Our cancer cover explained

Our cancer cover explained

Our plans can help with faster cancer diagnosis, which is key to successful treatment. We cover eligible scans and consultations up to diagnosis, including MRI and PET scans.

If cancer is diagnosed, we don’t cover the private treatment of it but can still support people going back into the care of the NHS. And throughout, you and your team will have the additional support of a dedicated cancer phone line, to help you and family members with questions and information.

Why don’t you cover cancer treatment?

We’re often asked if Equipsme is too good to be true. It isn’t. We do exactly what we say we do – simple plans, transparent pricing, up front terms and conditions and a focus on sustainable pricing, so more businesses can cover more of their people.

One way we’re able to keep our prices competitive and sustainable, is that we’ve very carefully chosen not to include cancer treatment, but we do include faster private diagnosis which is proven to save lives1.

We know cancer is emotive and a big concern, but treatment also comes at a big cost. It means some businesses can end up facing huge increases at renewal and that might mean having to cancel the policy if it’s no longer affordable.  We don’t want that, and employees don’t want to pay high P11D tax on expensive private medical insurance.

Our approach is to get our members with private diagnosis on their plan a faster cancer diagnosis. After that the NHS is often best placed, with more expertise, to provide the care, support and attention people need.  You’re also likely to end up being treated by the same Oncology specialist who saw you through the private diagnosis pathway.

Is cancer a concern for your business?

The risk of cancer increases with age, with half of all people with cancer in the UK aged over 702. The average age of Equipsme members is closer to 40 and according to the ONS 63% of the working population is aged 16 to 643. We have chosen to support the bulk of working age adults by charging the same for all employees aged 16-69, anywhere in the UK.

Faster diagnosis is key

What an Equipsme plan can do for you and your team is to get you answers and get you on the right path faster– and that’s incredibly important when it comes to cancer. The earlier you catch it, often the easier it is to treat.

For example, bowel cancer is the 4th most common cancer in the UK4 .While there are different types and grades of bowel cancer, when it’s spotted at Stage 1 before spreading elsewhere, 90% of people will survive bowel cancer for 5 years or more after their diagnosis. At Stage 4, only 10% will5.

And figures from the NHS, as at April 2024, show that once a diagnosis and treatment plan is agreed, treatment starts quickly – 89%5 of people diagnosed with cancer start treatment within 31 days, that compares to a target of 96%6. For the remaining 11% who didn’t start treatment within 31 days, this could be due to hospital delays, but most likely the need for complex treatment plans and further tests, scans and genetic results, to agree the right treatment pathway.

How Equipsme helps with diagnosis

Getting your symptoms checked out is essential. Equipsme members have access to a private GP who can arrange an ‘Open Referral’ to a cancer specialist for diagnosis, on Equipsme plan levels 1, 2 and 3. All members have to do is share the open referral letter with the Equipsme claims team at AXA Health, who will confirm if they are covered and if so, then help organise the referral to a private specialist at a convenient location and time.

“The Equipsme GP was great and provided a referral letter so I could contact AXA Health. They asked me some questions to make sure my claim was covered and it was, so they authorised a specialist consultation immediately. I was able to see someone privately within 4 days instead of having to wait weeks on the NHS.

I have been able to get support both privately and through the NHS. I’ve been able to see a specialist consultant and have a CT scan done privately and have blood tests done on the NHS. My longer-term treatment will be on the NHS, but I’ve found out what’s wrong early and now have a clearer idea of what’s going on which is a huge relief”.   Equipsme member

How does the relationship with the NHS work?

The NHS is brilliant at cancer care, and while the speed with which you can get back into NHS cancer treatment may vary, depending on where you live, we’ve found that the private and NHS sectors often work seamlessly together. Many consultants will work for the NHS, but also practice privately and they’re well used to referring private clients back into the NHS. And health information, like appointments and test results, is accessible by specialists and nurses working in the private sector and NHS.

What does the cancer care line do?

