Workers with cancer could be excluded from access to treatment paid through insurance policies offered by private medical insurance (PMI) providers because such policies often lack clarity and use ambiguous terminology, according to a study by consultancy Mercer and cancer charity Cancerbackup.
The study of 11 major PMI providers assessed their main corporate medical insurance policies for cancer, including issues such as scope and standard of cover, treatments included in the cover and limits.
“Some of the new and expensive treatments that are emerging are unavailable through the NHS. So understandably, cancer cover is an area of focus for companies purchasing private healthcare,” said Steve Clements, principal in Mercer’s health and benefits team.
“PMI providers are using it 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 can sometimes mean cancer treatments will effectively be excluded or cut short. Transparency and clarity must be improved.”
While PMI providers had similar views on how cancer care should be covered, the cover varied from one provider to the next.
The report also noted that use of the phrase “active treatment” for cancer allowed certain treatments to be covered for specific reasons but others to be excluded.
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