Cancer Corps. Why and how to develop critical illness insurance

Insurance program "Manage your health!" This is a reliable help in the case of diagnosing oncological diseases.

What to do and how not to waste time if you are diagnosed with oncology?

Was the diagnosis correct? The choice of drugs, methods of treatment and their effectiveness depend on the type of cancer cell.

Which doctor should I go to? In what clinic to be treated? For the treatment of each disease, it is necessary to find a doctor of the appropriate qualification and a clinic that has all the necessary high-tech equipment.

How to get a quota for treatment? Where to get effective medicines of the latest generation? Modern therapies and drugs can cost millions.

The insurance policy will solve all these issues for you.

The insurance program includes:

• service for routing and support at all stages and in all aspects of treatment (rechecking the diagnosis, second opinion of the best oncologists in the country, drawing up a treatment plan, organizing treatment as soon as possible in the leading specialized clinics in Russia, psychological and legal support, protecting the rights of the patient) ;
• payment for treatment in the amount of up to 7 million rubles in leading Russian clinics;
• insurance payment up to 300,000 rubles.

The "Manage Health" program was approved by the Russian Association of Oncologists, FGBU "Research Institute of Oncology named after N.N. N.N. Petrov" of the Ministry of Health of Russia, FGBU "Moscow Research Oncological Institute named after A.I. P.A. Herzen” of the Ministry of Health of Russia, the Federal Medical and Biological Agency.

The insurance contract is concluded without a preliminary medical examination or other procedures, on the basis of a health declaration.

You can insure yourself and your loved ones between the ages of 18 and 75.

Our partners

"Global Medical Assistance" is a company created with the support of the medical community, whose task is to provide patients with access to quality medical care.

AXA Assistance- a French company specializing in the provision of insurance services; one of the world's largest insurers.

You spend a minimum of your money and get the highest possible professional treatment!

A couple of decades ago, a doctor’s diagnosis “you have cancer!” sounded like a death sentence. But time passes, and science does not stand still. To date, doctors have not only learned how to help cancer patients survive and live with cancer, but also to cure them.

Cancer is easily curable at an early stage!

In Russia, there is a whole program to help cancer patients, for which the state allocates billions of rubles annually. Cancer patients are entitled to free treatment, free drugs...

But the question is to get through the bureaucracy and prove to medical officials that you are entitled to receive it.

Unfortunately, such “evidence” takes the most valuable thing - time!

After all, if you do not start treating the disease immediately after it is detected, it develops and gradually passes into another, more severe stage.

In Russia, almost EVERY THIRD person with cancer dies within ONE YEAR, after he learned about his diagnosis!

In Western countries, the survival rate is much higher ... and it's not about technology.

Unfortunately, there are no clear and precise criteria that will 100% say that a particular person will get sick, or vice versa, will never get cancer. Sports, the use of antioxidants - reduces the risk of disease, but does not remove it completely.

And the only RELIABLE protection against this is a financial “cushion” that will help start treatment immediately if such a diagnosis is made.

Critical illness insurance programs are such a “financial pillow”, because the Insured, after contacting the insurance company (after making the initial diagnosis), receives a large amount of money within 10-20 working days.

In addition to oncology, the list of critical diseases usually includes INFARCTION, STROKE, BLINDNESS, ACUTE RENAL FAILURE, THE NEED FOR VITAL ORGAN TRANSPLANT.

The cost of the policy depends on the age and gender of the Insured, as well as on the selected sum insured. Naturally, the younger you are, the cheaper the policy. So, for example, under one of the programs, insurance of a minor child for 1,500,000 rubles will cost from 2,580 rubles a year, while a 47-year-old man will pay 30,090 rubles for this program.

You can learn more about these programs at.

P.S. Don’t think “oh, I won’t have anything like that!”. Believe that even 500,000 rubles (the cost of insurance is from 860 to 15,710 rubles a year) paid within 20 days after the diagnosis can help you regain your health.

Do it right now. And… take care of yourself! After all, you are the most valuable thing you have.

