Oncology and Cancer Treatment
We pay for cancer treatment from your available Oncology Benefits
It's challenging to hear that you or a loved one has been diagnosed with cancer. Support is an essential part of living with cancer. Our Oncology Programme is easy to use and gives you and your family peace of mind that you have cover for cancer treatment.
How the Oncology Benefit works
The Oncology Benefit gives members cover for approved cancer treatment. All members registered on the Oncology Programme have access to chemotherapy, medicine and materials, in-hospital and out-of-hospital radiation treatment and PET scans.
Your cancer treatment cover
Remedi offers three benefit options to choose from: The Comprehensive, Classic and Standard benefit options.
Your cover will depend on the benefit option you are registered on. From 1 January 2025, the family limit on the Comprehensive and Classic benefit options was removed and your cover is structured per person, limited to an overall oncology benefit limit. This means that your individual cover for cancer will no longer be limited to an overall family limit, giving you peace of mind should you be diagnosed with cancer.
You will be liable for co-payments of up to 20% if you are registered on the Comprehensive or Classic benefit options and have reached your overall individual per person oncology limits. For health professionals who do not have a payment arrangement with the Scheme, your co-payment could be more than 20% if your treatment cost is higher than the Remedi Rate. Health professionals who have a payment arrangement with the Scheme will be funded at 80% of the agreed rate of all further treatment and you will need to pay the balance from your own pocket.
Your individual per person limit is a rolling limit from the date of diagnosis to the following year. This is to allow you sufficient funds to get treatment for each member in the family during their yearly treatment period from date of diagnosis.
Radiology and pathology approved for your cancer treatment are also covered from the Oncology Benefit. Cancer treatment that falls within the Prescribed Minimum Benefits is always covered, with no co-payment if you use service providers who have agreements with us. Members who are registered on the Standard benefit option are therefore assured of sufficient cover for Prescribed Minimum Benefit level of care and adequate cancer cover to pay for your treatment.
Oncology Innovation Benefit
From 1 January 2025, Remedi has introduced cover for members registered on the Comprehensive option for a defined list of innovative cancer medicines that meet the Scheme's criteria. These medicines are not available on the Classic or Standard options. You will need to consult with your healthcare provider to determine whether you may need access to these high cost innovative drugs to access this benefit. You may need to pay 25% of the cost of these treatments. Your healthcare provider can assist you to guide you through your personal treatment programme and the options available to you in terms of your treatment plan.
Oncology Reference Price
From 1 July 2025, Remedi Medical Aid Scheme will introduce an Oncology Reference Price. This is the highest amount we will pay for a group of generic or similar medicines.
- The reference price will apply to chemotherapy, hormonal therapy and supportive oncology medicines.
- Medicines listed on the supportive medicine list (formulary) or the preferred product list will be fully covered up to the agreed rate.
- For medicines not on these lists, we will pay up to the Scheme Rate or Medicine Reference Price, whichever is lower.
What this means for members
- If the cost of the medicine is equal to or less than the Medicine Reference Price, the member will have full cover and the medicine will be completely paid for.
- If the medicine costs more than the Medicine Reference Price, the member will need to pay the difference between the Medicine Reference Price and the provider's price.
Registering on the Oncology Programme
Contact our care team by phoning 0860 116 116 to register yourself or your dependants on the Oncology Programme. You can also email DCO_oncology@discovery.co.za. For more information about the Oncology Programme and the benefit limits available to you on each of the available Remedi Options, access our oncology benefit guide here. For more information about the Oncology Innovation Benefit, click here to read the guide on our website.