Critical Illness Insurance vs Cancer Insurance – Benefits, Inclusions, Exclusions, and Features

Critical Illness Insurance 

Critical illness plans are health insurance policies especially crafted to cover the expenses of critical diseases, which are generally not covered under regular health insurance plans. These policies are designed to overcome the limitations of traditional health policies and to allow comprehensive coverage to the policyholders.

Benefits of Critical Illness Insurance

The key purpose of critical illness coverage is to support the insured in paying for the expensive healthcare treatments of certain critical diseases.

• Under such plans, the insured receives a lump sum amount in case the person is diagnosed with a critical illness
• They can use this amount for the treatment of any disease that is enlisted under the plan
• The best thing about such policies is that you do not need to show hospital bills as proof to claim such plans
• Another advantage of the policy is that it covers the insured with a good amount ranging between INR 15 – 50 lakhs. And the policy is available at a low premium price compared to many regular health plans. This is mainly because a critical illness plan only covers some specific critical diseases and not all.

Drawbacks of Critical Illness Insurance

Critical illness covers have many advantages. However, when you talk about assessing them in terms of their usefulness in covering Cancer and its treatment, the plans may not suit much.

• One major disadvantage of critical illness plans is that they cover Cancer only at an advanced stage
• Since critical illness plans come with a 90-day waiting period and the insured has to wait for that long to start treatment
• Such plans pay only when a malignant tumour portrays uncontrolled growth showing destruction of normal tissues. This can be seen only at an advanced stage of the disease

Cancer Insurance Plans

The cancer insurance plans are designed to address the shortcomings of critical illness insurance plans. These dedicated plans offer cancer care treatment and can be termed as a special critical illness policy.

Most of these cancer-specific plans allow coverage for an entire range of expenses associated with cancer diagnosis and treatment. Such policies offer coverage for chemo and radiation therapy, surgery, as well as hospitalization costs.

Inclusions of Cancer Insurance Plans

Most of these cancer health insurance policies offer comprehensive cancer coverage, including most cancer types in the early and advanced stages. Below are some common cancer types included under these insurance plans:

• Lung cancer
• Prostate cancer
• Breast cancer
• Stomach cancer
• Hypolarynx cancer
• Ovarian Cancer

Under a cancer insurance policy, the insured can raise a claim to receive a payout at minor and major stages of the disease.

Exclusions of Cancer Insurance Plans

Below are the conditions in which treatment expenses are excluded under cancer insurance plans: 

• If it is skin cancer, most plans do not pay for the expenses
• Insurers also do not pay claims if Cancer is caused directly or indirectly by STDs, HIV, or AIDS
• Claims are also not paid if the disease is the result of any PED or pre-existing diseases or because of any congenital conditions

How do the Cancer Insurance Plans work?

Here’s how the cancer insurance plans work:

• If an insured person is diagnosed with Cancer, the plan pays a certain amount of the sum assured as a lump sum payout as per the policy limits
• The payout allowed under the plan is disbursed by dividing it into different stages depending on the severity of the disease
• The payout varies depending on the stage of the disease and as per the claims already made earlier under the plan
• Some insurers offer free regular cancer check-ups throughout the term of the policy

Features of Cancer Insurance Plans

Feature	Details
Eligibility	Minimum entry age – 18 years Maximum entry age – 65 years The policy can be renewed once the policyholder crosses 65 years of age (defers as per policy)
Sum insured	Minimum – INR five lakhs Maximum – INR 50 lakhs
Premium waiver benefit	Some insurers offer a premium waiver benefit If the claim of an insured is approved under an advanced stage of the disease, all future premiums are waived off You can receive such benefits only if the policyholder is regular in paying premiums and the policy is active
Affordability	These plans are reasonable compared to the benefits they offer
Tax benefits	Premiums paid towards these plans qualify for tax exemptions u/s 80D of the Income Tax Act