Critical Illness Insurance Gives People a Chance to Heal

Photo: Fotolia/ribalka yuli

The market for critical illness insurance, including cancer, is growing rapidly following the increase in morbidity and due to people's increased attention to their health. Moreover, the rapid growth of this market has become a driver for the entire segment of life insurance.

Conscious choice

Every year on February 4, humanity celebrates World Cancer Day. Critical illness insurance has become one of the ways of this struggle.

In the Russian critical illness insurance (CHI) and cancer insurance market, only about a dozen insurance companies are active, specializing in either VHI or life insurance. Moreover, most of them entered this segment in the last year or two. Prior to this, the diagnosis of a malignant tumor was traditionally considered an exception to the insured events of VHI, life insurance and accidents. Since 2014, however, a separate specific market segment has begun to form - critical illness insurance, including cancer. As it became clear that these products were becoming more and more popular with customers, more and more insurers began to “connect” the service.

It is currently quite difficult to correctly measure the market size due to the fact that different companies attribute the risks associated with oncology to different areas. Someone includes them as an additional option to the personal and corporate VHI program (for example, SPAO Ingosstrakh covers this risk under corporate VHI agreements for 50,000 employees of clients). Someone - as a standard or additional risk in life insurance. Someone - as one of the risks in the program of treatment abroad (SC "Welfare").

“We did not make a separate assessment of the market volume, but we assess it as insignificant, and the market itself as very far from saturation,” says Elena Kovaleva, General Director of IC Soglasie-Vita.

With the increased interest of insurers in such products, many companies have launched separate “oncological” programs or VHC programs in the last year, including oncology (VTB, Ingosstrakh-Life, IC “Welfare”), and some have begun to actively sell such policies online, which should also spur the growth of the segment as a whole. In December 2016, VSK announced electronic sales, just the other day - "Consent-Vita", in March it plans to launch the online service "MetLife".

According to rough estimates by the insurers themselves, the total capacity of the market for accident insurance, life insurance and VHI, which may include cancer risks, is no more than 5 billion rubles. This figure, in particular, is given by Oleg Merkulov, Deputy General Director of VTB Insurance. The company entered this segment of the market relatively recently - in 2013, but is very active: in 2016, it seriously expanded the line, due to which the number of contracts for this type of insurance increased almost 2.5 times - from 64 thousand to 2015 to 155 thousand for 2016.

A 50% growth in 2016 was also shown by another relatively new participant in the VHC market - IC "Welfare": the program for insurance against the risk of treatment and operations abroad, including cancer insurance, was launched in 2014. In 2016, another VHC program called Conscious Choice appeared. In just a year, the company collected about 100 million rubles of premiums for these two types of insurance.

The “old men” who have already gained a portfolio a long time ago, of course, do not demonstrate such rapid growth. MetLife can be considered a pioneer in critical illness insurance (CHI), which began offering the inclusion of such risks to its corporate clients back in 2005, and to “physicists” in 2008. Over the years, the insurer has collected a huge portfolio of contracts, including cancer insurance - 400 thousand. Now he has cancer risks included in VHI programs, accident insurance, and life insurance. In 2016, the increase in the number of contracts for health insurance will be 5-6%, for corporate voluntary health insurance, including oncology, - 15%.

Other experienced players in this market include PPF Life Insurance, which began including cancer as an additional risk back in 2010. The portfolio of the insurer includes more than 69 thousand contracts with the risk of "insurance against deadly diseases".

“Oncological insurance has been one of the drivers of the life insurance market for several years,” says Dmitry Dubina, technical director of PPF Life Insurance. “Our company is one of the leaders in this field, bringing new advanced products to the market.” In 2014, PPF Life Insurance was one of the first to develop separate programs for cancer in general and a special program for women.

MetLife also has specific "women's" programs. In 2014, the company introduced the Harmony women's critical illness insurance program, which focuses on comprehensive protection in the diagnosis of female and other types of cancer for young clients, as well as specific female diseases such as age-related osteoporosis, heart attack and stroke for women in aged 45 years and older. According to MetLife, 60-80% of critical illness insurance payouts are payouts related to the diagnosis of cancer in the insured.

