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One of the main focuses for SAB medical aid this year is to make sure that all of their members and beneficiaries get the medical care that they need to manage any conditions that they may have including those of a chronic nature. One of the the new initiatives they are introducing is a system that is designed to identify those taking chronic medication and claiming it through acute medicine benefits. Under the new process, pharmacists will receive a message asking them to let the patient know that they should register their condition with the chronic managed care department of SAB medical aid.
There are a number of benefits to registering for this program:
When you transfer the expense of your chronic medication away from your acute benefit you will be able to make sure that your acute benefit lasts much longer.
Your condition will be managed by a team of qualified professionals who will be able to monitor your condition and ensure that you are getting appropriate care.
When you are registered as having a chronic condition, the level of benefit you receive will be extended so that you will not exceed your medication benefits.
You will be able to access disease management services which will help to manage treatment.
It is important that if you are a SAB medical aid member, you understand that your pharmacist will wish to discuss this with you if you claim chronic medication via your acute benefits.
As a medical aid member you will be entitled to minimum level of health care services. With the SAB medical aid scheme this includes the treatment of 26 Chronic diseases as listed below:
1. Addison’s Disease
2. Asthma
3. Bipolar Mood Disorder
4. Bronchiectasis
5. Cardiac Failure
6. Cardiomyopathy
7. Chronic Renal Disease
8. Chronic Obstructive Pulmonary Disease
9. Coronary Artery Disease
10. Crohn’s Disease
11. Diabetes Insipidus
12. Diabetes Mellitus Types 1 & 2
13. Dysrhythmias
14. Epilepsy
15. Glaucoma
16. Haemophilia
17. HIV/AIDS
18. Hyperlipidaemia
19. Hypertension
20. Hypothyroidism
21. Multiple Sclerosis
22. Parkinson’s Disease
23. Rheumatoid Arthritis
24. Schizophrenia
25. Systematic Lupus Erythematosis
Ulcerative Colitis
If you opt for the Comprehensive plan from SAB medical aid then you will alsobe covered for additional diseases including:
When choosing a medical aid scheme for your family, it is important to make sure that your kids are properly covered. As a parent, it is your duty to make sure that your offspring have the best possible chance of staying healthy, and with the new childhood vaccinations cover offered by Afrox medical aid you will be doing exactly that.
As of 2011, all Afrox medical aid members can take advantage of this benefit which is designed to help all babies and children to be fully immunized in line with guidelines from the Department of Health. This will go some way towards helping protect the younger generations from a long list of infectious, not to mention potentially life threatening, diseases.
Some of the vaccinations which are not only recommended, but are also fully covered by the Afrox medical aid scheme include:
Diphtheria
Tetanus
Rota Virus Vaccine
Pertussis
Polio
Haemophilus Influenzae Type B
Hepatitis A
Hepatitis B
Measles
Mumps
Rubella
Conjugated Pneumococcal
Varicella Vaccine (Chicken Pox)
Cover for these vaccines are only available to beneficiaries who are under the age of 7 years. However, all children who are beneficiaries of an Afrox medical aid plan are eligible for the same medical care that adult members are including medications and hospital care described in the schedule of benefits for the particular plan purchased.
Care That Starts From Before Birth
Of course, the best way to give your child a great start in life is with appropriate prenatal care. Afrox medical aid also offers great maternity benefits for members. All Afrox medical aid members can access the maternity program completely free of charge in order to receive support, care and education throughout the pregnancy and post-natal period.
Afrox medical aid members who enrol on the maternity program are allocated a case manager who will stay in contact throughout the pregnancy and following the birth. This case manager is fully qualified to advise on a number of important issues including diet, exercise, homeopathic remedies, birthing choices including home births and breastfeeding advice.
The aim is to teach you how to take care of yourself and your baby before, during and after the birth itself. You will get the help and support that you need along with information about appropriate doctors, midwives, hospitals and birthing units in your local area.
