Discovery Medical Scheme - the country’s largest open medical scheme - changed its cancer screening benefit in line with international cancer guidelines.
The company confirmed the decision after concerns were raised on social media about its decision to only cover mammograms every second year, and pap smears every third year.
Consumers specifically questioned the Discovery Health screening policy toward high-risk patients.
Did you know @Discovery_SA no longer pay pathology cost for Pap smears annually but now only every 3rd year & Mamograms are no longer covered yearly but every 2nd year & if you’re booked in for a day procedure, read the fine print, there’s some sneaky changes there too. Meh!— Melain (@iammelain) March 13, 2019
Discovery Health’s head of clinical policy, Dr Noluthando Nematwerani, said the medical scheme changed its policy back in 2017.
She emphasised that screening policy is designed for healthy individuals, and high-risk patients will be tested on a more frequent basis.
Discovery members do, however, have the option to increase screenings subject to the benefits in their respective medical plans, Nematwerani told Business Insider South Africa.
“The screening changes were carefully considered and were based on a comprehensive review of evidence-based clinical guidelines both locally and globally.”
The American Cancer Society, for example, advises yearly mammograms for women aged between 45 and 54, and every second year thereafter.
Breast cancer is the most widely diagnosed cancer among female Discovery clients.
For cervical cancer, the American Cancer Society advises women to get a pap smear every three years.
Discovery Health covers prostate screenings for men only once its recommended by a health professional.
“Unlike for women, population-wide screening for prostate cancer in men is not recommended,” Nematwerani said.
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