Ingosstrakh-Life offers an original product that combines protection against the risk of oncological diseases and endowment life insurance: the program is designed for seven years, during which the insurance protection is valid. At the end of this period, if the insured event has not occurred, the insured receives back all his contributions.

The Edge of Health program has been supplemented with a comprehensive service component. “Our program has been operating for seven years and involves passing a check-up every two years, organizing and paying for treatment in the amount of up to 300 million rubles. By purchasing the program, the client can simply make one call to sign up for a check-up or declare an insured event (diagnosing a critical illness), we take care of the rest, - says Vladimir Chernikov, General Director of Ingosstrakh-Life. - Namely: the organization of a preventive examination in any clinic in the Russian Federation where the selected version of the program operates, obtaining a second medical opinion in case of a critical illness, immediate organization of treatment, visa support, transfer, accommodation and even payment for prescribed medications that will be necessary take after treatment.

For the rest of my life?

The spread of insurance coverage, tariffs, the form of payment of insurance compensation and the service accompanying the service is so large that it is difficult to systematize.

The list of critical illnesses from VHCs can include from one to 40 diagnoses. The most common are cancer, myocardial infarction, stroke, kidney failure, paralysis, blindness, multiple sclerosis, Parkinson's disease, muscular dystrophy, coronary artery bypass grafting, vital organ transplantation. Insurance premiums vary from 3,900 to 39,000 rubles, and the amount of the premium does not always directly depend on the sum insured. Other factors that increase the cost of insurance may be the age and gender of the insured, a set of risks and services. But far from all companies have gender and age differences, some divide the insured conditionally into adults - from 18 to 64 years old - and children - up to 18 years old. A number of insurers, such as IC "Welfare" and "MetLife", have children's programs that include oncology.

Usually increase with age. However, there are also programs in which, upon entering at a certain age, the premium remains unchanged throughout its duration. By the way, this is another argument in favor of long-term insurance (usually contracts for HCZ are concluded for seven, ten years or for life).

It makes no sense to insure against short circuit or separately oncology for a year. “Naturally, when we talk about the future, we mean not one year, but a much longer period. If the annual policy is guaranteed to be renewed, it does not matter which policy you choose - annual or long-term, - says Dmitry Maksimov, General Director of IC Blagosostoyanie. “If the policy is only an annual one and the next year it is supposed to undergo repeated examinations or significant changes in the insurance conditions, then you need to understand that such a program cannot be a solution to the problem.”

Most VHC contracts have a waiting period (90-180 days), during which no insurance amount is paid in case of cancer or other short-term disability. Thus, the company insures itself, reducing the risk that a person enters into an insurance contract, already knowing or suspecting the diagnosis. Malignant neoplasms detected before the purchase of the insurance policy, as well as the presence of an HIV infection in the insured person - exclusions from insurance coverage under such programs.

Oleg Merkulov from VTB Insurance explains that a waiting period is necessary, since conducting examinations at the stage of buying an insurance policy is long, labor-intensive and ineffective (an examination may not diagnose a disease). “If a person falls ill during the waiting period, the insurance amount is not paid to him, but the assistance system begins to work: we provide all legal and consulting support for patient routing to ensure treatment within the framework of state guarantees,” says Merkulov.

Money or kind?

The sum insured under VHC or cancer treatment contracts varies in different companies and for different types of contracts - from 500,000 to 300 million rubles. The average amount of insurance coverage, according to MetLife, is 700-850 thousand rubles. At the same time, the maximum payment made by this company under such insurance is 7.5 million rubles, and under the corporate program - 9 million rubles.

There are two fundamentally different approaches to the payment of insurance compensation: cash or payment of medical bills and additional services. Some companies (for example, "Consent-Vita", "PPF Life Insurance") upon the occurrence of an insured event (diagnosis of a critical illness and / or malignant tumor) practice a standard one-time non-targeted payment. As a rule, 500 thousand or 1 million rubles, depending on the contract.

