Life cover boosts medical costs

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Liberty claim statistics show that cancer remains a major cause for claims. The prevalence of particular types of cancer in South Africa is also evident. Photo: Supplied/Archive
Liberty claim statistics show that cancer remains a major cause for claims. The prevalence of particular types of cancer in South Africa is also evident. Photo: Supplied/Archive
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Many financial advisers are using life products to supplement medical costs. While legislation does not allow for cover such as critical illness insurance to be marketed as a product to cover medical costs, for most policy holders that is exactly what it is used for.

READ: Don’t overlook the cost of your health in retirement

The cost of getting cancer, for example, can be extensive. Critical illness cover pays out a lump sum on the diagnosis of a major disease or medical event, such as cancer or a heart attack, and some policies even cover trauma events.

Rather than taking out comprehensive medical cover, some members are taking out a basic hospital plan, adding gap cover and then supplementing with a critical illness benefit. Alternatively, they are opting for primary healthcare insurance combined with critical illness benefits.

While this is not ideal, at least it offers South Africans some form of protection against high medical costs, given the current status quo, by allowing a mix-and-match approach.

A 30-YEAR-OLD COULD BUILD MEDICAL COVERAS FOLLOWS:

  •  Basic hospital plan: R1 400
  • Comprehensive severe illness cover forR1 million: R200
  • Gap cover: R280

OR, USING PRIMARY HEALTH INSURANCE:

  • Sanlam Primary Care with accident benefit: R579
  • Comprehensive severe illness cover forR1 million: R200

READ: The bitter pill of medical costs in SA

Liberty claim statistics show that cancer remains a major cause for claims. The prevalence of particular types of cancer in South Africa is also evident. Death and impairment by cancer and leukemia were the top reasons for claims, representing 27%. This was followed by cardiac and cardiovascular-related causes, comprising 20% of all claims. Cancer and leukaemia constituted 25% of overall claims last year in men and 31% in women.

When Lebogang Khumalo’s* doctors found a small mass in her chest last year, the initial biopsy said it was benign. But more than a dozen hours after her “short” surgery began, she awoke in the intensive care unit at Netcare Milpark Hospital and discovered that she had been rushed into a major open-heart procedure.

As she recovered over the next few days, she learnt that the mass had spread across her entire chest and that doctors were concerned that intensive growth meant she was in an advanced stage of cancer.

Even after the majority of the mass was removed, further tests revealed she would need at least six months of chemotherapy to fully destroy the remaining pieces of the lump, which had been identified as stage 4 anaplastic T-cell lymphoma.

Khumalo assumed that medical aid was enough to cover the treatment and that the minimal disability and basic critical illness cover would be sufficient to prevent the financial implications that came with such a serious disease.

khumalo says :

Sadly, this wasn’t the case. I never really thought I’d need to use the cover, at least not when I was so young. So it was a basic plan and, even though it helped, I’m still heavily indebted.

Kresantha Pillay, head of Liberty’s Lifestyle Protector, agrees, saying that many people – both young and old – have the same misconceptions.

“Unfortunately, people underestimate the true cost of cancer and purchase inadequate cover. Without the right protection, your treatment can deeply affect your financial health,” says Pillay, who adds that, to reduce the financial burden on a policy holder diagnosed with a critical illness, Liberty has removed the 14-day survival period following a confirmed diagnosis of a critical illness.

READ: ‘Why medical aid is so expensive

When Khumalo contacted her insurer, who was also her medical aid provider, following her diagnosis, she was informed that her medical aid only provided R400 000 per year to battle cancer. This ran out within the first few months, and, even though her disability and critical illness cover was paid out to help cover the costs, she was still expected to pay 20% towards the total cost, since all her insurance and medical aid funds had run out.

She estimated that she had spent R250 000 out of her own pocket to cover the shortfall, sending her family into serious debt. The strain of the surgery and treatment also made working impossible, and her salary during her time off work was cut to 75% as she recovered.

*Not her real name


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Maya Fisher-French 

Personal Finance Editor

+27 11 713 9001
personalfinance@citypress.co.za
www.citypress.co.za
69 Kingsway Rd, Auckland Park
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