Cancer insurance ‘hard to navigate’
Diagnosed with advanced breast cancer in 2013, Terre Maize Nicholson was given less than two years to live, with only limited treatment options.
The bad news came at a bad time – her workplace was in the process of looking into subsidising health insurance for staff.
‘‘My diagnosis came a month before I was going to be able to afford insurance, basically,’’ Maize Nicholson said.
While she has beaten the odds and kept the cancer at bay, it has depleted her resources.
Having exhausted her KiwiSaver, Maize Nicholson considered selling her wedding rings and set up a Givealittle page – something she was loath to do.
‘‘I grew up below the poverty line and my mother refused to ask for a handout or welfare . . . it’s hard to ask for money but this is a matter of life and death.’’
Maize Nicholson has insurance but it doesn’t cover what she needs, with access limited to medicines from the Pharmac-approved schedule.
She said her situation was far from unique. ‘‘One woman applied for insurance after her oncologist recommended Ibrance [a non-funded breast cancer drug] and they turned her down because it was recommended by a non-network oncologist.’’
Policy caveats are not uncommon. Nicky Alexander, co-founder of NZFB Insurance Solutions, acknowledged the insurance world was ‘‘incredibly hard to navigate’’.
‘‘People are taking out policies recommended to them by bulk providers, hopping online, filling it out and thinking: yay, I’m covered; and then it comes time to claim and it doesn’t get paid out.’’
Last year, Alexander’s company had a record number of breast cancer claims in excess of $2 million.
Southern Cross Health Society also recorded a nine per cent increase. Chief marketing officer Chris Watney said it was hard to pinpoint the reason for the rise.
‘‘Previously, a lot of our members would go to the public system for treatment but they’re [now] being encouraged into private by their consultants.’’
He said the increase could also be attributed to the country’s rising rates of breast cancer – up 18 per cent in the past decade, according to the International Agency for Research on Cancer.
The agency has said this is due to more women attending breast screening, an ageing population and lifestyle factors.
While women over 50 were most likely to get breast cancer, about 400 Kiwis under the age of 44 were diagnosed every year.
Stephanie Wiki was one of those but she was in a better position than some, having founded an insurance advisory business.
‘‘I had a lot of knowledge about the disease prior to being diagnosed . . . it gave me the strength to think: I’m going to be fine; and while I didn’t need a non-Pharmac drug if I had, I had the right policy to cover it.’’
Wiki, who is now cancer-free, said insurance companies were within their right to decline certain drugs.
‘‘Make sure your policy doesn’t have an exclusion for nonPharmac-approved drugs ... read the fine print and know the right questions to ask.’’