A person spends these funds at his own discretion: he can send them for treatment, pay for rehabilitation in Russia or abroad, purchase imported medicines, pay any current expenses. In "Consent", in case of late detection of the disease, payments can be made twice: first, upon the diagnosis of the disease, and then upon the fact of death.

Other insurers have chosen the option of paying for the necessary medical care within the limits of the insurance amount stipulated by the contract and, in some cases, service support for the insured. As a rule, this path is followed by insurance companies that are part of a large holding company with a developed system of medical care (for example, Welfare, which is part of the Russian Railways system) or that have partnerships with service medical companies (such as Best Doctors, Europ Assicstance, Chez Medical Tours) .

In VTB Insurance, if a disease is detected, the policy makes it possible to double-check the diagnosis in a good clinic with leading oncologists, develop a treatment plan, and choose a specialized clinic in accordance with the established disease. The insured is under the supervision of doctors for three years - despite the fact that the validity of the policy, taking into account the waiting period, is 18 months. Ingosstrakh-Life provides full treatment for cancer patients within a year after the expiration of the contract, if the start of treatment or the occurrence of an insured event occurred at the end of this period.

Most companies pay not only for the diagnosis and treatment itself, but also for regular oncologist examinations, tests and re-diagnosis, which are necessary for critical illnesses.

May include payment for the travel of the insured to the place of treatment and accommodation of one accompanying person in a hotel, as well as payment for high-tech drugs for chemotherapy and blood-based drugs.

Whether all these options are included in the contract must be clarified in advance. It is also worth paying attention to how the company interprets the terms "oncological disease" and "precancerous condition", whether the detection of a benign tumor in a person is included in the insured events.

Director General of IC "Welfare" Dmitry Maksimov believes that if a person is well versed in medical services in Russia and abroad, he can choose a monetary refund. “But the majority, including myself, prefer policies that involve the organization and payment of medical care,” the expert emphasizes.

The main target audience of various products that include cancer insurance are middle-aged people (35-45 years old), since it is they who, when malignant tumors are detected, need urgent treatment. And it is they who, when diagnosed at the 1-2nd stage, can be helped to return to a full life. According to MetLife statistics, the most common insured event in VHC is the diagnosis of oncology at an early stage in the presence of a favorable clinical prognosis. It is in such cases that insurance payments will be a serious financial support in the treatment of oncology by the insured.

“A critical illness is a disease that significantly affects lifestyle, has an unambiguous definition, an objective and confirmable diagnosis, as well as detailed statistics,” explains Natalia Shumilova, President, Chairman of the Board of CJSC Medexpress. In general, the concept of critical illness came from personal insurance. The practice of the market followed the path of expansion of interpretation. Some companies currently classify up to 30 items as critical illness, including any illness that irreversibly changes a person's life. In most cases, so-called critical illnesses are excluded from insurance coverage under the VHI policy, but not always. “Unlike many other companies, Medexpress traditionally includes a wider range of medical services and diseases in VHI insurance programs. We pay for the treatment of oncological diseases, operations on the vessels of the heart within the framework of VHI. We do not limit the length of stay in the hospital, the number of hospitalizations, diagnostic and treatment services in the presence of medical indications,” says Natalia Shumilova.

VHI involves the organization of treatment at the expense of the insurance company (often with various restrictions and limits), and insurance against critical illnesses is a fixed payment upon diagnosis of those diseases that are usually excluded from VHI. These are different types of insurance, and therefore the ideal option for a person is to have both policies, Natalia Shumilova believes.

With regard to corporate voluntary medical insurance, insurers have already begun to include oncology in the policy - when surgery, radiotherapy, and isotope treatment are paid for during the initial detection. It costs, for example, in "Medexpress" only 600 rubles per person (for teams from 100 to 500 people), but the decision on insurance remains with the employer.

Voluntarily and independently

At the same time, health is a basic value of a person, and it is not entirely correct to shift responsibility for one's life to the employer. And if earlier even personal insurance options had an impressive list of limitations and exceptions, now the situation is changing, insurance companies are creating new products. Experts estimate their potential quite highly.

