{"id":255,"date":"2019-06-13T06:39:20","date_gmt":"2019-06-13T06:39:20","guid":{"rendered":"https:\/\/www.innov8fs.co.za\/blog\/?p=255"},"modified":"2026-03-18T11:46:47","modified_gmt":"2026-03-18T11:46:47","slug":"are-you-sure-you-are-covered-medical-aid-cover-vs-treatment","status":"publish","type":"post","link":"https:\/\/www.innov8fs.co.za\/blog\/2019\/06\/13\/are-you-sure-you-are-covered-medical-aid-cover-vs-treatment\/","title":{"rendered":"Are you sure you are covered? &#8211; Medical Aid cover vs Treatment"},"content":{"rendered":"<p>The study looked at the financial fallout of new cancer diagnoses on the finances of 9,5 million people older than 50 from 1998 to 2014, at two and four years after diagnosis. The study found that by the second year, a whopping 42,4% had depleted their entire life\u2019s assets. After year four, financial insolvency was 38,2%, with \u201cseveral consistent socio-economic, cancer-related and clinical characteristics remaining significant predictors of complete asset depletion. \u201cAs large financial burdens have been found to adversely affect access to care and outcomes among cancer patients, the active development of approaches to mitigate these effects among already vulnerable groups remains of key importance,\u201d the study\u2019s authors noted. Cancer patients in the US were found to be 2,65 times more likely to file for bankruptcy than those without cancer.<\/p>\n<p><strong>Hidden costs iro Medical Aid cover vs Treatment<\/strong><\/p>\n<p>Additional, hidden costs Whether or not you belong to a medical scheme, there are additional, hidden costs of cancer that ambush the pocket: Non-deductibles and co-payments for treatments, supportive care and other services, along with non-medical costs, such as childcare and loss of income. In South Africa, cancer is a prescribed minimum benefit, so if you belong to a medical scheme, your treatment will be covered \u2013 to an extent. And if you don\u2019t, you should be fairly well taken care of by the public health system. Dr Maritha van der Walt, chief medical officer at a large insurer, says consumers aren\u2019t acquainted with their medical scheme and life policies, so they don\u2019t know what cover they have \u2013 or that there are definite limits to that cover.<\/p>\n<p><strong>Some cancer treatments are more costly than others<\/strong><\/p>\n<p>Some cancers are more costly than others and not all available treatments \u2013 particularly those in trial phase \u2013 are covered. \u201cPeople get desperate,\u201d she says. \u201cThey hear about a new-generation treatment in Israel or elsewhere, and they want to travel to get it.\u201d And not enough attention is paid to the \u201chidden costs\u201d of the disease: For additional care, duration of treatment and recovery and travel for treatment. Van der Walt says often a spouse or parent needs to stop working and that loss of income isn\u2019t covered in most policies. \u201cAnd if you aren\u2019t near an oncology centre, you need to travel \u2013 there might be special rehab, beds, equipment, prosthetics, wheelchairs, etc.\u201d<\/p>\n<p><strong>Protect yourself financially against cancer diagnosis treatment<\/strong><\/p>\n<p>Dread disease cover David Weare, franchise principal at Momentum Consult, says that, given the prevalence of cancer, it\u2019s \u201cextremely important for clients to protect themselves against dread diseases and ensure a continuation of their lifestyle in the event of a life changing-event such as being diagnosed with cancer. \u201cCancer stats are continuously rising in South Africa, so having dread disease cover in place will make a huge difference to help with any expenses not covered by your medical scheme when seeking treatment.\u201d Page 2 of 2 Weare says having a financial plan in place will provide you with a snapshot of your financial position and will highlight any shortfalls or surpluses in your plan for death, disability and critical illnesses.<\/p>\n<p>New cancer cases have increased by 33% in the past decade, with \u201clifestyle cancers\u201d linked to smoking, bad diet and sun exposure rising particularly rapidly in developing countries, according to the World Health Organization. Precision medicine George Kolbe, the head of marketing for life insurance at Momentum, says cancer is an expensive disease to treat and, although medical schemes do give access to treatments, some of these might be capped in the long run. \u201cAdded to this is the cost of cancer treatments versus the quality of care that is actually provided, meaning how well individuals respond to cancer treatments, taking into account the side effects, and how many years it actually adds to their lifespan.<\/p>\n<p>\u201cThis is where precision medicine can make an immense difference when it comes to increased success of cancer treatments, limited side effects and the cost-effectiveness of the treatment. Even though our understanding of precision medicine is still in its infancy, it is well on its way to evolve into targeted treatments with verifiable outcomes \u2013 but those treatments are the ones that are very costly new-generation, precision immunotherapy drugs can cost R1 million.\u201d Kolbe notes: \u201cFrom an insurance point of view, precision medicine does open up new avenues with regards to the way that critical illness cover is structured, especially with early diagnosis.<\/p>\n<p><strong>Affordability of Cancer Cover <\/strong><\/p>\n<p>With affordability always an important consideration, it is vital for insurers to provide both tiered pay-out critical illness cover options and options that pay 100% earlier on, with both options covering the same events. \u201cSelecting the tiered pay-out options ensure that higher cover amounts are more affordable and the financial needs of clients are met as they arise; paying out a smaller percentage on diagnosis of lower severity events and more, if and when, the event progresses.\u201d He says comprehensive critical illness cover provides clients with additional funds that offer more choice, based on tailored preferences rather than generic availability.<\/p>\n<p><strong>Are you sure you are covered?<\/strong><\/p>\n<p>Know your benefits Van der Walt, who is also the convener of the medical underwriting standing committee at the Association for Savings and Investment South Africa, says: \u201cBe aware of your benefits. Many people don\u2019t know they have group risk cover through their employer. See your financial adviser to find out about group life cover and other benefits. \u201cPeople don\u2019t know or ask for a benefit statement \u2013 they don\u2019t understand the difference between the various policy types.\u201d Start showing an interest in the cover you have, she says. \u201cWe need to be aware, these things are happening, to young people too. It\u2019s happening to people we didn\u2019t think were at risk. These are lifestyle-changing events. Ask those difficult questions: If you get sick, injured, impaired or die, what happens?\u201d<\/p>\n<p>Do you have critical illness cover? Need a quote? Contact us \u2013 email: natasha@innov8fs.co.za or call: 0747311019<\/p>\n<p>Source: Momentum<\/p>\n<p>Authorised Financial Services Provider FSP 22205<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The study looked at the financial fallout of new cancer diagnoses on the finances of 9,5 million people older than 50 from 1998 to 2014,&hellip;<\/p>\n","protected":false},"author":1,"featured_media":256,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[35,36],"class_list":["post-255","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-cover","tag-medical-cover","tag-treatment"],"_links":{"self":[{"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/posts\/255","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/comments?post=255"}],"version-history":[{"count":1,"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/posts\/255\/revisions"}],"predecessor-version":[{"id":257,"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/posts\/255\/revisions\/257"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/media\/256"}],"wp:attachment":[{"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/media?parent=255"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/categories?post=255"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.innov8fs.co.za\/blog\/wp-json\/wp\/v2\/tags?post=255"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}