Funding your Cancer Care treatment

Netcare treats patients from various medical schemes. Patient’s treatment is dependent on their individual medical scheme and the option they subscribe to.

Generally, medical schemes will cover your approved cancer treatment up to a certain limit within a 12-month cycle from your Oncology Benefit. If your treatment costs more than the cover amount, the scheme will pay up to a percentage for all treatment that falls outside of the Prescribed Minimum Benefits (PMBs) and you will need to pay the balance.


Prescribed Minimum Benefits

Cancer treatment that falls within the Prescribed Minimum Benefits (PMBs) will be covered in full, and won’t require a co-payment by you or the account holder. This is if you use service providers that your medical aid scheme has a payment arrangement with.

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Private paying patients

Patients who wish to pay cash are encouraged to contact the Netcare Cancer Care facility that they will attend, for more information on what they can expect to pay.

View Cancer Care centres
Medical Aids

Cover for your cancer

How does it work?

Most major medical schemes offer an oncology disease management programme. These programmes add value by ensuring that members access funding for appropriate and cost effective oncology therapy before, during and after active treatment.

To better understand our oncology cover and the benefits that are available to you, please contact your medical aid provider directly.

What you need to do before your treatment:

If you are diagnosed with cancer, you need to register on an oncology programme with your medical aid.

In order to register, you or your treating doctor must send the medical scheme a copy of your laboratory results confirming your diagnosis.

Your cancer specialist will need to send the medical scheme your treatment plan for approval before starting treatment. The medical scheme will usually only fund your cancer treatment from the Oncology Benefit if they have approved your treatment plan.

Prescribed minimum benefits

When is cancer a Prescribed Minimum Benefit (PMB)?

Most medical schemes cover cancer but not all cancers qualify for prescribed minimum benefits. There are two types of cancer; cancer that affects non-solid organs and systems; and cancer of solid organs.

View prescribed minimum benefits
Cancer of solid organs qualifies as a prescribed minimum benefit (PMB) only if it is “treatable”, and only where:

They affect the organ of origin and have not spread to adjacent organs

There is no evidence of spread to other organs that are far from the organ where the cancer has started.

They have not brought about incurable damage to the organ in which they originated, or in another life-supporting organ.

If none of the above apply, there is scientific evidence that more than 10% of people with a similar cancer, in the same state of advancement, survive on treatment for at least five years.

If a solid-organ cancer does not meet the above-mentioned criteria, it is considered a non-treatable cancer and is therefore not viewed as a PMB in terms of the current legislation.

There are various cancers of non-solid organs and systems that qualify as PMB conditions – whether they are “treatable” or not. For example, acute leukaemia, lymphomas, multiple myeloma and chronic leukaemia all qualify for PMBs.

Further information

Contact the central customer service centre on

[email protected] or 0860 NETCARE (0860 638 2273)

Please note that the centre operates on weekdays between 08:00 and 16:00.