An example is the innovative product for individuals “Manage your health!” from VTB Insurance, which was launched in 2014 and provides financial protection in case of a number of critical illnesses. A key distinguishing feature of the policy is insurance in case of diagnosing cancer. Each insured under the product "Manage your health!" receives a guarantee of a free service for routing and support at all stages and in all aspects of treatment - from rechecking the diagnosis to selecting a clinic, consultations on the course of treatment, legal and psychological support, and more; insurance payment from 750 thousand rubles (in the first year) and up to 2.4 million rubles (for the tenth year of insurance); extension of protection to the list of "Critical diseases" (stroke, myocardial infarction, paralysis, terminal renal failure, the need for coronary artery bypass grafting or organ transplantation).

The cost of an individual policy starts from 5,590 rubles per year for adults and from 2,990 rubles per year for children. A family policy (two adults and up to three minor children) will cost from 11,180 rubles a year. The insurance contract is concluded without a preliminary medical examination or other procedures, based on the signing of a health declaration. However, to protect against unscrupulous policyholders, the policy begins six months after the conclusion of the contract. There are age limits and a list of diseases and conditions under which persons are not accepted for insurance. The terms of insurance are from three to ten years. This insurance program has passed the examination of the Russian Association of Oncologists, N.N. Petrov” of the Ministry of Health of Russia, FGBU “Moscow Research Oncological Institute named after P.A. Herzen” of the Ministry of Health of Russia, the Federal Medical and Biological Agency.

According to Kirill Pavlov, director of the VTB Insurance branch in St. Petersburg, the demand for this service is already significant and the number of policies sold is in the thousands.

Ambulance

A big plus of a personal insurance policy against critical cases compared to a voluntary medical insurance policy - even in addition to the typical exceptions to VHI - is that a person gets the freedom to manage money and the freedom to choose a medical facility.

“Among private clinics, interest in the treatment of critical diseases in general and oncology in particular is growing, we have the appropriate licenses. At the same time, the more insurance products develop, the better it is for clinics - we are ready to respond promptly to incoming requests, ”says the CEO, chief physician of American Medical Clinic & Hospital (American Medical Clinic, a large polyclinic and hospital complex providing medical services in 39 areas ) Efim Danilevich.

Cardiovascular diseases have their own specifics, regardless of the policy. When interacting with some accredited state institutions, even first-class insurance and assistance services are unable to help the patient. In the case of heart disease, not only hours, but even minutes are critical. “A case from our practice: we arrived at the patient and made a diagnosis within 15 minutes. Then everything was decided by time. In order for a person to be urgently admitted to the nearest medical facility, a call was required to the head doctor. But even in this case, assistance to the patient was provided only after four hours, ”says Lev Averbakh, CEO, chief physician of CORIS Assistance (assistance company - private ambulance, emergency room). “Sometimes it is easier to take a patient to Finland than to arrange him in a St. Petersburg hospital. In fact, a few years ago, sometimes we did this (by the way, on a CORIS car), and it saved people's lives,” recalls Tatiana Dolinina, Marketing Director of ASK Petersburg.

By the way, a number of insurers offer special programs (or additional options to standard programs) for treatment abroad. Thus, the Health Sphere product from the RESO-Garantia company, developed jointly with the Spanish company Sphera Global Gestión Médica Internacional S.L., provides the following services: a second medical opinion (a written opinion of an internationally licensed doctor recognized in his field - a specialist in such diseases, such as cancer, stroke, heart attack, hepatitis, diseases of the cardiovascular system, congenital malformations, etc.); medical consulting and orientation on various pathologies, diagnosis and treatment using remote access and telemedicine; organization of inpatient treatment (without paying the cost of treatment) at a fixed cost, insured against a possible increase; services (invitation, transfer, hotel accommodation, accompaniment in the clinic with an interpreter, monitoring of stay in the hospital). As Tatyana Savateeva, Deputy Head of the Directorate of the North-West Regional Center RESO-Garantia, explains, the program implies several levels of coverage and service.

