Compare The Best Private Health Insurance Policies For Cancer
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.
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.
Cancer statistics in Australia
Cancer continues to be one of the biggest health concerns affecting Australians – and our nation’s healthcare system at large. It’s something we simply can’t escape from, with the latest figures showing more than two in five Aussies (43%) will be given a cancer diagnosis by the age of 85.
In 2023, it’s estimated that approximately 165,000 new cases of cancer will be diagnosed, underscoring the harsh reality of this killer disease.
Tragically, cancer-related mortality remains a big challenge. It’s projected that around 51,000 Australians will lose their lives to cancer in 2023. These statistics not only highlight the urgent need for ongoing research and improved access to treatments, but they show us that cancer can strike you at any time – so it’s important to be prepared.
Despite these sobering numbers, there is hope to be found in Australia's cancer survival rates. Over the period from 2015 to 2019, an encouraging 71% of those diagnosed with cancer survived for five years or more after their diagnosis. This gives us hope that there are positives in early detection and plenty of new advancements in cancer treatments.
However, the burden of cancer on the nation remains substantial. In 2023, it’s estimated that cancer will be responsible for nearly three out of every 10 deaths in Australia. This only makes it more critical to take preventive measures in your everyday life, like:
booking regular screenings.
making regular skin checks
making sure you take advantage of early-intervention health advice to reduce the impact of cancer, should you be diagnosed. This is especially important if you have a family history of cancer.
What does cancer treatment involve for patients?
Cancer takes many different forms, and so too does cancer treatment. The type of treatment depends on several factors, including the type and stage of cancer, your overall health and your preferences for specialists and other medical professionals (if you have private health cover).
In general, cancer treatment can involve various types of treatment, all aimed at eliminating cancerous cells and managing the disease effectively for your long-term benefit. Treatments may include any or all of the below:
Surgery is a common approach for many cancer patients, especially when a tumour is localised and hasn't spread to other parts of the body. A surgeon will remove the cancerous tissue, which can be a small lump or an entire organ, depending on the extent of the disease. Surgical options include:
Minimally invasive procedures: Such as a laparoscopy, which operates on organs inside the abdominal and pelvic areas.
More complex surgeries: Like a mastectomy for breast cancer or prostatectomy for prostate cancer.
Chemotherapy is the use of powerful drugs to target and destroy cancer cells in your body. Many hospitals administer the drugs intravenously, but oral medications are also available.
At its root, chemotherapy is effective against rapidly dividing cancer cells. However, be aware that there are often side effects such as:
Loss of appetite
Skin and nail issues
Chemo can be used as a primary treatment for certain cancers, or in combination with other therapies to shrink tumours before surgery or radiation.
Radiation therapy uses high-energy rays or particles to damage and kill cancer cells. It’s a highly localised option that targets the specific area in your body where your cancer is located . Radiation can be delivered externally using machines (external beam radiation) or internally through implants (brachytherapy).
In most cases, radiation will be used after surgery in order to eliminate any leftover cancer cells. However in other instances it can be your primary treatment, especially for cancers like prostate and lung cancer.
As the name suggests, hormone therapy is mainly used to combat hormone-driven cancers, such as breast cancer and prostate cancer. It works by blocking hormones or interfering with their effects on cancer cells.
For breast cancer, hormone therapy may involve medications like tamoxifen^, while prostate cancer can be managed with drugs like androgen deprivation therapy^^. Hormone therapy can be a long-term treatment to prevent cancer recurrence.
There are also further treatment options for patients that require supportive care and complementary therapies:
Supportive care: To overcome physical and emotional challenges, supportive care may include pain management, nutritional support and the ongoing management of treatment-related side effects. Psychological support like counselling or support groups can also help you cope with the emotional impact of having cancer.
Complementary therapies: Some people may choose to explore complementary therapies like acupuncture, massage and yoga to alleviate stress and improve their overall wellbeing. These can be used alongside conventional treatments but should be discussed with your healthcare team to ensure they are safe and appropriate as part of your ongoing cancer management plan.
The bottom line is that cancer treatment is highly individualised. How you and your healthcare professionals manage it depends on the type and stage of cancer, as well as your overall health.
Be prepared for surgery, chemotherapy, radiation therapy or hormone therapy – or a combination of these – as well as any additional care and therapies to help manage both your physical and emotional needs throughout your cancer journey.
As a general rule, surgeries, chemotherapy, and radiation are used to kill off your cancerous cells and eliminate cancer from your body entirely.
Depending on your personal circumstances, you may also require additional support such as counselling, physiotherapy, speech therapy and more.
Waiting periods for cancer treatment
A waiting period is what happens when you purchase your health insurance policy and need to wait out a predetermined period before you can make a claim on certain treatments.
Although it can often feel like a long time to wait, it may still be shorter than a public hospital's waiting list and it may still mean that you get private treatment sooner.
Condition / Type of care
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
Counselling and psychotherapy.
If your existing policy doesn't offer the kind of cover you need, it might be time to consider 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 via private health insurance?
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.COMPARE & SAVE
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.