LA Health members who have been diagnosed with cancer can register on the Oncology Programme, where you will get support and access to reliable information on cancer and what steps to take to manage this disease. We cover all approved cancer-related care within this programme.
We work with you and your doctor to ensure the most clinically appropriate and cost-effective treatment plan. We pay most claims related to treating cancer from the Major Medical Benefit, and only some claims from the day-to-day benefits.
Cancer treatment that falls within the Prescribed Minimum Benefit is always covered in full at the Scheme's DSP, with no co-payment.
On LA Comprehensive, LA Core, LA Active and LA Focus all other types of cancer will be covered over a 12-month cycle, in full up to the applicable threshold, where after a 20% co-payment will apply to all further cover, without any overall limits. Refer to your benefit brochure for the applicable thresholds limits.
On LA Key Plus all other types of cancer will be covered as Prescribed Minimum Benefits at the Scheme's DSP.
Stem cell transplants (related to cancer treatment) are unlimited on the LA Comprehensive, LA Core, LA Active and LA Focus Options, if performed at the Scheme's DSP and is subject to registration on the Oncology Programme review and approval. A limit applies if a DSP is not used.
Stem cell transplants (related to cancer treatment) on the LA Keyplus Option will be covered as Prescribed Minimum Benefits at the Scheme's DSP and is subject to registration on the Oncology Programme, review and approval,
To register for the Oncology Programme, you or your treating doctor must send us a copy of your test results confirming your diagnosis via email to oncology@lahealthms.co.za.