Tatyana Dolinina points to another aspect - the financial well-being of the family in case the misfortune touched any of the working family members. For this case, there are also special products that involve payment after the occurrence of an accident, which will serve as a significant financial support. So, the policy from the company "ASK" "Close people" protects all family members from accidents with any of them. At the same time, a family is understood as close people who do not necessarily live in the same living space, and civil marriages are also taken into account. The insurance premium is minimal (from 1.2 thousand rubles), the total insurance amount for all is within 500 thousand rubles. If a family member is injured or disabled as a result of that injury, ASK will pay money based on the severity of the injury. If the injury is serious and the person is hospitalized for a long time, the family will receive additional money - 0.2% of the sum insured for each day of hospitalization.

Think strategically

The probability of cure for cancer with early diagnosis reaches 90%. But more than 40% of diagnoses in our country are made at the later stages. And diseases of the cardiovascular system are the main threat to the life and health of people around the world. Compulsory health insurance works far from the best way. In the current economic situation, the sudden detection of serious diseases can hit the family budget or simply make expensive treatment impossible. For such cases, you need a policy. By the way, in some cases, the policy involves a "voluntary-compulsory" annual examination, which will identify the disease at an early stage.

If we talk about ways to prevent and minimize the cost of treatment, then the personal insurance adviser to the territorial director of SOGAZ OJSC for the North-West Federal District, Doctor of Medical Sciences Igor Akulin, thinks strategically. First of all, the general state of health care leaves much to be desired - the prevention of diseases is practically absent, which ultimately leads to the appearance of a bunch of diseases. The practice of professional medical examinations and preventive measures would be very helpful. Also, Igor Akulin believes, it would make sense to create an institute of general practitioners in clinics at the level of a state or local city program. By the way, in the West, a person, bypassing a general practitioner, will not get an appointment with a narrow specialist. Igor Akulin recalls a very revealing experiment launched with his participation during his work in the Health Committee: three general practitioners in a particular medical facility covered 85% of calls, and only 15% of calls required further consultation of highly specialized specialists. But impressive results with the continuation of the experiment, and even more so with its expansion, would eventually require the reduction of such doctors, while the domestic system of training is sharpened just for the production of a large number of highly specialized specialists. The project was cancelled. At present, the mentality of a Russian patient is such that he certainly wants to go straight to a narrow specialist, considering a general practitioner or family doctor to be something like a “underspecialist”, not really understanding the objective expediency of an initial consultation with such a doctor.

St. Petersburg

Market average

Classical scroll critical diseases on NS:

• stroke;
• heart attack;
• kidney failure;
• transplantation of major organs;
• coronary artery bypass grafting.

extended scroll critical diseases on NS:

• benign brain tumors;
• other operations on the heart and aorta;
• multiple sclerosis;
• paralysis;
• loss of limbs;
• etc., up to 30 diseases.

Classical scroll critical diseases, excluded from programs VHI:

• oncology;
• surgical treatment of heart attacks and strokes;
• benign brain tumors.

Restrictions in programs VHI on treatment non-excluded critical diseases:

• on sums insured in relation to critical diseases in general;
• duration and number of hospitalizations;
• on drug supply;
• for rehabilitation treatment;
• on the use of modern high-tech types of treatment and diagnostics, including surgical ones;
• to pay for consumables;
• further dispensary observation and repeated courses of treatment.

Health insurance is one of the most demanded services nowadays. The VHI policy has long become the norm not only as a significant bonus for employees of large corporations, but also as a guarantee of fast and, in most cases, high-quality medical care for ordinary people. But until recently, insurance companies have been very picky about selecting their customers, especially in terms of their potential health problems. This is not surprising. The goal of an ordinary person who buys a paid medical policy is to minimize the cost of treating an unplanned illness. The goal of an insurance company is to make money. That is, to receive more money than to pay. Therefore, really serious and expensive diseases and conditions remained outside the interests of insurers for a very long time: HIV infection, cancer, organ transplantation, etc.

