Medical aid: Cancer cover has never been more critical

First published in Daily Maverick 168

October is Breast Cancer Awareness Month. While South Africa braces for a rising second wave of Covid-19 infections, medical experts are warning of a potential increase in cancer-related claims and diagnoses in the year ahead. Dread disease or critical illness cover can help you weather the accompanying financial storm.

Dr Noluthando Nematswerani, head of Discovery Health’s Centre for Clinical Excellence, says a serious, unexpected consequence of the pandemic is a reduction in screening tests among high-risk members who perceive seeing their doctor as increasing their risk of exposure to Covid-19.

Discovery’s data shows that, compared with last year, there has been a 44% reduction in breast cancer diagnoses, and a 51% reduction in mammograms performed.

These are alarming stats in light of the fact that cancer remains one of the leading causes of death and dread disease claims in the life assurance industry.

Life assurer Momentum Myriad says cancer accounted for 32% of total death claims and 42% of total claims for women last year.

When it came to Momentum’s critical illness or dread disease claims, cancer accounted for 41% of total claims. The highest proportion of cancer claims for women was related to stage 1 breast cancer at 50%, while stage 2 prostate cancer accounted for the highest proportion of claims for men at 39%.

Dr Liana Roodt, specialist breast, endocrine and general surgeon at Groote Schuur Hospital, agrees with Nematswerani, saying the Covid-19 pandemic will claim more lives on the back of the devastating impact on our public healthcare resources, the drop in the number of people able to afford private medical care and people’s reluctance or inability to attend their usual screening examinations. 

“I am afraid that we will be dealing with the aftermath of this global pandemic for some time to come,” she says.

Research from insurer 1Life shows that breast cancer deaths have increased by 20% over the past four months, which could indicate that not only may breast cancer patients have been avoiding going for treatment but also that more needs to be done to ensure stronger education around early detection, prevention and treatment options.

Laurence Hillman, chief executive of 1Life, says as private healthcare becomes less affordable, the financial impact of contracting a dread disease increases exponentially. 1Life stats show that only 4% of women have any form of dread disease cover.

How dread disease or critical illness cover can help you

Besides the preventative measures of pap smears and mammograms, dread disease cover can give you financial protection when you need it most. When you contract a dread disease, there are numerous financial costs you have to consider. These include:

• Day-to-day medical expenses. These costs may not be covered by your medical aid scheme or your benefits may be depleted early on in your treatment.


• Expensive medication or treatment. While medical aid schemes cover some costs, they may not necessarily pay for the specific treatment you want or need.


• Living costs. If you are part of a double-income household, the family will potentially have to maintain their standard of living minus your salary contribution. Your partner or spouse will also have to cope with the new expenses that include your care and treatment costs. If you are single, you may suddenly be faced with a loss of income while you are ill.


• Lifestyle changes. You may need to switch to a part-time job or one that is less taxing on your physical health and your children may need an au pair or nanny.

• Is there an increase in the premium each year and if yes, is it linked to inflation? In other words, will the policy still be affordable for you in 10 years’ time?


• Does your cover increase as your premiums increase?


• Are you able to increase your cover during different life stages such as getting married or having children, without having to go through the whole underwriting process again?


• What severe illnesses or dread diseases are covered by the policy?


• Can you also take out cover for your children so that if one of your children contracts a dread disease such as cancer, your dread disease policy will pay out?


• Can you make more than one claim during your lifetime?


• Are there time limits you have to adhere to when making a claim?


• Under what circumstances can a claim be rejected? DM168/DM/BM