How to Get Coverage for Proton Therapy in Cancer Treatment?

Proton Therapy Coverage in India: Steps, Hospitals & Patient Support

Proton therapy is a type of radiation treatment that involves a beam of protons to treat cancerous and non-cancerous tumours. In medical science, it has shown the potential to restrict symptoms of several kinds of cancer.

Insurance coverage for a patient diagnosed with proton therapy can vary by insurance company. The insurance seeker needs to submit their treatment plan to their preferred insurance company for prior authorisation approval. After this, the company confirms whether it is willing to cover the expenses of the radiation therapy.

Procedure to Seek Insurance Coverage for Proton Therapy in Cancer Treatment

You can choose a reputable healthcare provider or hospital with dedicated teams of patient representatives who work in association with insurance companies on your behalf. They can assist you by:

• Responding to the insurance company’s questions
• Framing letters of medical necessity and uploading necessary documents on your behalf
• Offering treatment plan options as needed
• Engaging in peer-to-peer discussions about your medical recovery
• Initiating and managing appeals on your behalf if the insurance company turns down your request
• Confirming your benefits, eligibility criteria, deductibles, and copayment needs as and when required
   

In India, the following hospitals are well-renowned for performing proton therapy:

• HCG Cancer Centre, Bangalore
• Medanta The Medicity, Gurugram
• Kokilaben Hospital, Mumbai
• Manipal Hospital, Bangalore
• Max Healthcare Saket, Delhi
• BLK-Max Super Speciality Hospital, New Delhi
• Jaslok Hospital, Mumbai
• Max Hospital, Delhi
• Fortis Memorial Research Institute, Gurugram
• Apollo Hospital, Delhi
   

You can get admitted to these hospitals to avail proton therapy if recommended by your doctor. This therapy has been proven to be a cutting-edge treatment option that ensures lasting benefits for cancer patients.

Are There Any Side Effects of Proton Therapy?

Some common side effects of proton therapy are:

• Eating and digestion issues
• Fatigue
• Skin redness around the body part which is being exposed to radiation
• Hair loss around the body part being treated
• Soreness around the body part being treated
• Frequent headaches
   

Who is a Candidate for Proton Therapy?

When you visit an oncologist, their team will offer you various treatment options that can be effective for treating your cancer. Therefore, under their guidance, you will decide which option is suitable for you.

Generally, proton therapy proves to be most beneficial for:
 

• Paediatric patients
• Those who are going to receive radiation for the second or third time
• Those whose tumour is situated close to critical internal organs
• Those who have a considerable life expectancy following radiation and are susceptible to second cancers during their lifetime
• Individuals with inherent conditions that predispose them to excessive toxicity or people who are at a greater risk of second malignancy following radiation
   

Nonetheless, the list discussed here is not exhaustive. It means other groups of patients may also significantly benefit from the proton therapy.