But times are changing. In recent years, one by one, major insurers have introduced new insurance programs against potentially fatal diseases, the cost of treatment of which puts not only the patient, but also his relatives on the verge of bankruptcy. MedAboutMe understood the nuances of critical illness insurance.

The concept of critical illness was introduced into practice by insurance companies. Today, this term means a disease that significantly changes a person's lifestyle, while it is unambiguously and objectively diagnosed, and a sufficient statistical base has been accumulated on it. The list of critical illnesses is not very large yet, but every year it is gradually increasing. For example, it now includes the following diseases, conditions, and medical procedures:

• stroke;
• CABG surgery (coronary bypass grafting);
• myocardial infarction;
• malignant tumors (cancer);
• organ transplant;
• terminal renal failure;
• paralysis;
• loss of limbs;
• loss of hearing or speech;
• Alzheimer's disease or Parkinson's disease, provided that the patient is under 60 years of age;
• multiple sclerosis, etc.

To date, this list, depending on the capabilities of the insurance company, may include more than 40 diseases. All these diseases and conditions have in common that, if not treated promptly, they are fatal or lead to severe disability. With early diagnosis, 90% of cases can be cured. The most frequent insured events, according to statistics, are stroke, heart attack and cancer.

Who needs critical illness insurance?

When the average citizen first encounters a disease on this list, they are faced with a whole palisade of problems:

• Diagnostic problems - especially when it comes to the province.
• The delay in starting treatment is due to the same problems with diagnostics, or the lack of specialists, or a shortage of drugs, or the inability to immediately get to the clinic where the necessary therapy is carried out.
• Lack of information on the treatment of such a complex disease.
• Shortage and other problems with access to effective medicines.
• Problems with the implementation and payment of rehabilitation measures.

At the same time, the well-being of our fellow citizens is falling, and the incidence of cancer and cardiovascular diseases is growing. And, of course, you want to be sure that if such a disaster affects you or your loved ones, “the rear will be covered”, and there will be enough money and strength to overcome the disease.

The following types of insurance assistance are distinguished for patients who have been diagnosed with a critical illness:

• cash payments;
• organization of treatment in Russia or in a foreign clinic.

Various combinations of these two basic forms are also possible.

Additional services include:

• Organization of a consultation for re-diagnosis and verification of the correctness of the diagnosis. Major insurance companies promise consultations with the best doctors in the country.
• Payment for the purchase of medicines that are not included in the standard therapy for this disease. So, some insurance companies offer payment for targeted therapy - the most modern technologies that work on the principle of a narrowly targeted action on the processes underlying the disease. At the same time, side effects on healthy cells are minimized. Such treatment can cost significantly more.
• Payment of rehabilitation expenses. Many expensive therapies turn out to be useless without long months of follow-up rehabilitation, which includes significant expenses for drugs and additional medical services. Sometimes rehabilitation costs several times more than the therapy itself.

Who cannot be insured?

But insurance companies are not ready to promise support and money to everyone. Their goal is to minimize their own risks. Therefore, not everyone can become a client under a critical illness insurance contract. The list of restrictions includes:

• Age. The potential client should not be older than 55 years.
• The presence of disability groups I-III associated with the presence of cancer or certain blood diseases. Disabled children also do not fall into the list of potential clients of insurance companies.
• Dispensary registration for cancer, blood diseases or HIV infection.
• Already existing oncological diseases or suspicious neoplasms that may turn out to be such.
• Imprisonment.
• The presence of diabetes.
• Previous severe heart and vascular diseases, as well as diseases such as cirrhosis of the liver, hepatitis B and C, Crohn's disease, ulcerative colitis and terminal renal failure.
• Registration with a narcologist or psychoneurologist.
• The presence of venereal diseases.
• The presence of ailments potentially requiring organ or tissue transplantation.

Each company has its own list, but in most cases it includes the above conditions and ailments. Many of them are increased risk factors for the development of an insured event, so insurance companies immediately exclude this category of patients from the list of persons who can be paid insurance compensation. A striking example is myeloproliferative or myelodysplastic blood diseases. It's not cancer yet. But often they disguise malignant diseases. The situation is similar with already cured cancer - the risk of recurrence is too high, etc.

