Cancer Treatment 

Every year South African medical schemes ask their members to review their plans and their cover and to make amendments to their benefits. Yet many people fail to do this and in this way they neglect to keep their cover up-to-date and relevant to their risk and their age.  

The risk of contracting cancer is high and treatment is extremely expensive. Many medical aid members are shocked when they learn that their specific plans do not fully cover the cost of life-saving treatment.  

The window period for making changes to a plan is normally afforded in December of each year. If members do not make use of this time, they are generally unable to make changes to their cover until the next window period; a year later. In order to make informed decisions it is vital to fully understand the terms and conditions of your plan. You need to know exactly what the nature of the cover will be when you contract a dread disease such as cancer. 

Make sure you know what your plan offers 

Cover for cancer treatment is a contentious issue. Many medical scheme members discover to their horror when they make claims that the cost of treatment for cancer will not be covered or that only a small portion of the cost is covered. Cancer treatment is horrendously expensive. That is why organizations such as Campaigning for Cancer have embarked on promotional and informational campaigns.

Medical aid members need to know exactly what they can expect from their medical schemes if they contract this dread disease.  

It may be worth it to consider the following ideas when thinking about oncology benefits: 

• Your plan needs to offer you cover of at least three hundred thousand rand per annum per member or beneficiary for oncology treatment. Anything less than this amount will not be sufficient.
• Do not believe it when your medical scheme says “unlimited cover”. This often means that they will pay ongoing costs but only at medical aid rates, which is inevitably much lower than the actual costs.
• Medical schemes often refuse to pay for the latest treatment options and will only pay claims for standard treatments such as chemotherapy.
• The cover offered by many schemes will not ensure any treatment better than that which is available from state hospitals. In fact, many medical aid members will be forced to undergo treatment at state facilities.
• The latest medication for cancer treatment can cost up to half a million rand a year. You would want the latest, most innovative treatment if you contract cancer. Check with you medical aid and make sure you know exactly what they will pay and what they will not cover. 

When your medical scheme affords you the opportunity to amend your plan and your benefits, it may be a good idea to obtain clarity about cover for cancer treatment. You may not want to think about the issue, but it is important that you make sure that you will be receiving the latest and best treatment should such a calamity strike you or your loved ones.  © Medical Aid Plan

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