Medication and You: What to Expect From Your Medical Aid Scheme
Finding a medical aid scheme which suits you can be time consuming, but it is always worth putting in that extra bit of effort to get the best medical aid quotes. When comparing your medical aid quotes, there are many different things to take into consideration.
If you are on medication, this is something you need to always keep in mind. You will find that some medical aid quotes are more expensive, depending on the medication you may require, along with the regularity of it.
Prescribed Acute Medication
The term ‘acute medication’ relates to a once-off medication prescribed for conditions not recognised as chronic by your medical scheme. It has to have been prescribed by a certified Medical Practitioner, and is subject to the application of MMAP (Maximum Medical Aid Price). The cover you get for your acute medication is dependent upon which of our medical aid quotes and packages you have chosen.
Essence: Our Essence package covers you for up to R295 per admission.
Equilibrium: Our Equilibrium package covers you for up to R360 per admission.
Silver: Our Silver package covers you for up to R175 per admission.
Gold: Our Gold package covers you for up to R360 per admission.
Platinum: Our Platinum package covers you for up to R410 per admission.
Over-the-Counter Medication
Over-the-counter medication is also known as self-medication. It will have a NAPPI code, which means that it can be obtained from a pharmacy without the need for a prescription.
The amount of cover for over-the-counter medication will depend upon which of our medical aid quotes and packages you have chosen. It will also depend upon the type of medication you are purchasing.
The cover is claimed in one of two ways. The scheme member can either pay the pharmacy in cash and submit a claim with proof of payment, or the pharmacy itself can claim the amount due directly from the Scheme.
Prescribed Chronic Medication
Prescribed chronic medication is usually used continuously for a period of at least three months. In order to claim cover for prescribed chronic medication, you need to first register a chronic illness…only then will you gain access to the chronic medication benefit.
The Doctor who has consulted the patient, or the Pharmacist afterwards, must register the conditions with MediKredit, including a severity status. The prescription will only then give the patient the right to obtain this medication from the pharmacy or Doctor’s dispensary. It is important that these conditions are followed, no matter which of our medical aid quotes and packages you have chosen, otherwise you will be unable to make a legitimate claim.
What is covered?
For each of our medical aid quotes and packages, there are a number of illnesses and diseases which are covered. Prescriptions and medication for these illnesses and diseases are covered by the scheme.
Addison’s Disease
Asthma
Bipolar Mood Disorder
Bronchiectasis
Cardiac Failure
Cardiomyopathy Disease
Chronic Renal Disease
Coronary Artery Disease
Crohn’s Disease
Chronic Obstructive Pulmonary Disorder
Diabetes Insipidus
Diabetes Mellitus
Dysrhythmias
Epilepsy
Glaucoma
Haemophilia
Hyperlipidaemia
Hypertension
Hypothyroidism
Hormone Replacement Therapy
Multiple Sclerosis
Parkinson’s Disease
Rheumatoid Arthritis
Schizophrenia
Systemic Lupus Erythematosis
Ulcerative Colitis
The Platinum package
There are added benefits for the Platinum package, including a longer list of medication:
Acne
Allergic Rhinitis
Alzheimer’s disease
Ankylosing spondylitis
Benign Prostatic Hypertrophy
Clotting Disorders
Cystic Fibrosis
Deep Vein Thrombosis
Diverticulitis and Irritable Bowel Syndrome
Gastro-Esophageal Reflux Disease
Hypoparathyroidism
Hyperkinesis
Hyperthyroidism
Interstitial fibrosis
Iron Deficiency Anemia
Major Depression
Meniere’s Disease
Menopausal Disorder (Calcium only)
Migraine
Myasthenia Gravis
Osteoarthritis
Osteoporosis
Paraplegia and quadriplegia
Peripheral Vascular Disease
Psoriasis
Rheumatic Fever
Stroke
Testosterone Deficiency
Urinary Incontinence
Make Sure You Choose Correctly
Because there are so many illness and diseases out there that could be covered, it is important that you choose correctly from your list of medical aid quotes. You need to ensure that you choose a scheme that is going to cover long term illnesses such as Cystic Fibrosis and depression if you know that you or your family member has them. There is no point in paying out for a scheme that doesn’t completely cover you, no matter how cheap the medical aid quotes are!
Give us a call today, and see what we can offer you. Come in for a chat with us, and we can discuss your exact requirements, and we will be able to give you medical aid quotes for the schemes that we believe would fit both your circumstances and your budget.
