Cover for cancer
As a Discovery Health Medical Scheme member, you have comprehensive cover for cancer. If you are diagnosed with cancer and once we have approved your cancer treatment, you are covered by the Oncology Care Programme
Registering for the Oncology Care Programme
If you are diagnosed with cancer, you need to register on the Oncology Care Programme. In order to register, you or your treating doctor must send us a copy of your laboratory results as well as:
- Call us on: 0860 99 88 77
- Email us on: DCO_Oncology@discovery.co.za
How we cover Oncology
We cover your approved cancer treatment over a 12-month cycle. This 12-month cycle is individualised depending on when you are diagnosed with cancer.
Oncology and Prescribed Minimum Benefits (PMB)
Cancer treatment that is a Prescribed Minimum Benefit (PMB), is always covered in full.
All PMB treatment costs add up to your cover amount for your plan. If your treatment costs more than the cover amount, we will continue to cover your PMB cancer treatment in full.
Your cover amount depends on the plan you choose. We will cover:
The first R400 000 of your approved cancer treatment on Executive and Comprehensive plans (excluding Classic Smart Comprehensive)
The first R300 000 of your approved cancer treatment on the Classic Smart Comprehensive plan
The first R200 000 of your approved cancer treatment on Priority, Saver, Smart and Core plans
Your cancer treatment, if it is a PMB, at a network provider on KeyCare plans (or state facility on KeyCare Start)
If your treatment costs more than the cover amount, and does not form part of a PMB treatment, we will cover up to 80% of the subsequent additional costs unless the treatment forms part of the extended cover offered by the Oncology Innovation and Extended Oncology benefits
Oncology Innovation Benefit and Extended Oncology Benefit (Executive and Comprehensive plans)
Oncology Innovation Benefit
On the Executive and Comprehensive plans, you have cover for a defined list of innovative cancer medicines that meet the Scheme’s criteria. You will need to pay 25% of the costs of these treatments.
Extended Oncology Benefit
On the Executive and Comprehensive plans, you also have extended cover in full for a defined list of cancers and treatments that meet the Scheme’s criteria.
Advanced Illness Benefit
Members in advanced stages of cancer have access to a comprehensive palliative care programme. This programme offers unlimited cover for approved care at home