Even medical aid members need critical illness cover. Here’s why

The sky-high costs of treating cancer or heart disease could easily exhaust most medical aid scheme plans

27 June 2018 - 22:09
Lerato Nkomo and her sister Phyllis went on an adrenalin-fuelled adventure.
Image: Supplied/Stangen Lerato Nkomo and her sister Phyllis went on an adrenalin-fuelled adventure.

“My younger sister, Phyllis, is my qhawekazi. I am the mother of a young baby and the sole breadwinner in our household. Phyllis is only 22 years old and for someone her age, she has done more than what could be expected of her,” says Lerato Nkomo.  

“It has been a real struggle to take care of our frail grandmother, and because of my long working hours, Phyllis has often had to step in to take care of her, attend to the house chores, and fetch my baby from daycare without any complaints and with great understanding of the situation on her part.  

“I am very much grateful to have her in my life and I wouldn’t trade her for anything.”  

Lerato wanted to thank her sister for her efforts, so she entered Stangen’s “Nominate Your Qhawe” competition and won an experience worth R5,000, plus R2,500 to invest in her dreams.  

“My sister has big dreams and is an adrenaline junkie,” said Lerato.  

Thanks to Stangen, she could treat her adventurous sister to a thrilling day of zip-lining and bungee jumping at the exquisite Sterkfontein Heritage Lodge in Krugersdorp. She plans to invest the R2,500 in her child’s future.  

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But not everyone is lucky enough to have such a devoted family member of friend, and being diagnosed with a critical illness can complicate such a situation greatly and quickly lead to financial troubles.  

Why you need critical illness cover even when you’re a medical aid member  

Private healthcare in South Africa is not cheap. Those who can afford to belong to a medical aid scheme spend a lot of money each month to ensure that when a family member needs it, they can afford the best treatment possible. But is it enough?  

Your medical aid may provide dentistry benefits. It may provide you with more than enough medical savings to visit a GP regularly if necessary. But if you fell seriously ill, like being diagnosed with cancer, would your medical aid cover everything? You can’t be 100% sure, right?  

A serious illness can strike at any time and keep you away from work for an extended period. At first your employer might be sympathetic, but soon you might receive a less sympathetic letter from the human resources department.  

And if that wasn’t enough, your medical aid might be watching the bills closely, ready to decline claims because you reached your benefit limits.   

A quick online survey on medical aid costs and benefits showed a leading medical scheme’s premier medical aid plan cost a staggering R6,000 per month for a single member contribution.

You’d think just about any medical claim would be covered at that price. Think again: the annual cancer benefit is limited to about R400,000 a year. That is an allowance of R33,000 per month, which might seem enough to cover treatment costs – until you understand how expensive cancer treatment can be. A mastectomy and access to new immunotherapy drugs can easily cost R500,000.  

A recent article on Moneyweb provided a rough estimate of costs relating to cancer treatment in South Africa. The costs are jaw dropping:    

  • Breast biopsy: R17,000
  • Scans: R30,000
  • Mastectomy: R62,000
  • Reconstructive surgery: R50,000–R140,000
  • Hormonal therapy: R650–R2,500 per month
  • Chemotherapy: R140,000 for six cycles
  • Radiation therapy: R51,000–R112,000 for five to six weeks’ treatment  

And if you think the odds are in your favour, think again. Statistics from the Cancer Association of South Africa website reinforce the fact that covering yourself isn’t a luxury anymore – it’s a necessity:      

  • Every year, 14-million people around the world hear the words: “You have cancer.”
  • A quarter of South Africans are diagnosed with cancer or have a loved one, family member, friend or colleague with cancer.
  • About 100,000 South Africans are diagnosed with cancer every year.
  • Environment and lifestyle factors, including smoking, diet and lack of exercise, cause 90% of all cancers.
  • The cancer survival rate is six out of 10.  

The heart disease stats aren’t any better:  

  • About 225 South Africans are killed by heart disease every day.
  • About 45% of South Africans have high blood pressure.
  • About 10 people suffer a stroke in South Africa every hour.  

If you consider the facts, how much critical illness cover do you think you need?  

Critical illness cover is no longer a nice-to-have. You should have a critical illness policy in place even if you belong to a medical aid. You can bolt your critical illness benefit onto your existing life-cover policy.  

Stangen’s critical illness cover pays out a lump sum if you have a stroke, suffer a heart attack, undergo heart surgery or are diagnosed with cancer (and you don’t die within 30 days of the first diagnosis).  

The exact qualifying definitions will be included in your policy wording and diagnoses must be confirmed by Stangen’s medical staff:  

  • Get up to R5-million cover.
  • There is no waiting period before you are covered, provided you answered your health-related questions honestly.
  • No medical examinations are required when applying.  

Can you really afford to delay the decision to get yourself covered? Probably not.  

This article was paid for by Stangen Life.