Asthma, Pneumonia, Bronchiectasis and Other Lower Respiratory Tract Diseases

May 26, 2018

Asthma, of which there are three main types. Is a disease characterized by increased respiratory distress of the bronchi with airway narrowing. It is also associated with inflammation.

Shortness of breath, as well as wheezing, can cause stress with the patient and those standing by. Most cases of asthma have an allergic component, and it becomes important for managing the disease to remove the allergens from the environment such as foods and dust.

Asthma and Respiratory Tract Diseases MUST have coverage by Medical Schemes

AsthmaThe Council of Medical Schemes oversees the law that governs medical schemes in South Africa. The Council has drawn up a list of about 27 chronic conditions. Of which asthma, pneumonia and other lower respiratory tract diseases are included. These diseases must have coverage by all medical schemes.

This list is known as PMBs or Prescribed Minimum Benefits, and medical aids have to cover the management of these lung diseases. Managing these lung diseases may include the use of drugs for those with moderate to severe symptoms. But sometimes there will be special tests to measure the flow of air going into- and from the lungs.

Once you have have asthma it will be important to inform the medical scheme so that you can become part of their chronic benefits. No medical aid can refuse lung disease treatments and they have to cover –

  • doctor’s consultations
  • medicines
  • diagnostic tests

 

You Must Apply for Chronic Benefits

Fedhealth is one such medical aid that provides chronic disease benefits on their different medical aid plans. Members registered with Fedhed Medical Scheme will need to apply for chronic benefits. Once they have done this, they will need to maintain the condition under control by following Fedhealth’s guidelines of their treatment plan.

For instance, their top-level plan, Maxima Plus, doesn’t have formulary restrictions and members can use the doctors they prefer. