Our Oncology Disease Management Programme is specifically designed to support you as a member if you’ve been diagnosed with cancer.
Our Oncology Disease Management team are a group of highly skilled healthcare professionals who work in conjunction with your doctor to ensure that the treatment you receive is both clinically appropriate and cost-effective. Our team is also supported by a number of oncologists and haematologists from the private, public and academic sectors.
What You Get
Our Oncology Disease Management Programme gives you the following benefits:
- Access to the Independent Clinical Oncology Network (ICON): We’ve contracted with ICON, an organisation that includes 75% of all practicing oncologists in South Africa in order to provide your oncology treatment. For more details of the ICON Network, visit www.cancernet.co.za or call 021 944 3750. Alternatively,you can call your Fedhealth Oncology Case Manager on 0860 100 572.
- Coverage for chemotherapy, radiotherapy & associated medicine: We’ll pay for chemotherapy and medicine directly associated with the treatment of cancer, provided a valid authorisation has been obtained. Treatment for conditions not directly related to the treatment of the cancer (e.g. depression) as well as treatment for the long-term conditions that may develop as the result of chemotherapy or radiotherapy will be funded from an alternative benefit (e.g. the Chronic Disease Benefit, the Savings Account or OHEB).
- Consultations & visits: These will be covered while you have either an active chemotherapy or radiotherapy authorisation. Prior to starting treatment and once treatment has been concluded, consultations are paid from the Savings Account or OHEB.
- Pathology: We’ll cover oncology-related pathology claims while you’re receiving either chemotherapy or radiotherapy and for 12 months post treatment.
- Radiology: We’ll cover general oncology-related radiology claims while you’re receiving either chemotherapy or radiotherapy treatment, and for 12 months post treatment.
- Specialised radiology (e.g. CT scans, MRIs, angiography, radio-isotopes): These procedures require a separate pre-authorisation, and will be paid from the Major Medical Benefit.
- PET scans: You can have up to two PET scans per family per year, restricted to staging of malignant tumours.
- Surgery & hospitalisation: These claims will be paid from the Major Medical Benefit, subject to you obtaining a valid authorisation from the Authorisation Centre.
- Stoma therapy: This will be paid from the OHEB first and once depleted, from the Major Medical Benefit. Pre-authorisation is not required.
- Terminal care & private nursing: As part of our Oncology Benefit, the Terminal Care Benefit will cover accommodation in a hospice or terminal care facility for the care of patients in terminal stages of life (subject to a limit). You’ll need to get pre-authorisation from the Hospital Authorisation Centre. Private nursing will be paid from the Alternatives to Hospitalisation benefit, where this is available.
How to Access This Benefit
If you’re a Fedhealth member and want to access the oncology benefit, you’ll need to get pre-authorisation. This process uses a set of cancer guidelines and protocols that are continually updated as new products are launched and new treatment protocols are established.
Need More Information?
Want to know more? Read more about Fedhealth’s oncology benefit here