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ONCOLOGY PLUS

Our Oncology Plus stand-alone policy, which can be taken in conjunction with any gap policy, will provide additional cover for the treatment of cancer, cover for co-payments as well as provide an extended benefit for biological drugs when an overall annual benefit limit, imposed by a medical scheme, has been reached.

Stratum Benefits

MONTHLY PREMIUM 2016

INDIVIDUAL / FAMILY . . . . . . . . . . . . . . . R 95
PER ADULT DEPENDANT . . . . . . . . . . . .R 60

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OVERVIEW

This option will provide additional cover for out-patient cancer treatment at a registered oncology facility provided it forms part of the medical scheme’s designated provider network

  • Benefit for out-patient cancer treatment is limited to R100 000 per policy per annum
  • Benefit for oncology related co-payments and biological drugs (as per the Stratum Benefits formulary), is limited to R100 000 per policy per annum
  • A once-off benefit of R5 000 per insured life is payable after policy inception on the first diagnosis of cancer, as per the Stratum Benefits recognised Cancer Categories

UNDERWRITING CRITERIA

APPLICABLE FROM INCEPTION OF THE POLICY

  • 3 Months general waiting period (no claims can be submitted within the first 3 months of cover)
  • A total exclusion for any pre-diagnosed cancer is applicable

GENERAL

  • Entry age before 70th birthday
  • Children will be accepted as child dependants up to and including the age of 27, provided they are registered dependants on the medical scheme option of either the principal member or the spouse
  • From the age of 28, a child dependant will be regarded as an adult and will therefore be charged an adult dependant rate, provided that the dependant is registered on the medical scheme option of either the principal member or the spouse
  • Entry age for adult dependants before 70th birthday
  • The Stratum Benefits policy extends cover to all dependants as registered on the medical scheme option of either the principal member or the spouse

STRATUM BENEFITS FORMULARY LIMITED TO

Herceptin, Mylotarg, Nexavar, Gleevec, Sprycel, Faslodex, Velcade, Tarceva, Alimta, Zevalin, Avastin, Erbitux, Sutent, Fludara, Mabthera with specific oncological condition and/or specific sub-groups of cancers limited to the sub-groups of the following Cancer Categories:

HER 2 + Breast cancer, Acute myeloid leukemia, Advanced hepatocellular carcinoma, Acute lymphoblastic leukemia, Chronic myeloid leukemia, Chronic lymphocytic leukemia, Non-Hodgkins lymphoma, Advanced renal cell carcinoma, Hairy cell leukemia, Myelodysplasia, HER-ve breast cancer, Gastrointestinal stromal tumor, Multiple myeloma, Non-small cell lung cancer, Metastatic colorectal cancer and Head and neck cancer