Do Medical Aids Cover Asthma Treatment
Asthma is one of 25 chronic diseases that your medical aid by law is obliged to cover. This list of Prescribed Minimum Benefits (PMBs) was introduced by the Council for Medical Schemes to provide basic healthcare to everyone that needs it. Medical aids have to cover in full the medical management of your asthma, including doctors’ consultations, diagnostic tests and medicine.
Before you undergo any tests it’s important to read and understand your specific medical aid policy to see what conditions they have for PMB.
What is asthma?
It’s a lifelong lung disease where the inside walls of your airways narrow and become temporarily inflamed. This means less oxygen gets to the lungs making it harder to breathe. When different stimuli trigger asthma the airways constrict, the muscles around the bronchi contract and phlegm is increased.
The disease can be mild, moderate, severe or very severe, where hospitalisation is required. It’s often sporadic and seasonal but if properly controlled most people can live healthy lives.
Causes of asthma
Asthma affects people of all ages but it frequently begins in childhood. The reason why people get it is not completely understood but it’s believed to be a combination of environmental and genetic factors. Your chance of having asthma is higher if there’s a family history of the disease, if you were born prematurely, had bronchiolitis as a child or if you’ve developed another condition like a food allergy.
There are common triggers that irritate the bronchi and these bring on a variety of symptoms. They differ from person to person but often include:
- Pollen, mould, dust mites and animal fur
- Foods like peanuts or shellfish that cause an allergic reaction
- Cold air
- Air pollutants like tobacco smoke
- Some medications
- Strong emotions and stress
- Sulphites and preservatives in certain foods and drinks
Symptoms of asthma
Classic signs include coughing, wheezing, being short of breath, having a tight chest and coughing up phlegm. The intensity of these can differ between people and you can experience one or more of them. A severe onset of symptoms is known as an asthma attack and these may also include a racing pulse, feeling agitated or restless and your lips and fingernails turning blue.
Diagnostic tests for asthma
Not everyone who has asthma will display these symptoms and if you have these symptoms it doesn’t necessarily mean you are asthmatic. The most accurate way to diagnose the condition is for a doctor to analyse your medical history, do a physical exam and conduct lung function tests which determine how efficiently your lungs are working.
- A spirometry test which measures the quantity of air you are breathing in and out and how quickly you blow out air.
- A body plethysmography test that calculatesthe air in your lungs after you’ve taken a deep breath.
- A peak flow test measures how hard you can breathe out.
- A lung diffusion capacity test calculates how efficiently oxygen can pass from your lungs into the bloodstream.
Treatment is based on whether you’re diagnosed with intermittent, mild, moderate or severe asthma.
How common is asthma?
Asthma is one of the most widespread lung illnesses in the world,affecting about 300 million people, and it’s estimated that there are around3.9 million South Africans living with the disease. It’s often seasonal and it changes in severity over time, requiring adjustments in treatment. There is no cure but it can effectively be controlled with a combination of medicine, lifestyle changes and identifying and avoiding triggers.