Cancer care lacks clarity

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PMI cover varies from one provider to another

Private medical insurance (PMI) policies lack intelligibility when explaining cancer care, according to a recent study by Mercer and cancer charity Cancerbackup.

The research found many people thought PMI providers used ambiguous terminology when explaining what cancer treatments they did and did not offer.

Also highlighted was the concern that while most health insurers take a similar view on how cancer care should be treated in the context of PMI, the cover varied from one provider to the next, with some policy providers funding drugs such as Herceptin while others do not.

Commenting on the findings, Steve Clements, principal of Mercer's health and benefits team, argued clarity and transparency must be improved: "PMI providers are using (cancer cover) 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.

Clements added: "New therapies are coming onto to the market. Some of these will lead to long-term treatments where the goal is to slow the spread of the disease, prolong life or improve the quality of life by easing the symptoms rather than to cure. PMI providers must be clearer about whether or not these will be covered in their policies."

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