Cancer Treatment
The Standard Care Plan offers you access to an Oncology management programme to assist with the management of cancer. Registration is compulsory. You have access to an Oncology benefit limit of R367 440 per beneficiary, per 12-month period. This is paid at 100% of SRR for in and out of hospital services subject to Scheme protocols.
After the depletion of the Oncology Limit, the Scheme will cover 80% of SRR and you will contribute towards the balance of treatment costs. Access to care remains unlimited. Innovation drugs will incur a co-payment of 20% from commencement of treatment.
How to register:
As soon as a cancer diagnosis is made, please forward your confirmation of diagnosis via email: oncology@angloms.co.za and call 0860 222 633 to register on the Oncology management programme.
A consultant oncologist and a team of in-house medical staff at the Scheme's Administrator constantly monitor new and innovative drugs for the treatment of cancer, manage the Oncology Programme and will work with your healthcare provider to ensure appropriate care.
Applications for chemotherapy are assessed in accordance with recognised treatment protocols. All drug therapies used for the side-effects of chemotherapy and pain relief need to be authorised. Once you have completed your course of chemotherapy, the Scheme will accept the post-chemotherapy or remission treatment plan. Remember to get your oncologist to register a post-treatment plan for you with the Scheme.
Pharmacy network:
The Designated Service Providers (DSP) for approved oncology medicines are Dis-Chem Oncology Courier Pharmacy, Medipost Pharmacy, MedXpress, MedXpress Network Pharamcy, Qestmed, Olsens Pharmacy or Southern Rx for oncology medicines administered in rooms, or scripted and dispensed medicines at a retail pharmacy. No co-payment will apply in 2025 for the use of a non-DSP.
Innovation medicine:
Funding is available for a defined list of innovative cancer medicines. The Scheme will pay 80% of the Scheme Reimbursement Rate for these treatments.
Treatments:
The programme covers a wide range of treatments and services, including chemotherapy, radiotherapy, hormonal therapy, consultations, blood tests, radiology, and more.
Hospital admissions:
Approved hospital admissions for surgery and chemotherapy or radiotherapy are funded according to your plan. Most medical expenses for surgery will be paid from the Risk Benefit and not your Oncology Benefit.
Bone marrow transplants:
The Scheme funds bone marrow donor searches and transplants up to the Scheme Reimbursement Rate.
Diagnosis tests: All investigative tests related to pathology and radiology, prior to your diagnosis, will be paid from an unlimited benefit on the Managed Care Plan and a limited pathology and radiology benefit limit on the Standard Care Plan.
More information on the oncology benefits is available in the Oncology Management Programme information that you will receive on registration.
Oncology Benefit