Oncology limit on the Standard Care Plan

As we announced in last year October’s MediBrief, as of January 2020, Standard Care Plan members have a limited oncology benefit. The oncology benefit limit is R300 000 per beneficiary over a 12-month period which, for most members, is more than enough. However, if the limit is reached, the Scheme will cover 80% of your treatment costs and, thereafter, you will contribute the remaining 20%. If you are registered for this benefit, you would have received detailed information about what this means for your treatment regime and funding. Please keep an eye on your limit and how much you are using during the year. Further, speak to your oncology case manager and check your statements. If medicines that the Scheme regards as ‘innovation drugs’ are prescribed as part of your treatment, a 20% co-payment and the cost in excess of the Scheme Reimbursement Rate will be for your account.