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:
1. Acne
2. ADHD
3. Allergic Rhinitis
4. Alzheimers
5. Ankylosing Spondylitis
6. Benign Prostatic Hypertrophy
7. Carcinoid Syndrome
8. Cardiac Dysrhythmias
9. Cerebral Palsy
10. Cerebrovascular Disease
11. Congenital Malformation of Heart
12. Depression
13. Deep Vein and Other Thrombosis
14. Eczema
15. Endocarditis
16. Gastro-Oesophageal Refl ux
17. Gout
18. Heart Valve Disease
19. Hepatomyalgy & Splenomyalgy
20. Hypoparathyroidism
21. Menopause
22. Osteoarthritis
23. Osteoporosis
24. Paraplegia/Quadraplegia
25. Polycystic Ovarian Syndrome
26. Psoriasis
27. Pulmonary Hypertension
28. Stroke
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LA Health medical aid is part of the more well known Discovery Health Ltd. The scheme currently provides cover to nearly 65,000 members primarily from the local government industry. Although the LA Health brand is often overshadowed by the Discovery name, the scheme has actually been in operation for around 40 years.
The program focuses on enhancing the lifestyle that their members currently enjoy based on extensive research which indicates that making small, sustainable adjustments to your day to day life can make a positive impact on your overall health and can even help to prevent certain diseases. Some of the changes advocated by LA Health medial aid include:
- Being more physically active.
- Following a healthy eating plan.
- Taking preventative measures.
- Making good lifestyle choices.
These seemingly insignificant changes to your every day habits can make a substantial difference in both improving and maintaining your overall well-being, not just physically but also mentally and spiritually.
LA Health medical aid members can choose from five different plans all of which offer integrated health and lifestyle benefits which will help members with their quest for a healthier lifestyle. Across these various options the scheme strives to be able to cater for any member’s individual needs. The plans offered include:
- LA KeyPlus
- LA Focus
- LA Active
- LA Core
- LA Comprehensive
Chronic Illness Cover
One of the things that really sets LA Health medical aid apart from similar schemes is the long list of illnesses which are covered in full under all five plans. These include Bipolar Disorder, COPD (Chronic Obstructive Pulmonary Disease), Haemophilia, HIV & AIDS, Multiple Sclerosis and Parkinson’s Disease among many others. Partial cover is also offered on a range of other conditions including organ transplant, stroke and major psychiatric disorders. The scheme also operates a dedicated oncology program which is also accessible to members on all plans.
Day To Day Medical Expenses
Depending on the plan level selected, members are also covered for many of those day to day medical expenses including eye care, dentistry, doctor’s appointments, over the counter medication and prescription treatments. With the higher level plans there is also additional access to a medical savings account
Preventative Measures
As noted, LA Health medical aid id passionate about improving health and they advocate preventative measures to help members avoid illness. Some of the preventative care benefits offered at some plan levels includes :
- flu vaccination
- mammograms
- pap smears
- prostate antigen screenings
- annual vitality checks
- cholesterol and blood pressure monitoring
LA Health medical aid certainly has a somewhat unique take on how to approach health care schemes. Their focus on making positive lifestyle changes is something that other providers should be looking at since healthier members will surely mean more affordable premiums!
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