Oncology Benefits In and Out of Hospital

Hearing that you have cancer and need cancer treatment can strike so much fear in your heart. We all know someone who has had cancer  – the pain, suffering and loss. Some people are so fearful of cancer’s connotations that they avoid visiting the doctor for a diagnosis. They consult a doctor only when their symptoms become unbearable. Radiation, chemotherapy and surgery are some of the therapies to treat cancer. And for many the side effects of these are worse than the cancer itself. They don’t even find out if their medical cover has oncology benefits.

Chronic stress, poor diet and environmental toxins are just some of the conditions that cause cancer. Its devastating to hear you have cancer with a medical aid, but without one, the costs for cancer treatment are so prohibitive, it’s like the end of the world.

Nobody can Afford to Get Cancer

Oncology BenefitsDo you know that between May 2012 and April 2013, the total spend for oncology claimants on Discovery Health’s medical aid was R2,298bn. Many South Africans don’t have medical aid. Tens of millions of people have to rely on  public clinics and hospitals.

Noelene Kotschan is founder and director of Pink Drive. She says that in private care, breast cancer treatment could cost between R750 000 and R1.5-million. That depends on the different treatments required. Medical aid is the only way to afford the care that you need.

Most Medical Aids offer Oncology Benefits

Most of the South African medical aids offer an oncology benefit on the more comprehensive schemes. It is important to know if your medical aid includes an oncology benefit or if you will require extra cover.

If your type of cancer isn’t on the list and your oncology benefits run out, the medical aid will pay for treatments but there will be a co-payment for the treatment. If your cancer  qualifies as a PMB, your medical aid will pay for all your doctor consultations, specialised radiology, radiation, pathology, chemotherapy and surgery, and in this instance, your medical aid scheme may make it that you only use certain health care providers.

With the Discovery Oncology Programme, the medical aid covers the first R200 000 or R400 000 of your approved cancer treatment. That is over a 12month cycle up to the Discovery Health Rate.

Fedhealth’s Cancer Benefits

Fedhealth Medical Aid offers their Oncology Disease Management Programme and with this programme you get the following benefits –

●   coverage for chemotherapy, radiotherapy and associated medicine. If you suffer with depression because of your cancer or you develop long-term conditions because of your chemotherapy for instance, your Savings Account will fund your treatment
●   access to the Independent Clinical Oncology Network (ICON), an organisation which includes 75% of all practicing oncologists in South Africa.
●   they cover pathology, radiology and specialised radiology, stoma therapy, PET scans, terminal care  private nursing, surgery and hospitalisation

Each medical aid in South Africa offers different cancer treatment benefits. When you choose a plan, make sure you are aware of the oncology benefits and various levels of treatment covered. This is  because many medical schemes place an annual limit on the amount that can be spent on oncology and some even exclude some treatments.

It is up to you to find out  all you can and if your particular medical aid will pay for the advanced treatments required with some cancers.