NEW DELHI: There are few things more alarming than battling cancer. One is not having the money for its treatment. Given the recent spike in incidence of cancer and its treatment costs, this could soon be a reality than mere speculation. According to the World Health Organisation (WHO), nearly 10 lakh new cases are reported in India every year.More disturbingly, nearly 5 lakh people die annually of cancer, and WHO expects the number to go up to 7 lakh by the end of 2015. The incidence is projected to rise five-fold by 2025 and the prevalence is likely to increase to 19% in men and 23% in women by 2020.While the risk of dying from cancer before the age of 75 years is only 7.1%, according to Globocan 2012, an international cancer research project, insurers claim that one in five cancer claims is by those between 36 and 45 years of age. This means that the disease is set to disrupt the family’s finances due to the loss of a source of income.According to a 2004 research on the economic burden of cancer on Indian households—by Anup Karan, Ajay Mahal, Victoria Y. Fan and Michael Engelgau—the spending in a cancer-afflicted home was 36-44% more than in other households with similar demographics.Their borrowings and debts were also higher. In the past 10 years, these costs have risen significantly (see Rise in treatment cost), which means that cancer care cost is likely to shoot out of reach for millions of Indians. "The costs have gone up due to more expensive infrastructure, new technology-based investigation costs and newer drugs," says Naresh Parmar, CEO, Karnataka region, Apollo Hospitals A skewed doctor-to-patient ratio (one for 2,000 patients) worsens the situation. Specialists are not only hard to come by but are expensive as well. The high-risk scenario not only calls for ways to prevent the disease and undertake regular check-ups for early detection, but also adequate financial security to tackle the treatment costs, both in early and late stages. While there are several players in the insurance market offering a variety of products to combat the costs, it is not easy zeroing in on a single product. In the following pages, we shall not only provide the insurance options that can help you cover the disease, but also the ones that will suit your needs the best.Though there has been a rise in demand for health insurance products, India continues to have the highest levels of under-penetration in the world, with only 0.16% of the total population insured for health, as per Irda. Little wonder then that 70% of healthcare expenses are met from one’s pocket. Since cancer care is long term in nature, it also translates into a recurring expenditure. This has a huge financial implication for the family, making it imperative to buy insurance. Keeping pace with the surge in incidence of cancer, new products with special features and higher covers are being launched by the insurance industry.You can pick from the regular health policy that covers hospitalisation expenses, critical illness covers that insure a range of diseases, including cancer, and lastly, specialised cancer care products. However, before we list the advantages and drawbacks of each option, it is important to consider the benefits of screening or preventive check-ups for cancer.If detected early, cancer treatment is not only effective, but the costs are lower too. You can also avail of the tax deduction of up to Rs 5,000 annually under Section 80D for such screenings (see Early screening, low cost)."Prevalent cancers, such as cervix, breast, colon, lung, prostate, ovary, etc, can be detected through routine screening. A definite improvement in survival has been established due to screening programmes in case of cancers like breast, cervix and colon," says Parmar.Typically, however, patients approach a doctor or an oncologist only when the disease has advanced, making treatment more expensive and survival less likely. "In India, 70% of cancers are detected in advanced stages. Voluntary screening is abysmally low even among the educated," says Parmar. Genetic screening, the result of technological advancement, has made it possible to avail of targeted therapies that are much more effective.However, these are also more expensive. For instance, the average cost of treatment for breast cancer through a private practitioner would be Rs 5-6 lakh, including investigations, surgery and radiotherapy. However, with targeted therapy, six cycles of chemotherapy can cost up to Rs 20 lakh. More the reason that you consider the various insurance options available to you.A regular health plan, be it individual or family floater, is an indemnity policy that covers the medical expenses incurred during hospitalisation. So it pays for the costs as long as it is within the sum insured limit. It covers all major critical illnesses, including cancer, but the waiting period is usually 3-4 years of continuous policy renewal.However, there are two big drawbacks of such a plan. One, it comes at a high price. So, a Rs 10 lakh indemnity policy for a 30-year-old costs around Rs 10,000 a year, compared with a dedicated critical illness cover, which costs only about Rs 3,000. Even if you try to make it economical by buying a floater cover for two adults, it will cost you Rs 15,000 annually, but a critical illness plan for two would cost around Rs 6,000 per year. This is because the