Quality medical coverage is something that is important to everyone. Without some form of medical coverage, or medical aid scheme in place, if you or your family members fall ill, or need regular medication or treatments with a chronic illness you could incur exorbitant bills. For as long as it has been around, Nampak Medical Aid has made its focus on helping its members to be healthier through various medical treatments and preventative screening processes, as well as providing the necessary emergency medical attention that might be needed. With the recent merger of Discovery Health and Nampak Medical, the initial idea of some individuals is that there will be a drastic change in the medical benefits and plans that members can choose whereas others only see this as an opportunity for better medical coverage.
One thing is for certain, whether you were a member of Nampak Medical Aid before or after the merger with Discovery Health, you and your family will still benefit from all of the medical coverage you and your family needs. One of the best aspects to choosing a policy from Nampak is that they have medical aid schemes that take into consideration the specific medical needs of you and your family. You can rest easy knowing that when you select your scheme you will be taken care of regardless of what you need. If you need to get a policy that covers hospital stays, chronic illnesses, oncology, or day-to-day benefits, you will find everything you need.
One of the best things about the medical aid schemes offered by Nampak, and now Discovery Health, is that individuals can compare each of the schemes and determine exactly which one will fit their needs the best. There is no need to get a scheme that you cannot afford or that has benefits that you do not need if it is not necessary. Whichever scheme you and your family choose to sign up for, you will know that when an unexpected accident or medical emergency strikes, you will not have to fly into a panic wondering how you will get the treatment that you need because you cannot afford excessive medical bills. Your family or yourself will be able to see the doctor that is needed or be admitted to the hospital if it is necessary.
If you have not taken the time to look into getting the right medical aid scheme for yourself and your family, then now is the time to start. If you had heard of the great plans that were offered by Nampak Medical Aid then do not worry. You will still be able to get the key medical cover that you need despite their merger with Discovery Health. Get peace of mind, get medical cover today.
Getting the medial aid coverage that you need is sometimes easier than one may think. For those employees of Media24 and their affiliates, there are two different medical aid plans in place to help with any potential medical illness or emergency that may happen in the life of you or your qualifying dependant’s lives. Not only does Naspers medical aid offer the medical cover that the employees of Media24 and their qualifying family members need, it is required that any employee that works for this company selects and signs up for one of the two different medical plan options. This helps to ensure that when the need arises for medical assistance, whether for a chronic illness or a medical emergency, there is coverage in place to help pay the costs of the treatments.
The two plans that Naspers medical aid has available are the N Option Basic and the N Option Plus. Each of these plans was designed with specific benefits in mind for their members. One of the most important forms of cover that is in place, in both of these plans, is the Chronic Illness benefit. There is a list of Chronic Illnesses, or diseases, that qualifying members can get regular medicine and treatment for regardless of the plan for which they are signed up. Some of these illnesses or diseases include diabetes, asthma, Parkinson’s disease, epilepsy, glaucoma, and bipolar mood disorder. There are additional diseases that the N Option Plus plan covers, as it is a more comprehensive medical plan, than its counterpart is.
Along with the medical assistance that is provided for pre-existing, or chronic illnesses, both of the Naspers medical aid plans cover a variety of different medical treatments and medical necessities. One of the most important forms of coverage that is offered is the hospital benefit. This is a critical benefit to have if the need should arise for you or a family member on your plan requires admittance into a hospital for some type of medical treatment. It is important to note that prior to admittance into the hospital that the member contact Naspers medical staff to confirm that the admission and treatment is covered by the medical plan that is held. If this is not done prior to admittance, it is possible that the member could be liable for the costs incurred for not only the hospital stay but also the treatment. Other treatments and services cover medicines, medical emergencies, oncology, and coverage for a variety of tests.
Having medical care in place is essential for not only the maintenance of regular health but also in the unfortunate occasions an accident or other emergency leaves you seeking medical assistance.
