Oncology Innovation Benefit: Supporting Access to Cutting-Edge Cancer Treatments
Starting in 2025, we are introducing the Oncology Innovation Benefit to offer cancer patients access to a select list of advanced and high-cost cancer treatments. This fund aims to provide crucial support to members undergoing treatment, making it easier to access cutting-edge therapies that may otherwise be out of reach.
What is the Oncology Innovation Benefit?
The Oncology Innovation Benefit provides coverage for a defined list of high-cost medicines and innovative technologies that have shown significant promise in the treatment of cancer. These treatments will be available to members who meet the necessary clinical criteria, as determined by our team of specialists. Approval for coverage is subject to review by our expert panel, which evaluates each case based on individual needs.
How does it work?
From 2025, the Oncology Innovation Benefit will cover up to 75% of the cost of approved medicines, with members contributing either 25% or 50% of the cost, depending on the treatment prescribed. The exact percentage covered depends on the specific medicine or technology prescribed to you. This benefit applies to treatments that meet specific clinical criteria and have been authorised by the fund's specialist panel.
What are the coverage limits?
The fund will cover treatments up to a maximum of R250,000. If the cost of your treatment exceeds this limit, we will continue to pay up to 75% or 50% of the Fund Rate, depending on the medicine prescribed. If your service provider charges more than the Fund Rate, you will be responsible for covering the difference. In some cases, this could be more than 25% or 50% of the total cost if the treatment is priced above the Fund Rate.
Why is this important?
Cancer treatments can be prohibitively expensive, and new, innovative therapies often come with high costs. The Oncology Innovation Benefit aims to alleviate some of this financial burden by providing members with substantial financial support. This initiative ensures that our members have access to the latest and most effective cancer treatments, helping to improve the quality of care and outcomes for those battling cancer.
Additional Information
For further details about your cover and how to access these benefits, please refer to the Oncology Innovation Benefit, which provides comprehensive information on all the benefits and how they work.