Looking After You in 2026: Your Benefit Updates
We are excited to share a range of benefit improvements for 2026 that are designed to make healthcare more accessible and supportive for you and your family.
1. Better Support for Mental Health
To help members manage their mental wellbeing, the Scheme is enhancing the Mental Health Benefits. The Mental Care Benefit for at risk members will be available to members with moderate to severe symptoms of depression, as assessed using the PHQ 9 (Patient Health Questionnaire - 9). This questionnaire is used to screen for and measure the severity of depressive symptoms. Eligible members will now have access to one risk-funded face-to-face or virtual consultation with either:
- A Premier Plus Network General Practitioner (GP), or
- A Network Psychologist
To see if you qualify for this benefit, you can complete a PHQ-9 assessment with your GP or mental healthcare professional via HealthID. Keep an eye out, the PHQ‑9 will be live on our website very soon, allowing you to complete it anytime and from anywhere!
2. New Oncology Pharmacy DSP Network
To ensure that quality cancer treatment remains affordable and accessible, the Scheme has introduced an Oncology Pharmacy Designated Service Provider (DSP) Network.
Members are now required to obtain their oncology medicines from the Scheme's DSP Network pharmacies.
This change offers members:
- Lower co-payments and reduced medicine costs
- Reliable access to high quality oncology medicines
- Streamlined service with expert oncology pharmacy support
3. At Home Cancer Screening Tests
As part of our focus on preventative care, the Scheme is expanding screening benefits for certain cancers. Members can now complete colorectal and cervical cancer tests in the comfort of their own home using an easy to use self-sample kit.
To do this, you can:
- collect the test kit from your pathology lab, or GP
- complete the test at home by following the instructions provided in the kit
- drop the sample at your closest pathology lab
Your doctor will receive the results of your test and discuss them with you.
4. HPV Vaccination for members aged 9-26
HPV (Human Papillomavirus) is a common virus that can cause certain cancers. Vaccination helps protect against the most harmful types.
Cover for the HPV vaccine, is now available to both males and females aged 9 to 26 years.
You can visit your GP or clinic to schedule your vaccination. The Scheme will fund a course of up to three doses of the HPV vaccine at 100% of the Scheme Rate, per beneficiary per lifetime.
These benefit enhancements reflect the Scheme's ongoing commitment to supporting your health, wellness, and peace of mind. Whether it's mental health support, cancer prevention, or improved access to essential medicine, our goal is to help you stay healthy in 2026 and beyond.
Visit www.retailmedicalscheme.co.za for more details about these benefits.