cancer

• Hospitalization Expenses:
  • Covers room (Single Standard A/C), boarding, and nursing expenses.
  • Costs depend on the room category stated in the policy.
• Medical Fees:
  • Covers fees for surgeons, anesthetists, medical practitioners, consultants, and specialists.
• Treatment Costs:
  • Includes anesthesia, blood, oxygen, operation theatre charges, ICU charges, medicines, and drugs.
• Ambulance Charges:
  • Covers emergency road ambulance charges for transport to the hospital if there’s an admissible claim.
• Pre-Hospitalization Expenses:
  • Covers medical expenses incurred up to 30 days before hospitalization.
• Post-Hospitalization Expenses:
  • Covers medical expenses incurred up to 60 days after discharge, up to 2% of the basic sum insured.
• Day Care Procedures:
  • All daycare procedures are covered.
• Cataract Treatment:
  • Limits:
    • ₹30,000 per eye (up to ₹40,000 per policy period) for ₹5,00,000 sum insured.
    • ₹40,000 per eye (up to ₹60,000 per policy period) for ₹7,50,000 and ₹10,00,000 sum insured.
• Health Check-Up Costs:
  • Covers health check-up expenses up to ₹2,500 for every claim-free year.
• Medical Second Opinion:
  • Facility for obtaining a second opinion from a network doctor based on submitted medical records (not for legal purposes).
• Wellness Services:
  • Promotes a healthy lifestyle through:
    • Diet and nutrition programs.
    • Weight management programs.
    • Specialist consultations via the Star Telehealth app.
• Rehabilitation and Pain Management:
  • Covers expenses for rehabilitation and pain management up to 10% of the basic sum insured per policy year.
• Modern Treatment Coverage:
  • Covers expenses for modern treatments (specific limits apply).
• Hospice Care:
  • Covers up to 20% of the sum insured for hospice care after a waiting period of 12 months.
• Co-Payment:
  • A co-payment of 10% applies to insured persons aged 61 years and above.

Lump Sum Cover for Cancer (Optional)

• Lump Sum Payment:
  • If the insured suffers a recurrence, metastasis, or a second unrelated malignancy, a lump sum amount is paid.
• Waiting Period:
  • A waiting period of 30 months applies for this benefit.
• Claim Conditions:
  • Claims are admissible only if treatment starts after 30 months from the policy’s inception.

Cumulative Bonus (Applicable for Section I Only)

• Bonus Accrual:
  • 5% of the basic sum insured for each claim-free year, up to a maximum of 50%.
• Conditions:
  • Calculated on the expiring basic sum insured.
  • Reductions in bonuses apply based on claims made.

Special Conditions

• Claim Impact on Bonus:
  • Partial or full utilization of the basic sum insured affects the cumulative bonus.

What are the Exclusions in Pre-Existing Cancer Coverage Health Insurance?

Exclusions in Pre-Existing Cancer Coverage Health Insurance declared by Star Health are listed below.

Pre-Existing Diseases

• Expenses related to treating pre-existing diseases and their complications are not covered for the first 30 months of continuous coverage.
• If the sum insured is increased, the exclusion applies again for the additional amount.
• If the insured person has continuous coverage without breaks, the waiting period may be reduced based on prior coverage.
• Coverage for pre-existing diseases after 30 months is only available if they were declared and accepted by the insurer at the time of application.

Specified Disease/Procedure Waiting Period

• Treatment costs for certain specified diseases and procedures are not covered for the first 24 months of continuous coverage.
• This exclusion does not apply to claims resulting from accidents.
• If the sum insured is increased, the exclusion applies again for the additional amount.
• If a specified disease falls under the waiting period for pre-existing diseases, the longer waiting period will apply.
• The waiting period applies even if the condition arises after the policy starts or if it was declared without a specific exclusion.

List of Specified Diseases/Procedures:

• Treatment for cataracts, eye diseases, ENT conditions, thyroid diseases, and benign breast conditions.
• Certain benign lumps, cysts, and musculoskeletal conditions (not due to accidents).
• Gallbladder, pancreatic, kidney, and urinary tract conditions.
• Hernias and some tumors.
• Cervical, uterine, ovarian, and prostate conditions.
• Certain benign tumors and conditions are related to the male reproductive system.
• Anal fistulas, hemorrhoids, and varicose veins.
• Transplants and congenital internal diseases.

