Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 3 - Casualty Insurance › Appendix 1 - A SHOPPER'S GUIDE TO CANCER INSURANCE

Current through June 24, 2024
Should You Buy Cancer Insurance?
Cancer Insurance is Not a Substitute for Comprehensive
				Coverage.
Caution: Limitations On Cancer Insurance.
Prepared by the National Association of Insurance
				Commissioners
CANCER INSURANCE . . .
Cancer insurance provides benefits only if you get cancer. No
				policy will cover cancer diagnosed before you applied for the policy. Examples
				of other specified disease policies are heart attack or stroke policies. The
				information in this booklet applies to cancer insurance, but could very well
				apply to other specified disease policies.
CANCER INSURANCE IS NOT A SUBSTITUTE FOR COMPREHENSIVE
				COVERAGE . . .
Cancer treatment accounts for about 10% of U.S. health
				expenses. In fact, no single disease accounts for more than a small proportion
				of the American public's health care bill. This is why it is essential to have
				insurance coverage for all conditions, not just cancer.
If you and your family are not protected against catastrophic
				medical costs, you should consider a major medical policy. These policies pay a
				large percentage of your covered costs after a deductible is paid either by you
				or your basic insurance. They often have very high maximums, such as $100,000
				to $1,000,000. Major medical policies will cover you for any accident or
				sickness, including cancer. They cost more than cancer policies because they
				cover more, but they are generally considered a better buy.
SHOULD YOU BUY CANCER INSURANCE? . . . MANY PEOPLE DON'T
				NEED IT
If you are considering cancer insurance, ask yourself three
				questions: Is my current coverage adequate for these costs? How much will the
				treatment cost if I do get cancer? How likely am I to contract the
				disease?
If you have Medicare and want more insurance, a comprehensive
				Medicare supplement policy is what you need.
Low income people who are Medicaid recipients don't need any
				more insurance. If you think you might qualify, contact your local social
				service agency.
Duplicate Coverage is Expensive and Unnecessary.
Buy basic coverage first such as a major medical policy. Make sure any cancer
				policy will meet needs not met by your basic insurance. You cannot assume that
				double coverage will result in double benefits. Many cancer policies advertise
				that they will pay benefits no matter what your other insurance pays. However,
				your basic policy may contain a coordination of benefits clause. That means it
				will not pay duplicate benefits. To find out if you can get benefits from both
				policies, check your regular insurance as well as the cancer policy.
Some Cancer Expenses May Not Be Covered Even by a Cancer
				Policy
. Medical costs of cancer treatment vary. On the average,
				hospitalization accounts for 78% of such costs and physician services make up
				13%. The remainder goes for other professional services, drugs and nursing home
				care. Cancer patients often face large nonmedical expenses which are not
				usually covered by cancer insurance. Examples are home care, transportation and
				rehabilitation costs.
Don't be Misled by Emotions.
While three in ten
				Americans will get cancer over a lifetime, seven in ten will not. In any one
				year, only one American in 250 will get cancer. The odds are against your
				receiving any benefits from a cancer policy. Be sure you know what conditions
				must be met before the policy will start to pay your bills.
CAUTION: LIMITATIONS OF CANCER INSURANCE
Cancer policies sold today vary widely in cost and
				coverage.
If you decide to purchase a cancer policy, contact different
				companies and agents, and compare the policies before you buy. Here are some
				common limitations:
Some policies pay only for hospital care.
Today
				cancer care treatment, including radiation, chemotherapy and some surgery, is
				often given on an outpatient basis. Because the average stay in the hospital
				for a cancer patient is only 13 days, a policy which pays only when you are
				hospitalized has limited value.
Many policies promise to increase benefits after a
				patient has been in the hospital for 90 consecutive days.
However, since
				the average stay in a hospital for a cancer patient is 13 days, large dollar
				amounts for extended benefits have very little value for most patients.
Many cancer insurance policies have fixed dollar
				limits.
For example, a policy might pay only up to $1,500 for surgery
				costs or $1,000 for radiation therapy, or it may have fixed payments such as
				$50 or $100 for each day in the hospital. Others limit total benefits to a
				fixed amount such as $5,000 or $10,000.
No policy will cover cancer diagnosed before you applied
				for the policy.
Some policies will deny coverage if you are later found
				to have had cancer at the time of purchase, even if you did not know it.
Most cancer insurance does not cover cancer-related
				illnesses.
Cancer or its treatment may lead to other physical problems,
				such as infection, diabetes or pneumonia.
Many policies contain time limits.
Some policies
				require waiting periods of 30 days or even several months before you are
				covered. Others stop paying benefits after a fixed period of two or three
				years.:
FOR ADDITIONAL HELP . . .
If you are considering a cancer policy, the company or agent
				should answer your questions. You do not need to make a decision to purchase
				the policy the same day you talk to the agent. Be sure to ask how long you have
				to make your decision. If you do not get the information you want, call or
				write
Office of the Commissioner of Insurance
121 East Wilson Street
P.O. Box 7873 Madison,
WI 53707-7873
(608) 266-0103
If you have a complaint against an insurance company or agent,
				write the Office of the Commissioner of Insurance at the address above, or call
				the Complaints Hotline, 800-236-8517.