Are you an employee of Truworths, Woolworths, or Unison Risk Management and have no medical cover for yourself or your family? Does one of your dependant family members have a chronic illness that needs regular treatment or medications but you are unable to afford them? If you are just looking for quality medical cover that you can afford then it is time that you look into the different plans that are offered by Wooltru medical aid. With Wooltru you will be able to select from various plans to get the medical cover you need that will give you the peace of mind knowing that not only will pre-existing conditions be treated but in the event that you or one of your loved ones experiences some sort of medical emergency cover is in place.
The different plans that Wooltru medical aid offer are the Core, Plus, and the Extended. No matter which of the plans you select your contributions are automatically deducted from either your salary or your pension. Coverage will last for an entire month, even in the event that you end up resigning from your position. Each of these plans feature a variety of different benefits to help you and your loved ones maintain the best health that is possible. Day-2-day benefits allow you to choose from a list of approved, or network general practitioners, dentists, and optometrists. All aspects of your health and well-being are important, that is why your benefits cover not only your body but also your eyes and teeth as well.
Hospitalisation benefits are also a key benefit. This benefit covers you or your loved ones any time you are required to be hospitalised in emergency or non-emergency situations. For those non-emergency situations, it is important to get authorisation a minimum of two days prior to admittance to ensure your benefits are applied. For those members that plan to get pregnant, maternity benefits are also available. In order to qualify for these benefits you need to register for the Maternity Programme within the first 16 weeks of your pregnancy.
Some of the most important benefits that members can benefit from by selecting one of the three plans offered by Wooltru medical aid include preventative testing and chronic care. Having quality preventative testing available to yourself and your loved ones can help with the early diagnosis of potentially serious medical conditions that require medical treatment. This early treatment can lead to either being cured, or learning how to live with the specific illness. Chronic care is a benefit that helps countless people get the treatment and the assistance that they need when diagnosed with any of the specified illnesses on the chronic disease list. Live your life with a bit less worry by getting the medical coverage that you need by selecting one of the Wooltru medical aid plans.
You are young, fit, and healthy. The last thing that you ever need to worry about is having a medical aid scheme for yourself and your family members. This may be the mentality that you have, but the truth of the matter is everyone should have some sort of medical aid scheme in place to help take care of things when emergencies occur. Though you may feel that you are invincible and that you and your family will never get sick or have any sort of accident, though that would be nice if it never occurred, the truth is illnesses and accidents happen every day to even the healthiest individuals. It is for this reason that everyone, no matter what age or level of health, needs to have some sort of pre-existing medical aid scheme such as Bonitas Hospital Plan. Having one of these plans in place will help you to deal with the unexpected medical emergencies or illnesses that can happen.
When you start looking into a medical scheme for yourself and your family, you need to consider what type of cover you need to have. Do you only need to look for medical cover for yourself? Does any member of your family, that you have to get coverage for, have a pre-existing medical condition that needs special attention? Are you on a tight budget so you can only afford a very basic plan that doesn’t have all the extra benefits of expensive plans? Regardless of any pre-existing medical conditions, or your budget, you are sure to find a Bonitas Hospital Plan that will work for you and your family.
With Bonitas, you can choose for a couple of different options, the BonEssential and the BonCap. Both of these plans will provide you with the coverage that you need should you, or your loved ones, require hospitalization due to an unforeseen accident or illness. You will not have to worry about how you will pay for the hospital stay or the treatment with one of these plans in place. Both of these plans cover hospital visits and cover 26 chronic conditions that you are your family members may have or be diagnosed with at some point. Of the two policies, the BonCap is a more elaborate plan that offers the individual more benefits. Some of the additional benefits include coverage related to optometrists, dental services, and pharmaceutical needs in addition to hospital stays.
If you have yet to get yourself some type of medical aid scheme for yourself and your immediate family members than look into one of the Bonitas Hospital plans available and have the peace of mind that comes with knowing when illness or accidents happen you are covered.
GEMS medical aid was established in January 2005 in order to help Government employees to satisfy their healthcare needs. Prior to the founding of GEMS medical aid many government employees were not able to afford any type of medical cover. Those who did have cover found that it was becoming more and more expensive over time and they were not getting value for money. In addition, the government did not have much of an opportunity to participate in the management of the medical scheme which their employees are enrolled with.
