Private medical insurance (PMI) policies need to improve transparency when it comes to cancer cover, according to Mercer.
Research from Mercer carried out in conjunction with Cancerbackup, found that insurance policies offered by PMI providers often contain ambiguous terminology regarding cancer care.
The research highlighted that while PMI providers have a similar view on how cancer care should be covered in the context of private medical insurance, the cover varies from one provider to the next.
The research also noted the term ‘active treatment’ is often only loosely explained in policy documents.
PMI providers often use the phrase ‘active treatment’ for cancer to govern their decisions on cover for a particular course of treatment, which allows certain treatments to be covered for specific reasons (e.g. radiotherapy to shrink a tumour) but others to be excluded (e.g. hormone therapy of on-going control of spread and symptoms).
Mercer also notes the term ‘active treatment’ is not recognised by the Association of British Insurers.
Steve Clements, principal in Mercer’s health & benefits team, says transparency where cancer is concerned must be improved.
“PMI providers are using it [cancer care] to differentiate themselves from their competitors. While there have been substantial improvements, there is continued ambiguity over what is and isn’t covered in some cases.
“Eligibility rules for chronic conditions, for example, can sometimes mean cancer treatments will effectively be excluded or cut short,” he says.
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