Palliative care should not be a “nice to have” on a medical scheme. For people living with serious illness, it is an essential part of good healthcare — helping to manage symptoms, support patients and families, and often prevent avoidable hospital admissions. Yet access to comprehensive palliative care benefits still varies widely between schemes.
This is what such a benefit should entail:
- It should include consultations with appropriately trained palliative care doctors, nurses, social workers and counsellors, and, where needed, allied health professionals, as well as appropriate medications for symptom control, limited equipment and home oxygen when appropriate.
- Importantly, palliative care should be funded separately from oncology benefits, so that patients do not have to use up benefits intended for cancer treatment in order to access palliative care.
- These benefits should be available to all patients living with serious illness, not only those with a cancer diagnosis.
- There should be no co-payments for care provided within the palliative care benefit. This means that reimbursement rates need to be sufficient for appropriately trained providers to deliver the care without passing a shortfall on to the patient.
Such a comprehensive palliative care benefit is not only in the best interests of patients and their families. Good palliative care can also help medical schemes use resources more appropriately by reducing avoidable hospital admissions and other unnecessary healthcare utilisation.
As of August 2026, this is broadly how things stand:
| Medical scheme | Palliative care benefit |
|---|---|
| Discovery Health and Discovery-administered schemes, including Bankmed, LA Health and Remedi | The Advanced Illness Benefit (AIB) provides palliative care cover for eligible patients. This includes professional palliative care services and medications. |
| Fedhealth, Bonitas, AECI, BonCap, BonCore, SAMWUMED, Keyhealth, Parmed and GEMS | These schemes use the Alignd Palliative Programme, which provides comprehensive palliative care cover, including professional services and medications. Unfortunately, this benefit is currently restricted to patients with cancer for GEMS and Fedhealth. |
| MMI-administered schemes, excluding Momentum | Reasonably comprehensive palliative care benefits are available for people with cancer and other serious illnesses, although authorisation can sometimes take time. |
| Medihelp | Offers palliative care benefits for eligible patients with cancer and other serious illnesses, including professional services, medications and some consumables. |
| Bestmed | Has a very limited palliative care benefit. Cover is restricted to patients with cancer, and co-payments likely apply. |
| Profmed | Has a limited palliative care benefit. |
| Momentum | Currently has no formal palliative care benefit. |
| CAMAF | Currently has no formal palliative care benefit. |
| POLMED | Currently has no formal palliative care benefit. |
| Other medical schemes | Benefits remain variable. Many still have ill-defined, limited or no formal palliative care benefit, and reimbursement may be incomplete. |
If you belong to a medical scheme, it is worth asking:
Do you have a formal palliative care benefit? Who qualifies for it? Does it include people with serious illnesses other than cancer? What professional services, medications and equipment are covered? And will I be expected to make a co-payment?
If your scheme does not have a comprehensive and transparent benefit, please raise the issue with them. Medical scheme members should be asking for equitable access to good palliative care, regardless of diagnosis.