GEMS medical aid have a very clear mission statement in that they aim to ‘provide all public service employees with equitable access to affordable and comprehensive healthcare benefits’. They have very strong values including simplicity, flexibility, integrity, value for money and clear communication with members.
With 5 different products, GEMS medical aid has a plan to suit everybody. The plans are named after gemstones : Sapphire, Beryl, Ruby, Emerald and Onyx. The plans offer a range of benefits at different price ranges. In fact, GEMS medical aid claim that when compared to similar plans from other providers that they will come out between 10% and 25% cheaper. The Sapphire plan in particular is designed to be as affordable as possible by providing out of hospital care at private treatment centres and in-hospital care at designated public facilities. Meanwhile the Beryl plan will provide in-hospital care at public or private facilities.
The Beryl and Sapphire plans are the entry level choices offered to GEMS medical aid. Members who are subscribed to these plans are required to access medical care only from designated providers. There area number of service providers who are contracted to GEMS medical aid to provide a number of different services including:
Access Health – Maternity Programme;
Europ Assistance – Emergency Medical Evacuation Dispatch (EMED) contact centre;
Medipost Pharmacy – Chronic Medicine Courier Pharmacy;
Medscheme – Contributions and debt management services; Correspondence services;
Medscheme Health Risk Solutions (MHRS) – Managed care services;
Metropolitan Health – Membership and claims services;
Metropolitan Health Risk management – Clearing house services;
Opticlear – Optometry managed care services;
Pinnacle Health Solutions – Marketing and tele-marketing services;
Prime Cure – HIV/AIDS disease management services, Dental management services; and
Universal Healthcare Services – Chronic medicine management services; Strategic managed care services.
For the most comprehensive cover, members can opt for the top level Onyx plan from GEMS medical aid.
If you are expecting a child then it is only natural that you will start thinking about your baby’s health right from the moment of conception. It is also natural to be concerned about healthcare before, during and after the birth of your baby. These are the kind of healthcare needs you need to consider before signing up to a scheme like Hosmed medical aid or similar. If you know that at some time in the not to distant future you will be looking to start a family then you would be wise to ensure that your medical aid provider actually covers pregnancy and newborn health care.
Before The Birth
Prior to actually giving birth, you will need appropriate prenatal care including obstetrician visits, ultrasound scans and perhaps even prenatal vitamins. You will need to check with your medical aid provider to ensure that you are covered for these treatments as not all schemes will. If we take Hosmed medical aid as an example, members are limited to two ultrasound scans per pregnancy although they will cover all treatments and consultations up to the agreed cover limit. This applies to all three levels of cover offered by Hosmed medical aid, but other schemes may only offer cover on certain plans or may require an additional premium to be paid.
During The Birth
If your medical aid provider covers prenatal care then it is usually the case that they will also cover your hospital expenses and doctor’s fees during the birth itself. It is usually for even caesarean sections to be covered as long as they are not elective. It is important to be aware that you may need to choose a hospital from an approved list provided by your medical aid scheme and if your gynaecologist’s rates are above the usual tariff rates you will be liable to pay the excess.
After The Birth
You will need to register your new baby as an additional member/ dependent on your medical aid program. However, this is a hectic time for your family and the majority of medical aid schemes will cover newborns for up to 30 days following birth. Cover should include any necessary ICU treatments if the child is in difficulty. However, a prolonged hospital stay for the mother may not be covered.
It is fairly easy to add your new baby to your medical aid scheme providing that your name is on their birth certificate. The majority of schemes will offer a family plan for your convenience. In fact, with Hosmed medical aid you only have to pay for your first 3 children, so larger families can enjoy free cover for any additional children that they might have.
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When it comes to getting the best possible coverage at an affordable price from schemes such as Netcare medical aid there are a few important things that you need to keep in mind. The choice can be overwhelming if you do not know what exactly to look for, so we have put together this list of the key points to consider when choosing medical aid.