health plan takes bigger risks and covers a wider range of ailments.It will pay for your hospitalisation bill along with the cost of treating a major ailment, whereas the critical illness plan will pay only in case you are diagnosed with one of the acute illnesses.Two, since such a cover has sub-limits and caps for various heads like room rent, doctor’s fees, medicines, intensive care and ambulance charges, it usually doesn’t cover the entire expense of hospitalisation and the patient ends up paying from his own pocket.It also fails to cover the full cost due to the recurring nature of medical care and expenses. Also, if you want to consult a facility or specialist outside India, it will not be covered by most health plans. "The average size of a health cover is around Rs 5 lakh, which might be able to take care of the initial cost of treatment or provide for generic treatment of breast and cervix cancer.However, where the cost is higher, you would need a special critical illness plan that can foot bigger bills," says Sanjay Dutta, Chief Underwriting Officer, ICICI Lombard General Insurance. Critical illness covers A dedicated critical illnesses (CI) plan provides a wider cover against a range of diseases at a competitive price.Since an acute illness can also mean loss of income, prolonged domiciliary care and change in lifestyle, the financial burden could include more than hospital bills, which is beyond the scope of an indemnity plan. The CI policy pays a lump sum on the diagnosis of 20-30 critical ailments listed in the policy document. The lump sum can be used as per one’s requirement, be it to pay for the expensive treatment or recuperation aids.You won’t require a hospital bill to make a claim as in the case of a regular health plan. This plan comes with a waiting period of 90 days and a critical illness discovered during this period is not covered. This also does not offer lifelong renewability, implying limited coverage in terms of tenure.It can be bought as a standalone policy or rider. "The rider is cheaper since it is pushed as an add-on with a base product and there is no additional operational cost," says Dutta. The only disadvantage is that it is attached to another plan and if you want to discontinue the base plan you’ll have to give up the CI cover as well.Also, riders do not offer a high sum insured, usually up to Rs 5 lakh, while a standalone CI plan generally offers the options that range from Rs 15-50 lakh. The biggest drawback is that such plans cover cancer only at an advanced stage. "While the plan may cover your first heart attack and entry stage kidney disorders, even pay for dialysis, it will pay for cancer only if the malignant tumour shows uncontrolled growth, with invasion and destruction of normal tissues—an advanced stage," says Sudhir Sarnobat, CEO, Medimanage , a health insurance consultancy firm.Cancer care products Recently, HDFC Life introduced a dedicated cancer care plan that covers early stages of cancer. The insurer pays 25% of the sum insured at initial stages and 75% or 100% at an advanced stage, depending on whether a claim was made at the early stage. The plan can be renewed up to 85 years and is reasonably priced. A Rs 20 lakh cover for a 35-yearold would cost only Rs 1,800 per year and the maximum cover size available is Rs 40 lakh."A regular critical ailment plan provides only a lump-sum benefit, whereas the cancer care product provides this benefit along with a waiver of future premiums. The plan also provides an indexation benefit which takes care of medical inflation," says Sanjay Tripathy, Senior EVP, Marketing, Product, Digital & E-Commerce, HDFC Life.The premium variant of the plan also pays an additional 1% of the sum insured for five years on diagnosis of cancer at an advanced stage. The ICICI Pru Life had come out with a similar cover, but this has been withdrawn. Though a fantastic proposition at an inexpensive price point, the downside of such plans is its USP as pitched by insurers: it is a targeted, cancer-only product.How should you secure yourself against cancer treatment costs? While a health insurance plan will not be sufficient, one needs to buy it to cover hospitalisation risks for other ailments.So, you can depend on it for paying the initial surgical and generic treatment costs. The best part is that it comes with lifelong renewability. However, you’ll need a bigger cover if there is a need for specialised treatment.Buy a critical illness plan instead of a dedicated cancer care product to take care of the costlier treatment. Cancer is not the only ailment that threatens us. Lifestyle-related risks include heart ailments, diabetes, kidney and liver-related illnesses. Hence, a wider coverage would be a wiser pick.You could buy a dedicated plan only if you fall in the high-risk category of people suffering from cancer, say, those with family history of the disease or those who are heavy smokers or tobacco users. About 35-40% of cancers are related to the use of tobacco. In such a case, paying an additional Rs 2,000 or so a year as premium may be worth it. Currently, the only gap in the product range is a policy that covers one after the detection of the ailment.“We already have plans that insure heart and diabetic patients. There is no reason why insurers will not introduce a similar product for cancer as well," says Dutta optimistically.