The flu season is here again and with this year’s flu season expected to be more severe, South Africans should seriously consider getting their influenza (flu) vaccine, a local disease expert warns. We are here to remind our Medical Aid Members that use this time to get the flu vaccine, to strengthen immunity, and let you enjoy this winter in the healthiest way possible. Since Covid 19 came into our lives, its very hard distinguish the difference between the two. It is rather important to note that Flu and COVID-19 are very different diseases. Although Flu and COVID-19 may present similar symptoms, the viruses that cause them are not the same. COVID-19 is caused by infection with SARS-CoV-2, and flu is caused by infection with influenza viruses. To gain protection against each, you need to have the vaccine developed against each disease. You don't have to wait between COVID-19 and flu vaccinations. You can have them at the same time and, if you've had COVID-19 and recovered, it's safe to have the flu vaccine. Remember to give the healthcare provider your Medical aid company name and your Medical Aid number. Below we indicate with the different medical aid Providers , you can go about getting the vaccine through your Medical Aid Provider. Discovery Flu shot is paid from savings, or if you are on the Smart Plan, it is paid from your OTC benefit; if you are on the Core Plan, you then will need to pay from your pocket. You may go to: Medirite + Pharmacy (No dispensing and admin fees), ICPA (independent community pharmacy association), Clicks or Dis-chem. Momentum Flu vaccine is paid from Health Platform Benefit, you can either contact Momentum via WhatsApp (+27860117859), Momentum App, access your Momentum profile or call 0860117959 to notify Momentum. Bonitas Bonitas offers all members a free flu vaccine once a year. Simply go to Dis-chem, Clicks, or Pick n Pay Pharmacies. FedHealth FedHealth offers all members a free flu vaccine once a year, you need to pay R36 for admin fee. Fedhealth covers both flu vaccines, namely quadrivalent (QIV) and trivalent (TIV) vaccines. Profmed One flu vaccine per person per year is covered by Profmed Scheme. You must use a Designated Service Provider (DSP). If you want to know more about preventative benefits, please contact Namhla in our Health Department, email service@daberistic.com , Tel (011)658-1333
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Every Medical Scheme includes maternity benefits.If you are not already pregnant before applying for your medical aid, you can enjoy maternity benefits when you fall pregnant. This article will focus on Discovery Medical aid company. If your medical insurance is Momentum, Bonitas, Fedhealth or Profmed, please contact us for your maternity benefits. Benefits will be activated when your pregnancy or baby profile is created on the My Pregnancy or My Baby programme on the Discovery app, or on website www.discovery.co.za or when you register your baby onto the Scheme. You can also activate the programmes by calling 0860 99 88 77 and following the voice prompts. These benefits are available per pregnancy per child up to two years after birth. Once these limits are depleted, you will have to pay for out-of-hospital healthcare expenses related to your pregnancy. Benefits Overview During Your Pregnancy For Two Years After Birth Benefits Details
Antenatal consultations You are covered for up to 8 consultations at your gynaecologist, GP or midwife covered from the Maternity Benefit at the Discovery Health Rate. Pre- and postnatal care You have cover for up to five pre- or postnatal classes (including online classes) or post-birth consultations with a registered nurse, up until two years after birth. Once these have been used, we pay antenatal classes from the available funds allocated to your Medical Savings Account. Prenatal screening You are covered for one non-invasive prenatal testing (NIPT) or one T21 chromosome test subject to clinical entry criteria and/or amniocentesis or chorionic villis sampling (CVS) from the Maternity Benefit at the Discovery Health Rate. Blood tests Cover for a defined basket of blood tests per pregnancy from the Maternity Benefit at the Discovery Health Rate. Ultrasound scans You are covered for up to two 2D ultrasound scans including one nuchal translucency test from the Maternity Benefit at the Discovery Health Rate. 3D and 4D scans are paid up to the rate we pay for 2D scans. Medicines for morning sickness, iron supplements and folic acid (Medical Savings required) Discovery pays for medicines and supplements that are taken during your pregnancy from the available funds allocated to your Medical Savings Account. If these accounts are more than the money you have available in your Medical Savings Account, you will have to pay these costs. GP and specialist care after birth Your baby under the age of two