Look At The Level Of Coverage
Every medical aid program offers slightly different levels of coverage. You may find that one scheme covers pregnancy while another doesn’t. Even between plans in the same scheme there can be large differences in cover. It is important to think about what sort of cover is important to you so that you can make sure it is included in your plan.
Look Into Payment Policies
When it comes to paying for your medical treatment procedures differ between schemes. For example, what Netcare medical aid does may not be what Liberty does. Some schemes will pay providers directly meaning that you only have to pay your agreed deductible or co-pay amount. However, with other schemes you may be expected to pay your own medical bills and then submit a claim to be reimbursed. Depending on your medical aid provider it could take as long as 30 days to receive your refund.
How Much Will It Cost
Perhaps the most important consideration when choosing your medical aid provider is the cost of cover. It is a good idea to work out how much your budget for health care is so that you can immediately eliminate those which are too expensive. It is never wise to sign up for medical aid you cannot afford as your cover will lapse if you are not up to date on payments. Always keep in mind that more expensive is not always better, it could be that you would be paying for services you will never use so make sure you are looking at which plan offers the best value for money.
Have You Considered Your Health
When choosing medical aid you need to take your own health and the health of any family members attached to the plan into consideration. If you have an existing condition then you need to make sure that your medical aid will cover your treatment. Some of the chronic illnesses covered by Netcare medical aid include: Asthma, Bipolar, COPD, Crohn’s Disease, Diabetes, Haemophilia, Parkinson’s Disease and Schizophrenia among others. However, this list will be different with other providers so take care to ensure your condition is on the list.
Does The Scheme Cover Hospital Care?
Not every medical scheme covers hospital care as standard. Often it is added as an additional premium for those requesting it. If you can afford to do so you should definitely opt for a plan which offers hospital care as you will never know when you might require treatment in a hospital or ER. As an example, the Netcare medical aid scheme does include hospital care provided you are admitted to an approved treatment facility within the Netcare group. Hospitalisation must also be pre-authorised under the rules of the Netcare medical aid scheme.
These are the top 5 things to take into consideration when choosing the right medical aid cover for you and your family, but you may have additional needs in which case you must thoroughly examine the terms and conditions of the program before making a commitment.
It is a rather common fact that most of people do not think about their health and the need for medical coverage until the unexpected accident or illness strikes. It is in that moment that we not only have to deal with the stress of having to deal with a medical problem, but we have to find a means to pay for the medical treatment and medications that we will need in order to recover properly. With so many different medical aid schemes available, it can be a daunting task trying to find the right policy that will work for you and your family. You may feel that because of your financial situation that you will not be able to afford to get a quality scheme. The reality of the situation is there are a wide variety of options that you can choose. LA Health medical aid has a variety of plans that offer a broad spectrum of benefits.
With each of the five different benefit options that you can choose from at LA Health, you are sure to find something that can fit into your budget as well as provide the benefits you need. The different plans offered are LA KeyPlus, LA Focus, LA Active, LA Core, and LA Comprehensive. Although each of these policies varies on what specific items they cover, they do cover a number of important medical needs and issues that can arise. Just some of the items that are covered include planned operations, oncology, and emergencies and casualties that require a hospital stay. Additional coverage takes care of the medicines that are required for chronic illnesses or other prescribed medicines.
Along with the cover for hospital stays and medicines, the right medical aid scheme can also offer coverage a number of additional items. This can include trips to your general practitioner, specialists, dentists, physiotherapists, and a host of other medical professionals. If you are planning to become pregnant, this is an additional medical benefit that is covered. The most important thing with LA Health medical aid is the overall health and well-being of those that use their various medical aid benefit plans. The goal is to help you live a life that is not only fulfilling, but one in which you are as healthy as you can be to have a quality life.
Your health and the health of your family is one of the most important things there is, because without it, life can be a struggle. Take care of your health, and those you love, by getting the proper medical aid scheme that will ensure that they are taken care of, in case an illness or emergency strikes that requires medical attention.
