Oncology
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, 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, whereafter a 20% co-payment will apply to all further cover, without any overall limits. Refer to your benefit brochure for the applicable thresholds limits
PMB related PET Scans (related to cancer treatment) are unlimited on the LA Focus, LA Active, LA Core and LA Comprehensive Benefit Options. These types of scans are subject to preauthorisation and the use of the Scheme’s DSP. A co-payment will apply if a DSP is not used. All other authorised PET-scans accumulate to the applicable oncology thresholds and a 20% co-payment after the threshold is reached.
On LA KeyPlus PET scans are only covered at the Scheme’s DSP providers. If it is done elsewhere, the Scheme will not pay for the PET scan.
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 subject to registration on the Oncology Programme. A limit applies if a DSP is not used.
Please call us on 0860 103 933 to register on the Oncology Programme.