Medical Aid for Cancer Patients

The costs associated with treating cancer can be staggering. Without medical aid cover or the financial means to pay for your treatments in cash, you will have to settle for treatment at a public hospital. Public service strikes, understaffed facilities and overworked state employees are some of the considerations one has to deal with if undergoing cancer treatment at a state hospital.

Fortunately medical aids cannot refuse cover to a person with a pre-existing condition and this includes cancer. With comprehensive medical aid cover, you can rest assured of quality medical treatment at a private hospital and often the oncologist of your choice.

Oncology Benefit on Medical Aid

All medical aids, even hospital plans, have to provide a certain level of oncology (cancer) cover. This may include the oncologist’s fees, chemotherapy and radiation therapy (‘radiotherapy’). The extent of the benefit may vary among medical aids but even if you only have a hospital plan, many schemes may still provide some out-of-hospital oncology cover.

Certain cancers are considered as a Prescribed Minimum Benefit (PMB) and therefore a medical aid is obliged to cover the treatment. However, this may also depend upon whether the cancer is treatable or not. Without a medical aid, attempting to pay for your cancer treatment out of your own pocket may be unmanageable unless you are a high income earner.

Cost of Cancer Treatment

The cost of treating cancer depends on a number of factors like the type of cancer, stage and treatment options that your oncologist may deem necessary to fight the disease. Unlike a benign tumour, cancer cannot be totally obliterated after surgical resection. Chemotherapy and radiation therapy and sometimes even follow-up surgery may be necessary and this can be ongoing for months or even years. The costs can quickly add up and most people can only manage the bills if they have medical aid cover.

It is not unheard of for cancer treatments to reach into the hundreds of thousands of rands. In addition to treating the cancer itself, your doctor may need to consider reconstructive surgery in some cases. This may not be covered by your medical aid and if you have exhausted your financial means by paying for the cancer treatment, you may have to forego reconstructive surgery.

It is important to bear in mind that treating cancer is expensive. Opting for a cheaper medical aid plan may therefore work against you as the costs associated with a cancer patient’s medical needs are significantly higher.

Exclusion Periods for Cancer Patients on Medical Aids

Most medical aids impose a 1 year waiting period before they pay for the treatment of a pre-existing condition. In addition, a medical aid may not pay for any bills within the first 3 months of cover if you had not previously been a member of a medical aid.

Cancer is a disease that needs immediate medical care. Waiting for the 1 year period to pass can be a matter of life or death. It is therefore important to consider medical aid cover while you are young and healthy, especially if you are at risk of developing cancer, rather than waiting for the condition, or any condition, to set it in.

Even if your medical aid will not immediately cover your cancer treatment, it is important to remember that as a cancer survivor, your chance of developing cancer again in the future is higher. Your medical costs in general may also be higher depending on how well you recover after the initial treatment. Therefore medical aid cover is essential.

You should discuss your medical options with an accredited broker or the medical aid itself if you have cancer. Attempting to withhold information when applying for a medical aid is considered as fraud and you may be liable for all the medical costs incurred during the course of your treatment.