Discovery continues to lead the industry by rolling out exciting benefits and offerings: Mental wellbeing Shari'ah compliance arrangement Infertility and assisted reproductive therapy benefit Hospital network and day surgery updates New clinic and other services for employers Diabetes care programme Chronic Illness Benefits Co-payments and deductibles To find out more, please click on each tab below.
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Mental wellbeing Statistics according to WHO shows one in four people in the world will be affected by mental disorders at some point in their lives, this positions mental disorder amongst one of the leading causes of ill-health worldwide. Mental ill-ness often left undiagnosed and with 84% of adults never receiving treatment and this impacts society and WHO estimates cost to global economy may exceed $16 trillion by 2030. Discovery’s approach to alleviate this disorder, they have introduced management in mental wellbeing. Below programs offered are:
Shari’ah compliant arrangement From 2021 members from our Muslim community can appoint to have their contribution and claims across all plans to conform with Shari’ah principles through the Shari’ah compliant arrangement. • Model is compliant and is based on Takaful principles • Process flow happens in an acceptable manner • No interest earned or paid at any stage • No ambiguity in contracts • Members’ interests are protected • Investments are managed in Shari’ah Compliant manner • No interest earned or paid on Shari’ah Compliant arrangement. Funds will be invested in a compliant manner allowing members opportunity to earn profit on Medical Savings Account balances. • Members that partake in this arrangement attain affirmation on their contribution and balances remaining after settlement of claims and other expenditure will be invested in Shari’ah compliant investments. Infertility and assisted reproductive Therapy benefit When a couple is looking forward to building a family and the incapability to fall pregnant is aggravating. It affects many families and takes a emotional toll, however, many infertility cases can be remedied through treatment such as drug, surgical repair and assisted reproductive techniques including intra-urine insemination (IUI) and in vitro fertilisation (IVF). Taking a leap of faith on possibility to become a parent can come with a price tag, an average of R65000.00 – R85000.00 for a single IVF treatment cycle, this may be a hefty cost for many families in which will hinder and or have reservations from taking on this treatment. Discovery would like to support couples/ families distressed from infertility with introducing cover for Assisted Reproductive Technologies (ART) and the benefit will include cover for: • Up to two cycles of ART if Scheme’s benefit and clinical entry criteria are met. • This includes a series of care for the progress of the full duration: consultations, ultrasounds, oocyte retrieval, embryo transfers, admission costs including lab fees, medication and embryo and sperm storage. • The total limit of R110 000.00 per person per year at Discovery health rate applies. • Members will be subject to 25% of the costs and any excess above the Discovery Health Rate. • This benefit will be attainable at Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG) accredited centres only and subject to clinical pathways and protocols. • Lastly, the benefit is only available to female members that has been on Executive and Comprehensive Plans for at least 2 years and the age between 25-42 years old.
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Chronic Illness Benefits
Diabetes Care Programme 2021 Premier Plus GP network will become the Designated service provider for members with Diabetes on the comprehensive plans. It is supported by the extensive coverage offered by the Premier Plus GP network and the clinical outcomes achieved by the diabetes care programme. The chosen GP will be member’s DSP for the ongoing management of diabetes as well as cardiovascular conditions. Statistics has shown in improvement when member’s care is coordinated by a single doctor. Hospital Network Updates and Day Surgery New hospitals will be added, and some existing hospitals will be replaced with region specific substitutions for 2021 to ensure continued optimisation of the Delta, Smart and KeyCare hospital networks In the Day Surgery, they will extend this offer to Comprehensive plans given focus on provider and patient safety because of COVID-19. The 2021 new hospital network and day surgery lists will be published by the end of October 2020.
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Limits, Co-payments, deductible and Thresholds
Next: Vitality 2021 - To Help members stay motivated Co-payments For Endoscopic Procedures
New Clinic and Other Services for Employers Daily monitoring of COVID-19 exposure, prevalence, and disease progression:
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Medical aid is a form of insurance where you pay a monthly amount, called contribution or premium, in return for financial cover for medical treatment you may need, as well as any related medical expenses. Medical aid and health insurance are two different products. Medical aid, or medical scheme, is regulated by the Medical Schemes Act, provides in-hospital cover and chronic illness benefits, and pays for treatment according to specific medical scheme tariffs. Some medical aids also provide for day-to-day medical expenses. Health insurance, on the other hand, is regulated by the Short-term Insurance Act. It provides a more limited set of health benefits, up to a monetary limit. Health insurance is a cheaper alternative for people who cannot afford medical aid. Why medical aid is important Having a good medical aid plan with a reputable medical scheme can help you protect both your health and your wallet. The reality is that your health, and that of your family holds immeasurable value to you. There are many advantages of belonging to a medical aid. It financially protects you if you suddenly have to pay large, unexpected medical costs. Being a member of a scheme also means you have access to private medical care, instead of having to rely on public health services. If you are looking for advice on healthcare needs for you, your family or your company, you can contact us on the following channels: - WeChat: daberistic - Email: Health@Daberistic.com - Phone: working hours 011 658 1333 What is Gap Cover? Gap Cover is the invaluable safety net that covers the shortfall between what medical schemes pay and what specialist doctors charge. Without a gap cover policy, a member would be required to pay this unexpected cost from their own pocket. In addition, a comprehensive gap cover policy also covers co-payments, penalty fees and cancer benefits. At Daberistic, our preferred provider is Sirago. Why Choose Sirago? • Personalised customer service • Gap Cover Solutions • Cover for in and out of hospital • Shortfall cover for day-to-day specialists, GP consultations, dentists and Alternative Therapy • Standard waiting period • Emergency Room Cover for accident, trauma and Illness • No maximum entry age. Benefits do not cease at the age of 65. • Cover for you and your family either on single medical scheme membership or on multiple memberships. • Sirago provides effective turnaround time so as not to compromise policyholders. • A stated benefit is paid straight into the policyholder's bank account or arrangements can be made to settle directly with providers • Claims run weekly • You can claim online, an industry first and for our clients: https://www.daberistic.com/gap-claim-ch.html |
AuthorKevin Yeh Archives
January 2025
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