Customer demand and affordability, not insurers’ budgets, are driving cuts and changes to the way cancer care is covered by private medical insurance (PMI), according to Aviva.
Aviva Health medical director Dr Suba M, was asked at LaingBuisson’s Private Acute Healthcare conference if with increasing costs whether insurers are likely to limit or restrict cover for high cost treatments or drugs?
In response Dr Suba M said there was a misunderstanding that it is insurers that limit such cover.
“Insurers are pooling risks of people and packaging it in a different ways that is available and accessible for people to purchase,” Dr Suba M explained.
“So ultimately it’s the customers.”
“So if we’re saying, actually this is not affordable, it’s because customers are coming to us and saying ‘do you know what? I can’t’. It’s either no cancer versus all the other different things,” Dr Suba M continued.
“We want to keep people at work and have something that’s affordable. So at Aviva we’ve had to have a tiered approach to cancer cover – partly because big corporates with deep pockets can afford all types of cancer cover.
“But then we do have small and medium sized employers who say, ‘one claim will wipe us out’.
“That’s the whole point of insurance – pooling risk.
“But it’s not necessarily insurers trying to protect that budget. It’s more about how can we package it in a way that more customers have access to different ways of financing ways to get better. So it’s both I think.”