027 248 9320 theo@uprotectnz.com

The cost of life-saving cancer drugs CAN be covered by medical insurance

While recently enjoying a Sunday-morning coffee at Millies in Millwater on the Hibiscus Coast, I read in the Herald on Sunday the very sad story of a fit, non-smoker who was diagnosed with stage 4 metastatic lung cancer.  The article noted that

“… that the “miracle drug” keeping Julie alive, known as Osimertinib (Tagrisso), costs them nearly $11,000 a month in New Zealand because it is not funded by Pharmac and it is not covered under any health insurance”.

The comment that the cost of this specialised cancer drug is not covered under any health insurance is totally wrong, for the following reasons:

  • Drugs that are Medsafe-approved but not funded by Pharmac (such as Osimertinib) ARE covered by a number of medical insurance policies. Conversely, it is important to be aware that there are also a range of basic medical insurance plans that either do not cover the cost of such drugs, or if they do, will cap the cost at a very low level ($8,000-$10,000 per year). For expensive cancer drugs, such basic cover is therefore largely meaningless;
  • Medical insurance policies are NOT created equal: some are entry-level plans which provide very basic cover. The superior plans DO provide cover for the cost of expensive cancer drugs in the sum of between $300,000 to $600,000 per year.

The sad situation outlined in the Herald on Sunday article highlights the importance of working with a specialist insurance adviser who has access to, and knows, the good-quality products and medical insurance policy wordings across the market and can explain what medical insurance covers.

If you wish to consider medical insurance, the expert insurance advisors at UprotectNZ on the Hibiscus Coast will guide you to a plan that will cover the cost of expensive drugs that are not publicly funded by Pharmac and we will outline exactly what medical insurance covers. Please contact us.

That’s what we do.