Oncology Programme

Members registered on the Oncology Programme have access to chemotherapy, medicines and materials, radiation in- and out-of-hospital and PET scans. All Oncology treatment allocates to a threshold of R250 000 applies per beneficiary per year, subject to Prescribed Minimum Benefit. Once the threshold is reached, non-PMB claims are paid at 80% of the Fund Rate.

If the treatment is PMB-related, the Fund will continue to pay for any authorised treatment that may still be necessary. You must make use of the Fund's DSPs, where applicable.

Full cover for medicine for the treatment of cancer if obtained from a DSP pharmacy provided the medicine is selected from the Fund's list of preferred products.

Oncology Innovation Benefit

The Fund provides limited benefits for cancer patients requiring access to a list of cutting-edge and high-cost cancer treatments. The Fund will cover specific medicines and depending on what is prescribed for you, we will cover 50% or 75% of the cost. The treatment must meet certain clinical criteria and be approved by our panel of specialists.