years is covered for two visits to a GP, paediatrician or an ear, nose and throat specialist from the Maternity Benefit at the Discovery Health Rate. Other healthcare services You are covered for one flu vaccination during your pregnancy. You also have access to postnatal care which includes a postnatal consultation within six-weeks post-birth for complications postdelivery, a nutritional assessment with a dietitian and two mental healthcare consultations with a counsellor or psychologist. You are also covered for one breastfeeding consultation with a registered nurse or breastfeeding specialist from the Maternity Benefit at the Discovery Health Rate (DHR). Point-of-care devices (Medical Savings required) If you are registered on the My Pregnancy or My Baby Programmes, you also have access to the latest remote monitoring medical examination device called TytoHome until your youngest child turns six. Discovery pays up to 75% of the Discovery Health Rate for one device per family every five years. You will need to pay 25% of the cost of the device. For more information, refer to the Connected Care for healthcare at home guide available on www.discovery.co.za under Medical Aid > Manage your health plan > Find important documents and certificates. Discovery covers normal deliveries or home births or birthing home delivery with a registered midwife If you choose to have a water birth or normal delivery at home or birthing home, Discovery will pay for care from a midwife for your approved delivery from your Hospital Benefit. The midwife must be registered with a valid practice number. For a water birth at home, Discovery will pay for the cost of the hire of a birthing pool from your Hospital Benefit at the Discovery Health Rate. This must be hired from a registered provider who has a valid practice number. If you use a midwife within our network, the birthing pool is included in the amount we pay. Hospitalisation for your delivery You have cover for hospitalisation for your delivery from the Hospital Benefit, if approved. We pay the hospital account from your Hospital Benefit up to the Discovery Health Rate. You have cover for a water birth in hospital. The midwife must be registered with a valid practice number. Treatment for neonatal jaundice If your baby needs phototherapy due to neonatal jaundice, Discovery will pay for the phototherapy lights from the Hospital Benefit as long as you call for authorization. Please consult the treating doctor for the treatment codes so that we can provide you with the authorization number of the treatment. Is Baby Immunization Covered? Baby immunization is paid from your available Medical Aid Savings, if you are on a hospital plan (Core Plan) then you need to pay for it from your own pocket. The suggestion we would provide, whether you have Medical Aid Savings, is that you should call the Dischem near you, ask them if they have stock for government/public immunization shots, this would not only save your time from queuing at a Public Clinic, but also save you money, as the price difference between the private and public immunization shots can be huge. If you would like to know more about your Maternity Benefits, please contact Jo or Namhla in our Health Department email: service@daberistic.com Tel: (011)658-1333 COVID-19 restrictions have affected many people and a lot of the Vitality members motivation to achieve their weekly Vitality goals was diminished so many people cancelled their Vitality. However it is important to remember that the key to combat COVID-19 is to stay healthy, the Vitality health programme provides a steppingstone to support members to reach a healthier lifestyle. The Vitality health programme offers members great rewards and discounts with partner companies to motivate members to reach their healthy lifestyle goal. If you have not joined Vitality make sure you join now while they still have the special where new members get the first 3 months free. These are some of the Active Rewards and Discounts that you can get:
Call us and join with first 3 months premium free, contact Tammy or Namhla tel (011)658 1333 email service@daberistic.com Due to pandemic, rising costs and high taxes are eroding pensions and retirement savings in South Africa. Many are forced to use the state-funded healthcare services which is already under pressure, causing long queues and even longer waiting lists. There is no doubt that we want the best medical attention for our elderly parents when they fall ill therefore private health care is our solution. It is important to understand what options is best suited for your aging parent’s needs. Where do you start? You would need to sit down and discuss with your parents and obtain the following information:
Once you have answers to the above, the next set of questions you need to discuss is to do a realistic budget to finance the plan.
