All the large open medical schemes in South Africa have announced their contribution increases for 2024. Below is the list. Discovery Health says the average weighted increase across DHMS plans is 7.5% for 2024. Excluding the Medical Savings Accounts, the increase on Risk Contributions is 10.5%.
If you want to review your medical aid plan, please call our Health Department on 011-658-1333, Option 2 or email service@daberistic.com.
0 Comments
Are you recently diagnosed with High Blood Pressure? Or Diabetes? Did you know that your Medical aid actually covers your monthly medication? Different medical aid schemes may cover different chronic conditions, but the general 27 conditions are covered by most of the medical aid across all plans. Below we list them:
How to apply for Chronic illness benefit? Discovery:
Once the form has been received and reviewed you will get a confirmation via email whether or not the request has been approved, and/or what medications are approved/declined. The letter of benefit will have details on how you will be covered under the condition. If your script has an end date (such as 3 months or 6 months), to continue with treatment, you must visit the doctor again to get the new script, and send it to Discovery to assess and update the approved medication. If you have any updated new prescription (medication or dosage), you must email the new prescription to Discovery as well so they can update it on their system. Medications that are covered Discovery has its medication formulary. If you are on the Essential Smart plan or Keycare plan, then your medication MUST be from the formulary; if you are on other plans, then medications from the formulary will be paid fully, and medications outside of the formulary will be paid partially. Approved medicine on the Chronic Illness Benefit medicine list (formulary) Bonitas: There are two ways to activate your Chronic Illness Benefits with Bonitas
Follow-up consultation and nominated doctor online Doctors normally advise you to follow up online to save time, normally this is perfect for members who need blood test review. They would send you to the nearest pathology for a blood test. Momentum
For further queries regarding your Chronic Illness Benefit contact Namhla in our Health department tel(011)658-1333, email service@daberistic.com 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 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 Given that COVID-19 is a global pandemic, all governments are required to coordinate and manage the response to the disease in the best way they can. As is the case in other countries, the South African Government has decided that it will source, distribute and oversee the rollout of the vaccination programme, and will therefore be the sole purchaser and distributor of the COVID-19 vaccines to provincial governments and the private sector, including medical schemes.
With the roll-out of the COVID vaccine, the South African government has also had relevant regulation, and different Medical Aid companies have their own relative ways to cooperate. The vaccines provided by the government are Johnson and Johnson (one dose) and Pfizer (two doses), and the Medical Scheme must be carried out according to the Government’s progress and allocation phase. As of 16 May 2021, people over the age of 60 are allowed to register on EVDS. South Africans must register on the Department of Health (EVDs) at the following website, when their age group is open to register: https://vaccine.enroll.health.gov.za/ Discovery Health In addition to the Department of health's online registration (EVDs), Discovery has launched its own registration and tracking program. Please refer to our article about the process and registration steps: https://www.daberistic.com/discovery_covid_vaccine_english.html Momentum Health Momentum is preparing to provide vaccines in an efficient way to assist members and the public to obtain vaccines in their allocated phase, the following has been established:
Momentum will communicate exact locations of the health care centres. Bonitas Health Bonitas Health did not give any special instructions, but for members who are qualified to register on EVDS, Bonitas has sent a SMS and an e-mail directly to the members. After receiving the invitation, they can register on the website of the Department of Health, and follow the process further. Momentum Medical Scheme focuses more than ever on keeping benefit design stable and ensuring that their members continue to enjoy comprehensive and affordable benefits. The 3rd largest open medical aid scheme in South Africa, Momentum Medical Scheme has announced an average annual contribution increase of 3.9% for 2021. This is substantially lower that the weighted average annual contribution increase of 8.2% for 2020.
If you have any queries or are interested in joining Momentum Medical Scheme, please contact us on 011-658-1333, 076-200-5488 or email service@daberistic.com. |
AuthorKevin Yeh Archives
January 2025
Categories
All
|