All Equipsme members can access the AXA Health Cancer Care team. The helpline is covered 24/7 by nurses and counsellors who can help answer questions, explain terminology, and discuss options. They’re there for families as well as patients themselves. And sometimes a listening and expert ear can really, really help. Because you don’t have to go through cancer alone.

Pre-existing conditions.

Please be aware that we exclude from physio, consultations, diagnosis and treatment cover any pre‑existing conditions that a person has had in the three years before their cover starts. All claims are subject to the terms and conditions of the Membership Handbook and prior authorisation by the claims team at AXA Health. For more information about what is and isn’t covered please read about ‘Our exclusions here’.

Where can I find more support?

Cancer research
NHS Cancer support
Macmillan Cancer Support

Further reading

What is prostate cancer?
How to check your breasts
What is ovarian cancer?
How to check your testicles

Please note all claims are subject to the terms and conditions of the Membership Handbook and prior authorisation by the claims team at AXA Health.

Sources and links

1. Cancer research links – why early diagnosis is important
2. Cancer statistics for England – House of Commons Library (parliament UK)
3. (Working age population – GOV.UK Ethnicity facts and figures (ethnicity-facts-figures.service.gov.uk)
4. Bowel cancer statistics | Cancer Research UK
5. NHS Cancer waiting times
6. NHS Stats Cancer waiting times

 

What happens when an Equipsme member has cancer symptoms?

If someone has our most popular Equipsme plan, which includes private diagnosis and suspects they may have symptoms that might be cancer, they can take an open referral letter from their NHS GP or the Equipsme GP service and submit a claim to AXA Health. This will then be assessed and if covered, AXA Health can help book an appointment with one of their recognised specialists to investigate the diagnosis further.

When you’re worried about cancer, every day waiting to see a specialist counts.

With Equipsme, people can get seen quickly, get answers quickly – and get on the right path as soon as possible. Tests, such as CT and MRI scans, and consultations that members need to get a diagnosis are included in the diagnosis benefit.

Terms and conditions do apply so if you are interested in an Equipsme plan we do recommend reading our full documentation. If you have any questions on what can be a complicated subject, please feel free to contact us.  If necessary, we will seek clarity from our insurance partner, AXA Health.

The consultant, and the specialist cancer nurses on our helpline, can then help answer questions if the patient has to go back into the NHS for their treatment.

How does the relationship with the NHS work?

Many consultants will work for the NHS, but also practice privately. They’re well used to referring private clients back into the public health system. The NHS is brilliant at cancer care, and while the speed with which you can get back into NHS cancer treatment may vary, depending on where you live, we’ve found that the private and NHS sectors often work seamlessly.

How do you support people who have cancer?

We’ve got a great team of specialist cancer nurses who work at the AXA Health cancer & heart helpline. They’re there to answer all the questions people forget to ask at their NHS appointments, explain all the jargon and options – and offer emotional support to cancer patients and their families.

Access to the 24/7 nurse helpline includes questions about family members. If you need advice day or night, they are there for you.

Can you promise that prices will stay low because of your cancer exclusion?

We can’t guarantee that prices won’t increase in future but we’ve been around since 2018 and have only increased our prices three times (correct as at April 2024).

By contrast, traditional PMI premium rises can be more than 10% each year. Some providers may also increase renewal premiums for the entire workforce if someone from the company has used their plan for cancer treatment. This could make cover unsustainable for a business to keep funding.

More stable pricing also helps maintain more sustainable P11D costs for your team. They too are affected by annual price increases and employees may ask to be removed from the scheme because it becomes too expensive.

Sustainability is important, especially when businesses are looking at whole of workforce cover, with Equipsme we have designed our plans to reduce the risk of surprises waiting down the line.

What if I want full cancer treatment cover?

If you’re looking for gold‑plated, bells and whistles private medical insurance, Equipsme probably isn’t for you. We recommend looking at some of the larger household names or talking to a specialist broker about your requirements.

But if you’re looking for something practical, usable, and good value for money – that works for everyone – then you’ll find we’re pretty unique

Get a quote for your business today