What if your parents cannot contribute? If your aging parents are financially dependent on you and you happen to be main member of a medical aid policy, you may consider adding them as your dependent as this means they can pay a reduced rate. However, they will be on the same option plan as you, should your option not be sufficient to cover their needs, your option is to upgrade your plan. If you’re on an option that includes savings, they become eligible for using your savings. You will need to be prepared for savings being exhausted due to extensive care required. What happens when parents don’t qualify as your dependent? If you decide to not add parents as Dependants or due to parents not qualifying to be your dependent, they can always choose a medical option according to budget and below are things to consider for when choosing your option. Full medical cover (with savings): On a comprehensive option, most elements are covered for. Such as hospital admission, chronic medication and day to day expenses, medical equipment, and possibly dentistry and optometry. These plans vary widely therefore, read through entire plan before signing up to make sure it qualifies all your parent’s needs. Basic hospital plan: These covers around 90% of hospital procedures, basic prescribed minimum benefit (PMB) condition and cancer benefit. It excludes expenses such as none PMB approved medication, equipment, doctor’s visits, optometry, or dentistry. This may not be a full coverage but highly affordable option. Gap cover is always recommended by Daberistic as this boosts your unforeseen gap payment by 500%. To read more about gap cover click here. What else to keep in mind?
If you would like cover for your parents, please contact Namhla or Tammy in our health department, email Service@daberistic.com, Tel 011-658 1333, option 2 for Medical Aid. For urgent assistance and to prevent delayed turnaround times due to reduced number of staff between 20th December 2021 to 3rd January 2022, please contact your insurance provider on the contact numbers below.
Medical Aid 1. Discovery Health: 086 099 8877 2. Fedhealth: 0860 002 153 3. Momentum Health: 0860 11 78 59 4. Bonitas: 086 000 2108 5. BonCap Members: 0861 239 333 Hospitals in Gauteng 1. Bedford Gardens: 011 677 8500 2. Life Fourways Hospital (Fourways): 011 875 1000 3. Morningside Medi-Clinic (Sandton): 011 282 5000 4. Sunninghill Hospital: 011 806 1500 5. Garden City Hospital: 011 495 5000 6. Waterfall City Hospital (Kyalami): 011 304 6600 7. Glynnwood hospital- 011 741 5000 Life cover 1. Discovery Life: 0860 00 54 33 2. Liberty: 0860 456 789 3. Momentum Myriad: 0860 69 74 23 4. Old Mutual Greenlight: 0860 50 60 70 5. Old Mutual Self-service support centre: 0860 60 65 00 6. Sanlam: 0860 726 526 Short-term Insurance (Car & Business) 1. CIB: 0860 104 952 2. Momentum: 086 078 4767 3. Brolink: 0861 338 339 4. Santam: 0860 505 911 5. Discovery Insure: 0860 999 911 6. Echelon: 0860 200 002 / 083 789 9932 7. First Road Assist: 0860 911 326 Emergency services 1. Netcare 911: 082 911 2. ER24: 084 124 3. Ambulance: 10177 4. Police: 10111 Discovery Health Medical Scheme (DHMS) is taking proactive steps to make sure members who need it have the necessary cover for COVID-19. Who is covered for treatment related to an outbreak disease such as COVID-19? The WHO Global Outbreak Benefit is available to all members of Discovery Health Medical Scheme (DHMS) during a declared outbreak period. This benefit offers cover for out-of-hospital management and appropriate supportive treatment of global World Health Organization (WHO) recognised disease outbreaks and out-of-hospital healthcare services related to COVID-19. The basket of care includes:
Once you suspect that you have COVID 19 or had a contact with someone who tested positive these steps are to be followed:
Once Discovery has received and review member will get the following benefits
Source: Discovery Health Spring season is finally here and that means the year is coming to an end. We can see a trend that more and more countries are opening up for tourists. In the time of such a pandemic it also reminds us how important it is to have medical cover abroad. Most medical schemes include international travel medical benefits, but each company's benefits are different. With some medical schemes you need to ensure that you need to activate your International Travel Benefit before you travel. With Discovery Health you do not need are to phone ahead to “activate” this benefit, all you need is your departure and re-entry stamps in your passport as proof! Depending on your chosen medical aid option, your cover limit will either be R5 Million or $1 Million and that will alleviate the burden off your shoulders knowing that you will be able to receive the best medical attention whilst on your travel adventures. Should you wish to find out more about International Travel Benefit topics such as:
If you will be travelling and may require a vaccine certificate, you may contact EVDS on 0800 029 999 to request a vaccine certificate for travel. This is a special request that they do and they will provide the member with an email address to send their information. They will need the below information:
If you have any other queries, please contact Namhla, Tammy or Jo in our Health department, email service@daberistic.com, Tel 011-6581333, Option 2 for Medical Aid. |
AuthorKevin Yeh Archives
January 2025
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