Monday, June 16, 2008

Insurance, Cost of Cancer

Question from a blog reader: "In terms of medical insurance and financial matters, what factors/costs should we be prepared for to manage cancer if we get it, or sustain quality of life..."

According to the World Health Organization, one out of three people will get cancer at some point in their lifetime. If somebody in your family is diagnosed with cancer, the last thing you want to think about is money. I have friends who are passing up treatments because they're too expensive. I cancelled a few chemo sessions during my first bout with cancer in order to save some money. Maybe that's why my cancer came back so soon. I doubt it, but who knows? The point is, you don't want to have to make life-and-death decisions based on financial considerations.

Our family had two layers of insurance when I was diagnosed with cancer - Tony's work insurance plus personal insurance. We burned through the annual limits for both within the first few months of treatment. We've probably spent a quarter of a million dollars on my cancer treatment so far.

My last chemo combination cost S$8,000 (US$5,800) every three weeks. That doesn't include all the other medications that go with the chemo, or the doctor and nurses' fees. It doesn't include the scans and tests. A full-body MRI at Mt. Elizabeth Hospital in Singapore costs S$3,766 (US$2,730). A PET/CT scan costs S$4,000 (US$2,900). Then there are the X-rays, liver ultrasounds, echocardiograms, and blood biomarker tests that I get almost monthly.

Cancer is very, very expensive. Spend the money and time now to lower your risk of ever getting cancer. But just in case you do, here's some financial advice based on what we've learned so far:

1) Get personal insurance on top of your work insurance.

2) Check your insurance policies to see what their coverage is for chemotherapy and kidney dialysis. This doesn't mean that you'll ever need either of these, but these are good litmus tests for how good the coverage is. Most insurance policies are just fine covering accidents and minor medical needs, but they're lousy at covering the big-ticket items like terminal illness or chronic illness.

3) Get disability insurance for the primary income earner in your family.

4) Get insurance to cover your family if your child gets cancer and you or your spouse has to quit your job to look after your child.

12 comments:

Anonymous said...

So, as a family living in Singapore, 2 adults, 2 kids, how much should we be paying out each month for medical insurance, if we don't have a company policy?

Just saying because it would run into about 3,000 per month and then, would it be worth it??

Would it not cost about the same in the long run??

Anonymous said...

Assuming that 1 of the family of 4 doesn't have cancer for 10 years --- or more?

Sorry, I just realised the folly of my words.

Forgive me Shin and don't post these comments, unless you want to?

Shin said...

Dear Anonymous,

That's a good point. If the premium on a very good comprehensive policy costs $3,000 a month, it's a legitimate question to ask if it's worth paying that much on the mere chance that one of the family members might have cancer some day. But that sounds really pricey. I've never heard of a policy that costs that much for just one month.

Our premiums were much less then that; hence, the terrible coverage we got for my cancer bills. Our insurance company (Tony's work as well as private insurance) is AIA. They're terrible. They're refusing to pay out one of my policies (I had two), claiming that my cancer was a "pre-existing condition", despite the fact that my doctor had misdiagnosed my lump as a clogged milk duct.

I know there are better insurance companies out there because I have friends with breast cancer whose insurance companies paid for their wigs when they lost their hair due to chemo. Mine wouldn't even pay for chemo!

So you might have to do some legwork, but I'll bet you can find good coverage without such high premiums.

By the way, I didn't see any folly in your words. You asked a perfectly legitimate question.

Anonymous said...

So which insurance company pays? Can you please ask your friend what theirs is?

Shin said...

Dear Anonymous re: which insurance companies pay.

I can't remember the names of the insurance companies that paid for my friends' wigs and mastectomy bras. If any of you are reading this, can you let us know?

I've compared AIA with Aviva here in Singapore and Aviva is MUCH better. In fact, we cancelled a number of our policies with AIA and switched to Aviva after our fiasco with cancer coverage with AIA.

Other blog readers out there who've had cancer treatment... which insurance company policies do you have and are you happy or unhappy with them?

Anonymous said...

William Russell an English company gives full coverage for onchology -I checked it out after your previous post. Whether full coverage includes wigs and bras I don't know!

Anonymous said...

Shin,
This reply is late-sorry!
I had a mastectomy in July of 1987. The mastectomy, mirror image biopsy, and tubal ligation(to prevent a pregnancy during treatment)were all done the same day. I spent eight days in the hospital. My hospital bill was $10.00 for the phone service. At the time, I had 100% coverage from Blue Cross Blue Shield of Massachusetts (USA). I know that nobody has 100% coverage anymore, but at the current 80/20 plan, I get a new prosthesis every two years and two bras every year. I pay 20% of usual and customary charges. That can get tricky, because when I had a custom body casting done for my first prosthesis, BC/BS would only pay as much as an off-the-shelf prosthesis cost. They didn't care that I was 26 years old and didn't want an old lady breast. That said, I can't complain about the coverage.
For a time in the 1990s I had BC/BS of New Jersey because my husband's company was headquartered there. After one of my biopsies, They only paid $72.80 on the general anesthesia bill! You can't put a cat down for $72.80!!!! We fought for better coverage constantly while covered by New Jersey.
We have been covered in Massachusetts for the last 15 years or so without incident. We are now moving to California, and I know NOTHING about the coverage! We will hqave several plans to choose from when we get there, and you can bet that I will be reading the fine print for the coverage for cancer treatment!
Pati

Anonymous said...

So other than William Russell, for those of us expats who live in Singapore, does anyone else know any other insurance company that pays as well?

Anonymous said...

When I was diagnosed in Singapore in 2004 we were with AVIVA through my company's insurance plan. They were awful with mastectomy surgery and hospital coverage, so my company fronted S$10k for us to get through the early bills. We've since paid them back. Aviva also wanted me in a group C ward -- not fun for someone who's dealing with breast surgery in their 30s due to cancer.
About 4 months later, AVIVA came back to say my cancer was pre-existing. It takes time to form these lumps, so it had to have been there for a while! Thus, it was a pre-existing condition and NOTHING would be covered. Right when you're trying to heal and get it together, you're hit with an insurance sledge hammer. That policy would not have covered any chemo or any radiation either.

As a result of my cancer diagnosis, we were able to push through a long awaited insurance change at work. We now have CIGNA International and I can highly recommend them. Very easy to deal with. Our company policy now covers almost everything if the doctors require it. Chemo, radiation, most tests, biopsies, hospitalization are all covered. One pProsthesis is covered too (but not custom, if that's an issue). I don't have a deductible nor any co-pay, and nearly everything is paid for 100%.

This is great news for my work colleague who was diagnosed with breast cancer last year -- she was fully covered from day 1. I wasn't so lucky, but my follow ups are now covered with 'no questions asked' (i.e. pre-existing was allowed at the start).
Problem now is that I'm working too hard/too many long to take much advantage of this great insurance plan!

Opal said...

Great work.

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