The hidden costs of cancer: what your medical aid won’t cover

Picture: Siphiwe Sibeko.

Picture: Siphiwe Sibeko.

Published Oct 21, 2021

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Kresantha Pillay and Dominique Stott

Over the next decade, the sheer burden of cancer in South Africa is estimated to double to at least 160 000 cases per year. It’s a sobering number from the civil society organisation, The Cancer Alliance, whose leadership believes the country is only going to be able to manage this massive number of cases through improved government budgeting, planning and helping patients understand the multiple hidden costs of a cancer diagnosis.

Earlier this year, Liberty’s 2020 Claim Statistics revealed that cancer and leukaemia made up 27% of all claims that year. However, it is believed that these numbers are not reflective of the actual number of potential cancer patients out there, with health industry experts suspecting that the national lockdown and anxiety over contracting Covid-19 has meant that people have postponed the check-ups that could have identified these critical illnesses.

This could mean a much larger number of cancer claims over the next year, as people become more comfortable visiting medical facilities again for these delayed checks and receive their diagnosis. Due to the delays, it means that for some, the diagnosis of a more severe stage of cancer is inevitable, which exponentially impacts not only the survival rate but the cost of treatment.

What many people don’t realise is that even with a medical aid, there are so many other costs associated with cancer treatment – both medical and lifestyle related – especially if the disease isn’t caught early enough.

Firstly, depending on the severity of the cancer, a patient may have to stop working to focus on their recovery, immediately affecting their monthly income. One might also be interested in pursuing other treatments – such as immunotherapy –which may not be covered by all medical aid plans. Regular check-ups, blood tests, chemotherapy and other cancer treatments will deplete medical aid funds, which may also not cover the vast number of other “hidden” costs. Transportation to hospital, family counselling, changes to the home environment in case of mobility issues, cosmetic surgery for breast cancer survivors, wigs for hair-loss caused by chemotherapy. The list goes on.

Through the insurance industry, there are multiple solutions to address these widening gaps, although usually the best option is critical illness cover.

The purpose this is to help cover these additional, unexpected costs. However, one needs to have an in-depth conversation with a financial adviser to help determine how much cover is needed to maintain a similar lifestyle pre- and post-diagnosis.

Central to this is a frank conversation with your oncologist and other medical practitioners. Something as simple as asking what you can expect in terms of how cancer can affect your lifestyle can already give you so much insight into your treatment.

Determining the extent and length of your treatment plan, how you’ll feel after treatments, how often you’ll need various tests, how long you may be off work – these are all questions that can help you understand your cancer journey and hidden costs.

However, the best cost-saver is preventative action.

In South Africa, some of the most common cancers are breast and cervical cancer among women, and colorectal and prostate cancer for men. All of these forms of cancer are easily detectible – if people get regular check-ups. These check-ups don’t require invasive procedures, and most are simply blood tests or stool samples that aren’t too costly.

From around the age of 45, women should be receiving yearly mammograms, and for men, it’s ideal that from around age 65 that they perform annual prostate checks.

These age brackets do reduce, however, for people with direct family members who have had cancer, as they have a higher hereditary risk factor.

For cervical cancer, one of the best ways to prevent it in our children is to vaccinate them against HPV (Human papillomavirus), both boys and girls, because HPV is the precursor to the majority of cervical cancers.

An HPV vaccine may be more expensive than your average flu jab, she says, but it could save your family a lot of financial and physical trauma in the future.

Ultimately, there are other ways to lower the risk of cancer, and most of us have heard them before - eat more healthy, balanced meals, don’t smoke, exercise at least three times a week, avoid too much sun exposure.

Sadly, diseases are unpredictable, which is why it’s always important to be prepared – emotionally and financially. Pillay says that financial conversations around critical illness have to happen early – because you may not get insurance after a diagnosis.

We know these conversations are difficult, but an accredited financial adviser is trained to help you identify the best possible solution for you and your family’s circumstances.

Dominique Stottis is the chief medical officer at Liberty. Kresantha Pillay is the lead specialist for Liberty’s Lifestyle Protector.

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