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Small business cancer diagnosis and claims process

When a member of your team is worried about possible cancer, it can be difficult to think about anything else. They will want to speak to a medical professional quickly, so they can get the answers they need. 

We’ve included some FAQs and answers to some common questions about how our cancer diagnosis and claims process works for our small business health insurance at AXA Health, so you and your team can know exactly what to expect.

Is cancer cover included in my AXA Health policy?

At AXA Health, we think that the best way for you to get the healthcare cover that works for your business is to let you build your plan yourself. We offer a range of cover options, so you can build a plan that works for you and your team. Whether you want to prioritise fast access to diagnosis for your team, or you’d like to provide mental health support^, we offer a wide range of cover options for you to choose from.

If you include one of our Outpatient options or our Diagnostics Only option on your plan then you and your team will be covered for diagnostics to detect cancer.^ Following the diagnostics, if your employee gets a confirmed diagnosis of cancer then the treatment and monitoring of their cancer will be covered if you have included the Treatment with Comprehensive Cancer Cover option on your plan.

Find out more about our Outpatient and Diagnostics Only options, including what we do and don’t cover.

^Individual exclusions may apply, regardless of group cover

Treatment with Comprehensive Cancer Cover option

Our Treatment with Comprehensive Cancer Cover option aims to reduce the impact of cancer on your wider health, as well being there to support you and your family.

Adding our Treatment with Comprehensive Cancer Cover option to your policy means you and your team can have access to the following benefits:

  • Prompt access to expert help – With AXA Health, there’s no need to get a GP referral in order to access a diagnosis for skin, prostate and breast concerns – your employee would just need to call us and, if appropriate, we’d help to arrange for them to get the right diagnostic appointment or assessment. To use this service, you'll need to have included either an Outpatient option or our Diagnostics Only option on your plan. Our Check4Cancer pathway is available to members aged 18 and over.
  • Dedicated support – If your employee receives a cancer diagnosis, we will provide them with a Dedicated Cancer Care Manager who will help them navigate the complexities of treatment and support them every step of the way
  • 24/7 access to support – Our 24/7 health support line means your employees will be able to speak to a nurse or counsellor day or night, so they’ll be able to get support with any health questions they have
  • Health coaching – We offer a dedicated health coaching service for people with cancer. A trained health coach will provide expert advice and support in working towards your employees personalised goals such as diet and nutrition and sleep
  • Fatigue management – For members diagnosed with cancer, we provide access to the app Untire, which helps reduce the impact of one of the most common side effects of cancer and its treatment – cancer-related fatigue
  • Freedom to choose treatment at home – We give members the option to choose to receive chemotherapy at home, where clinically appropriate
  • Costs of licensed drugs covered – If your specialist recommends it, we will cover the costs of licensed drugs being prescribed within the terms of their licence

Find out more about our Treatment with Comprehensive Cancer Cover option, including what we do and don’t cover.

What does the cancer diagnosis process involve with AXA Health?

For skin, breast and prostate concerns, your team won’t need to get a GP referral. The cancer diagnosis process below will apply. Please note, the diagnosis pathways are available to members who are symptomatic, we don’t cover preventative/screening when there are no symptoms. 

  • Step 1: Your team member calls our claims team on the number shown in their membership handbook
  • Step 2: They will then speak to one of our Personal Advisors, who will ask them about their symptoms and concerns to check whether the particular diagnosis pathway is the best option for them and if they are eligible. They may also ask about their previous medical history in relation to what they are experiencing, in order to determine whether they are eligible through their plan. 
  • Step 3: The Personal Advisor will then transfer your employee through to our trusted third party diagnosis pathway provider, Check4Cancer. Depending on whether your employee is calling about a breast, skin or prostate concern, the following process will then apply:

  • For breast concerns, an appointment will be booked for your employee as soon as possible to attend a One Stop Breast Clinic
  • During the appointment, they will receive a breast assessment and all the relevant tests will be carried out on the same day. This could include clinical examination, breast imaging (mammography and/or ultrasound), core biopsy as appropriate
  • Your employee will usually get their results straight away or within five days if a biopsy was taken. If the results are benign, your employee will be reassured
  • If your employee needs to go on to have further treatment, this will be discussed face to face. They will be asked to call AXA Health to check their cover and eligibility

  • Our provider, Check4Cancer, manages the skin diagnosis service. An appointment will be booked for your employee as soon as possible to see a nurse
  • At the appointment, the nurse will take photos of the lesion and complete a clinical assessment
  • A consultant will then review the photographs and if the lesion is:
    • A chronic skin condition then your employee will be asked to call AXA Health to check cover
    • Benign, not uncertain or causing a problem, your employee will be reassured via a letter and informed they do not need to take any further action
    • Causing a problem, uncertain or possibly malignant then your employee will be contacted via a call to let them know surgery/referral to a consultant is needed which will be arranged by Check4Cancer
  • When your employee sees the consultant, if surgery is needed then this will be performed and their biopsy results will be reviewed
  • Following the results, if they don’t need any further treatment then they will be contacted and advised of this
  • If your employee does need to have further treatment, this is booked in and they will be asked to call AXA Health to check their cover and eligibility

  • For prostate concerns, a confirmed raised PSA is required in order to access our pathway. This could be obtained from an NHS GP, a wellbeing check or through a self-pay service
  • Check4Cancer will carry out an initial triage over the phone. If your employee meets the criteria for direct MP-MRI scan access, they will be offered a scan and consultation appointment usually within 5 working days
  • If they do not meet the criteria for an MP-MRI scan, they will be offered a consultation appointment usually within 5 working days. At the appointment, the appropriate diagnostics will be established
  • Once the initial diagnostics have been performed, the Check4Cancer specialist will establish if an MRI guided biopsy is required
  • When your employee gets a diagnosis, they will asked by Check4Cancer to call AXA Health in order to check eligibility for next steps
  • If the results are clear, but your employee has a high risk of developing prostate cancer, they will be invited to a 6 month and/or a subsequent 12 month follow up with the specialist with a repeat PSA test
  • If your employee receives the all clear after the initial consultation and diagnostics and there are no concerns from the specialist, they will be discharged back to their GP

Our cancer pathways are available to members aged 18 and over and can be location dependant.

What other forms of support do I have available to me as an AXA Health member?

As AXA Health small business health insurance members, you and your team will also have access to the following included as standard, regardless of the cover options you choose:

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Care for cancer and heart conditions

Our experienced healthcare practitioners are available at the end of the phone day or night. Speak to our specialist cancer and heart nurses 9am-5pm Monday - Friday. Outside these hours our experienced nurses and counsellors provide round the clock support by phone.

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24/7 online GP service

Access to video or phone appointments with a GP or Advanced Nurse Practitioner, for up to 20 minutes, so your employees can get the treatment they need. AXA Doctor at Hand is powered by Doctor Care Anywhere. Appointments are subject to availability. Advanced Nurse Practitioners are available 8am-10pm.

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Health information and support

We'll give your employees access to our 24/7 health support line. It comes as standard, no matter what cover options you choose. It takes away any niggling health worries, helping them feel their best and give their best.

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Muscles, bones and joints service

Our muscles, bones and joints service is here to help your people manage or alleviate joint and muscle pain - whether it's a bad back or a sprained ankle. A physiotherapist will assess their symptoms online or over the phone and talk to them about what they could mean. Available for members aged 18 and over. 

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Wellbeing incentives

Such as up to 40% off monthly gym membership for you and your team. Terms apply

Find out more about our small business health insurance, including what we do and don't cover, and get a quote today

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