Oncology/Cancer

HIGH COVER LEVEL 1

BONITAS

2021
BonComprehensive

BESTMED

2021
Pace 3

DISCOVERY

2021
Classic Comprehensive

FEDHEALTH

2021
MaximaExec

MEDIHELP

2021
Plus

MOMENTUM

2021
Extender –
Any Hospital, Any Chronic

R618,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R245,400 for specialised/biological drugs, R44,220 for Brachytherapy

Unlimited. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R400,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

Limited to R600,600 and R187,300 for specialised medications at ICON, subject to level 2 treatment protocols. 40% co-payment for use of non-DSP

ICON enhanced protocols apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (10%)

R500,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

HIGH COVER LEVEL 2

BONITAS

2021
BonClassic

BESTMED

2021
Page

DISCOVERY

2021
Essential Comprehensive

FEDHEALTH

MEDIHELP

2021
Elite

MOMENTUM

2021
Extender: Any (Chronic: Any)

R410,400 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

Unlimited. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R400,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

PMB Unlimited
Non-PMB limit of R415,600 pfpa Protocols and DSP (ICON) apply. Co-payments apply to voluntary non-network services (10%) and/or deviating from protocol (15%)

R500,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

MEDIUM-HIGH LEVEL 1 COVER

BONITAS

2021
BonComplete

BESTMED

2021
Pace 1

DISCOVERY

2021
Classic Priority

FEDHEALTH

MEDIHELP

MOMENTUM

R344,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

MEDIUM-HIGH LEVEL 2 COVER

BONITAS

2021
Standard

BESTMED

2021
Pace 1

DISCOVERY

2021
Classic Priority

FEDHEALTH

2021
FlexiFed 4 Any Hospital

MEDIHELP

2021
Prime 3

MOMENTUM

2021
Incentive:
Any Hospital, Any Chronic

R344,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

Limited to R480,400 at ICON, subject to level 1 treatment protocols. 40% co-payment for use of non-DSP

PMB Unlimited
Non-PMB limit of R273,700 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

R400,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

MEDIUM-HIGH LEVEL 3 COVER

BONITAS

2021
Standard Select

BESTMED

2021
Pace 1

DISCOVERY

2021
Essential Delta Comprehensive

FEDHEALTH

2021
FlexiFed 4 GRID

MEDIHELP

2021
Prime 3 Network

MOMENTUM

2021
Incentive – Associated Hospital, Associated Chronic

R344,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R400,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

Limited to R480,400 at ICON, subject to level 1 treatment protocols. 40% co-payment for use of non-DSP

PMB Unlimited
Non-PMB limit of R273,700 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

R400,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

MEDIUM-LOW COVER 1

BONITAS

2021
BonSave

BESTMED

2021
Beat 3

DISCOVERY

2021
Classic Saver, Coastal Saver & Classic Delta Saver

FEDHEALTH

2021
Unify

MEDIHELP

2021
Prime 3 (Network)

MOMENTUM

2021
Incentive – Any Hospital, Associated Chronic

R344,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

Limited to R300,200 at ICON, subject to level 1 treatment protocols. 40% co-payment for use of non-DSP

PMB Unlimited
Non-PMB limit of R240,840 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

R400,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

MEDIUM-LOW COVER 2

BONITAS

2021
Primary

BESTMED

2021
Beat 2

DISCOVERY

2021
Essential Saver

FEDHEALTH

2021
FlexiFed 2 Any Hospital

MEDIHELP

2021
Prime 2

MOMENTUM

2021
Incentive – Any Hospital, Associated Chronic

R165,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

Limited to R300,200 at ICON, subject to level 1 treatment protocols. 40% co-payment for use of non-DSP

PMB Unlimited
Non-PMB limit of R240,840 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

R400,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

MEDIUM-LOW COVER 3

BONITAS

2021
Primary Select

BESTMED

2021
Beat 2 Network

DISCOVERY

2021
Essential Delta Saver

FEDHEALTH

2021
FlexiFed 2 GRID

MEDIHELP

2021
Prime 2 Network

MOMENTUM

2021
Incentive – Associated Hospital, Associated Chronic

R165,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

Limited to R300,200 at ICON, subject to level 1 treatment protocols. 40% co-payment for use of non-DSP

PMB Unlimited
Non-PMB limit of R240,840 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

R400,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

MEDIUM-LOW COVER 4

BONITAS

2021
BonFit Select

BESTMED

2021
Beat 3 Network

DISCOVERY

2021
Essential Delta Saver

FEDHEALTH

2021
FlexiFed 3 GRID

MEDIHELP

2021
Prime 2 Network

MOMENTUM

2021
Incentive – Associated Hospital, Associated Chronic

R165,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

In & out of Hospital: Unlimited, subject to pre-authorisation. Co-payment of R2,380 applies for non-PMB scans

PMB Unlimited
Non-PMB limit of R240,840 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

In & Out of Hospital: Unlimited. subject to pre-authorisation. R2,480 co-payment aR400,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

HOSPITAL COVER 1

BONITAS

2021
Hospital Standard

BESTMED

2021
Beat 1

DISCOVERY

2021
Essential Core

FEDHEALTH

MEDIHELP

MOMENTUM

2021
Custom – Any Hospital, Associated Chronic

R165,500 per family, subject to DSP (ICON), pre-authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

R300,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

HOSPITAL COVER 2 

BONITAS

2021
Bon-Essential

BESTMED

2021
Beat 1

DISCOVERY

2021
Essential Core

FEDHEALTH

MEDIHELP

Custom – Any Hospital, Associated Chronic

MOMENTUM

2021
Prime

Subject to PMB and DSP (ICON), pre- authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

PMB Unlimited
Non-PMB limit of R220,000 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

R300,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

HOSPITAL COVER 3

BONITAS

2021
Bon-Essential Select

BESTMED

2021
Beat 1 Network

DISCOVERY

2021
Essential Delta Core & Coastal Core

FEDHEALTH

FlexiFed 1 Network Hospitals

MEDIHELP

Custom – Associated Hospital, Associated Chronic

MOMENTUM

2021
Prime 1 Network

Subject to PMB and DSP (ICON), pre- authorisation and registration on the Oncology programme. Sublimit of R44,220 for Brachytherapy

PMB only. Subject to registration on Oncology programme. DSP: ICON

Oncology Programme covers first R200,000 of approved cancer treatment over 12 month period. Unlimited thereafter, with a 20% co- payment

Covered up to PMB level of care at ICON, subject to level 1 treatment protocols. 40% co-payment for use of non-DSP

PMB Unlimited
Non-PMB limit of R220,000 pfpa Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (20%)

R300,000 per beneficiary per year, thereafter a 20% co-payment applies. Treatment must be obtained from an oncologist authorised by the Scheme

Primary Care Network

BONITAS

2021
BonCap

BESTMED

2021
Pulse 1

DISCOVERY

2021
KeyCare Plus

FEDHEALTH

MyFed

MEDIHELP

Ingwe Network

MOMENTUM

2021
Necesse Network

Subject to PMB and Network Provider

PMB only. Subject to registration on Oncology programme. DSP: ICON

Subject to PMB, use of Network cancer specialist and registration on Oncology Programme

Covered up to PMB level of care at ICON, subject to level 1 treatment protocols. 40% co-payment for use of non-DSP

PMB Unlimited
Protocols and DSP (ICON) apply. Co- payments apply to voluntary non-network services (10%) and/or deviating from protocol (25%)

Limited to Prescribed Minimum Benefits at State facilities