It should be understood that each company has its own programs and tariffs. For example, there are programs for insurance only against cancer, and there is the so-called general insurance, etc. In addition, when concluding a critical illness insurance contract, you need to be very attentive to every line of the document. Insurance companies have developed a strategy to protect themselves from scammers, but it greatly limits the rights and respectable citizens.

Insurance companies will refuse insurance payment if the disease specified in the insurance contract occurs in the following cases:

• suicide attempt;
• alcohol poisoning;
• deliberate actions of the patient;
• the presence of a mental disorder;
• natural disasters;
• military operations, including civil war, and the consequences of exposure to radiation (and a nuclear explosion in general);
• driving without a license or under the influence of alcohol;
• self-medication without a doctor's prescription;
• professional sports;
• imprisonment, etc.

In addition, there is a long list of exceptions - diseases and conditions, the presence of which makes the insured event invalid. They can be divided into two main groups:

• Ailments that, according to representatives of insurance companies, should be treated only in specialized public clinics. These are AIDS, some types of especially dangerous infections (for example, plague, anthrax, viral hemorrhagic fevers, smallpox, etc.), tuberculosis, etc.
• Diseases that affect the entire body and their treatment is closely related to the underlying disease. In addition, the listed ailments are chronic and practically incurable within the limits of the insurance contract. They require cyclical and expensive treatment. This list includes: HIV infection, chronic renal and hepatic insufficiency, various congenital anomalies and malformations, hepatitis, degenerative diseases of the nervous system, cerebral palsy, parkinsonism, etc. Some companies will not undertake to insure people with HIV in their blood at all .

This is not a complete list of exceptions, each company has its own, so you should carefully study situations in which you cannot count on the help of insurers.

When can you start to get sick?

But, even when purchasing a VHI policy, a person is not immediately under his protection. When concluding a critical illness insurance contract, a so-called temporary deductible is used. This means that you cannot buy a VHI policy and go to the hospital the next day with a heart attack or cancer. There is a certain period from the moment of conclusion of the contract when the insurer is still not responsible for the insured event - this time is also called the "waiting period".

For example, in one of the major insurance agencies, the waiting period for cancer and cardiac surgery problems (CABG, etc.) is six months. For diseases of the spine - a year, and for diseases of the joints - as much as 3 years. That is, having concluded such an agreement, you should not start to get sick during the period of a temporary franchise - you will not be able to get insurance.

Annual insurance premiums under such contracts start from 3,000 for children and from about 6,000 for an adult. Family insurance can cost half as much per person.

Considering the real cost of diagnosing, treating and rehabilitating critical illnesses, insurers' payouts are low. Depending on the completeness of the list of diseases and additional conditions, the payment will range from 300 thousand to 2 million rubles. And you need to understand that for an insurance company, the priority is not the health of the client, but the money saved. Therefore, of course, the company's lawyers will defend the reduction of the amount of payments in all possible ways.

Insurance companies pay money into the hands of their client, they themselves do not distribute insurance funds to doctors and clinics. The amount that will have to be paid annually depends on the terms of the contract and the company's tariffs. Insurance can be purchased for 3, 5, 7 or 10 years. The period that has passed since the conclusion of the contract also affects the amount of payments. The longer a person pays the insurance company and at the same time remains healthy, the more money he will receive in the event of an insured event.

• The service of insurance against critical illnesses is becoming more and more popular every year. But its active distribution is limited by numerous reservations of insurers, which can make insurance meaningless.
• It should be understood that it is not worth counting on full compensation for diagnostics, treatment and rehabilitation in case of a critical illness - usually the costs are on average higher than the amount paid by the insurance company. But this money is a very significant part of them and can save the life of the patient.
• When concluding a contract of such a plan, one should be very careful in the process of reading its terms. Ideally, consult with a lawyer, because in the event of an insured event, it will be a matter of life and death, in the literal sense of the word.