Overview

There's no denying that a cancer diagnosis can quickly turn your life upside down in an instant, and while Private Health Insurance (PHI) can help ease the burden, in the long run, trying to navigate your way around the complexities of PHI cancer cover can initially add to your worries.

That is why we've put together this comprehensive guide, answering your questions to help you identify what treatments -if any- you may already be covered for, what kind of health insurance plan is most suited to your individual circumstances, and what you might also need to know to alleviate the financial pressure of being diagnosed with cancer.

Key Points

  • Medicare and the Pharmaceutical Benefits Scheme can cover some of your cancer treatment costs.

  • Choosing an appropriate private health insurance plan can mean that those costs not already covered don't leave you out of pocket.

  • It's important to really consider all aspects of your treatment, including palliative care and rehabilitation and carefully compare insurance plans to find one covering everything you could need.

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What does cancer treatment involve for patients?

Cancer takes many different forms, and so too does its treatment. 

As a general rule, surgeries, chemotherapy, and radiation are used to kill off your cancerous cells and eliminate cancer from your body entirely.

These treatments, along with hormone therapy, can also be used to minimise the risk of cancer returning, as well as to treat the side effects of your primary treatment and the symptoms of cancer itself.

Depending on your personal circumstances, you may also require additional support such as counselling, physiotherapy, speech therapy and more.

How much does cancer treatment cost in Australia?

The most recent available data on the costs of cancer treatment in Australia comes from the Consumers Health Forum of Australia (CHFA) and shows that almost 50% of cancer patients in Australia spent over $5,000 in out-of-pocket expenses treatments, while 25% spent in excess of $10,000. 

There's no escaping the fact that cancer treatment can be costly, but thankfully there are a few ways to reduce those costs.

Is cancer treatment covered by Medicare?

The good news is that regardless of whether you have private health insurance or not, Medicare will take care of a big chunk of your expenses.

Medicare alone covers your GP visits, blood tests, CT scans, MRIs, and some visits with a cancer specialist. 

If you are treated as a public patient, Medicare also covers the cost of treatments like chemotherapy and radiation.

Medicare and the Pharmaceutical Benefits Scheme – what's covered?

Along with all of the above, you can also use the Pharmaceutical Benefits Scheme (PBS), designed to help patients pay for medications.

This means that if your treatment involves drugs like antinauseants or immunostimulants, those medications' costs will either be subsidised or entirely covered by the PBS.

On this subject, it's important to note that some rare forms of cancer may require equally as rare medications which may not be covered and that you may be responsible for.

How does private health insurance cover cancer treatment in Australia?

Appropriate private Health Insurance can be used alongside Medicare to cover all or part of your treatment as a private patient in a public or private hospital and can give you much more control over the type of treatment you receive.

For example, appropriate private health insurance gives you the freedom to choose which hospital you're treated to and which doctor oversees your care. 

Depending on which health insurance company you're with and the level of coverage you have, your insurance may cover you for any medications not included on the PBS, as well as additional services such as:

  • Physiotherapy and other rehabilitation services

  • Home nursing

  • Ambulance journeys

  • Counselling and psychotherapy.

If your existing policy doesn't offer the kind of cover you need, it might be time toconsider switching. You can use our very simple comparison tool* to find a health insurance plan that's right for you within seconds.

Are there any waiting periods for cancer treatment?

A waiting period is when you purchase your insurance that you'll need to wait before it comes into effect.

If you already have cancer, then you'll be subject to a 12-month waiting period before your insurance can cover your cancer related treatments.

Although that's a long time, it may still be shorter than a public hospital's waiting list and may still mean that you get private treatment sooner.

For palliative care, rehabilitation and other treatments, the waiting period is two months.

How can I work out my out-of-pocket costs for cancer treatment?

Since every cancer is different, so too is the treatment, which means there's rarely a straightforward answer to the question "how much is this going to cost."

Fortunately, there is a simple way to work out what your out-of-pocket expenses might be and how to minimise them.

The first step is to consider all of the components that are going to make up your treatment. You can get advice from your doctor or specialist about what Medicare will cover you for with each one.

Anything left over will be your out-of-pocket expenses, though these can be reduced even further with adequate private health insurance.

Can I get health insurance after being diagnosed with cancer?

While you can get health insurance after being diagnosed with cancer, it's important to note that it will be classed as a pre-existing condition, and therefore a 12 month waiting period will apply. 

What's the best health insurance for cancer treatment?

Choosing the right kind of health insurance for your cancer treatment all depends on your personal circumstances, though there are a few things you'll want to keep in mind when selecting a plan:

  • Opt for at least a bronze plan as all plans from this level and up are required to offer some cancer coverage

  • Take your time to carefully compare plans as some may be more cost-effective than others

  • Check whether your preferred plan covers you for everything you need, including not just your main treatments but additional services such as therapy or medications not covered by Medicare.

Why might you want to consider trauma insurance (life insurance) for additional peace of mind?

Trauma insurance (often known as critical illness coverage) provides a financial safety net if your cancer leaves you too sick to work. 

Combining this with your private health insurance offers the added peace of mind that comes from knowing that not only are your treatment costs covered but that your day-to-day expenses are taken care of, too, ensuring that you can concentrate on making a full recovery.

Talk to our team today to help you determine whether combining trauma cover with your private health insurance might be a good move, or use our online tool to help you find the right option for you.

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This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.

*We compare products from a panel of trusted health insurers. We do not compare all products in the market. Not all products available from our panel of health insurers are compared and not all products are available to all customers.