30-Day Waiting Period

• Treatment for any illness within the first 30 days of the policy start date is not covered, except for accident-related claims.
• This exclusion does not apply if the insured person has had continuous coverage for over 12 months.

Investigation and Evaluation

• Expenses for admissions primarily for diagnostic purposes are not covered.
• Diagnostic costs unrelated to the current diagnosis and treatment are excluded.

Rest Cure and Rehabilitation

• Expenses for admissions primarily for enforced bed rest or personal care are not covered.
• This includes custodial care at home or in nursing facilities and services for terminally ill patients.

Obesity and Weight Control

• Expenses for surgical treatment of obesity are not covered unless:
  1. The surgery is recommended by a doctor.
  2. The procedure follows established medical guidelines.
  3. The person is at least 18 years old.
  4. The Body Mass Index (BMI) is:
     • 40 or higher, or
     • 35 or higher with serious health issues like:
       • Obesity-related heart problems
       • Coronary heart disease
       • Severe sleep apnea
       • Uncontrolled Type 2 diabetes

Change-of-Gender Treatments

• Expenses for any treatment or surgery to change the body to that of the opposite sex are not covered.

Cosmetic or Plastic Surgery

• Costs for cosmetic or plastic surgery are not covered unless:
  • It is for reconstruction after an accident, burn, or cancer.
  • It is necessary to remove a direct health risk, certified by a doctor.

Hazardous or Adventure Sports

• Expenses for injuries from participating in hazardous or adventure sports are not covered. This includes activities like:
  • Para-jumping
  • Rock climbing
  • Mountaineering
  • Rafting
  • Motor racing
  • Horse racing
  • Scuba diving
  • Sky diving

Breach of Law

• Expenses for treatment resulting from committing or attempting to commit a crime are not covered.

Excluded Providers

• Costs for treatment in hospitals or by providers specifically excluded by the insurer are not covered. However, in life-threatening situations after an accident, expenses for stabilization may be covered.

• Expenses related to the treatment of alcoholism, drug abuse, or addiction are not covered.

Substance Abuse

Treatments in Certain Establishments

• Costs for treatments received in health spas, nature cure clinics, or similar places are not covered.

Dietary Supplements

• Expenses for dietary supplements and over-the-counter products are not covered unless prescribed by a doctor as part of a hospitalization claim.

Refractive Errors

• Costs for correcting eyesight due to refractive errors less than 7.5 diopters are not covered.

Unproven Treatments

• Expenses for treatments that lack strong medical evidence of effectiveness are not covered.

Sterility and Infertility

• Costs related to sterility and infertility treatments are not covered, including:
  • Contraception and sterilization
  • Assisted reproduction services like IVF
  • Gestational surrogacy
  • Reversal of sterilization

Maternity

• Expenses related to childbirth, including complicated deliveries and cesarean sections, are not covered, except for ectopic pregnancies.
• Costs for miscarriages (unless due to an accident) and legal termination of pregnancy during the policy period are also not covered.

Circumcision and Related Procedures

• Expenses for circumcision are not covered unless necessary for treating a disease or due to an accident.

Congenital Conditions

• Expenses for congenital external conditions, defects, or anomalies are not covered.

General Health Issues

• Costs for convalescence, general weakness, and nutritional deficiencies are not covered.

Intentional Self-Injury

• Expenses for injuries resulting from intentional self-harm are not covered.

War and Nuclear Incidents

• Injuries or diseases caused by war or nuclear weapons are not covered.

Specific Therapies

• Expenses for certain therapies like Enhanced External Counter Pulsation Therapy, Chelation therapy, and other experimental treatments are not covered.

Other Exclusions

• Additional exclusions apply as detailed on the insurer’s website.

Moratorium Period

• After eight continuous years of coverage, the insurer will not look back at previous claims, except for proven fraud or permanent exclusions specified in the policy. This applies to the initial sum insured and any increases thereafter.

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