Dubai: Doctors' advice stipulates that all women above the age of 40 should undergo annual breast cancer screening. However, unless you've actually found a lump, or go to the doctor with a pre-existing condition, it's unlikely to be covered by insurance.
Free cancer screening is hard to come by, unless you've specifically paid to add it to your insurance policy.
A mammogram can cost anywhere between Dh400-Dh700, depending on which establishment you visit. This is sometimes coupled with an ultrasound, which can raise the cost to almost Dh1,000.
This raises a question over how much preventive screening is actually carried out — many cannot afford to pay the above costs, and others are unlikely to go for a test that isn't covered by their insurance plan.
"Preventative screenings are generally not covered in a standard policy. At AXA however, we offer the ‘health screen' benefit that pays for screenings up to a limit per year," Edouard Lesellier, Head of Regional Corporate Offering Health & Group Life, AXA Insurance Gulf, said.
In terms of treatment, he continued: "As long as the cancer is not a pre-existing condition at the time of signing up for the policy, cancer treatments are covered by us in full."
Essentially, you can have cancer treatment covered, but not prevention under a standard policy.
At Oman Insurance, the conditions are similar. "Almost all screening tests [are] covered in most of our insurance policies once clinically indicated," Dr Hazem Al Madi, Executive Vice-President, Head of Health Insurance Department, Oman Insurance Company, said.
"[A] Grand majority of our insurance subscribers are insured within group medical policies that doesn't exclude pre-existing conditions, that is, cover pre-existing conditions," the doctor continued.
In Abu Dhabi, some insurance plans offer annual breast and prostate cancer screening. Dr Michael Bitzer, CEO, Daman, said: "Female members aged 35 and above enrolled in Daman's enhanced health insurance plans are offered a free annual breast cancer screening. The screening includes a clinical exam, mammogram, CA 15.3 [a test specific to breast cancer] and pelvic sonogram." This relates to group and individual plans.
Goolcher Navdar, 50, had a mammogram two years ago, which showed that she had some cysts in her right breast. Last year she lost her job, and without any insurance, she didn't have the annual test she needed.
Thanks to a free mammogram this year, the cancer in her left breast was detected in time for surgery.
"What happened to me has been completely out of the blue, I never expected critical illness like cancer happening to me or anybody in my family. You always think it happens to other people, and we take our health for granted," she told Gulf News from her hospital bed.
Navdar afterwards found out that the cancer has spread to her lymph nodes, and she is currently undergoing intensive radiation therapy.
Extra insurance may be necessary
Health insurance cover for cancer screening always depends on the contractual terms of the insurance policy, the UAE Insurance Authority (IA) told Gulf News.
If the contract between the insurance company and the customer undertakes that screening is covered under the policy, the company is liable to pay the medical bills of the screening, Fatima Mohammad Al Awadi, Deputy Director General, IA, said.
If the company does not pay the bill in such cases, the customers can approach the authority, she said.
Customers who want coverage for screening have to ensure it's covered. If not they have to look for another policy, probably paying an extra amount.
"If they want any particular extra services, they can request the company to add it for which the company may sometimes demand some extra money."
Some insurance companies may add exception clauses in the contract to avoid covering serious illnesses, Fatima said.
In this case, customers have to pay a higher premium.
Thus, there are no uniform contractual terms and conditions for health insurance policies: they depend on customers' demands and offers from companies, the official clarified.
— With inputs from Dina El Shammaa, Abu Dhabi Deputy Editor
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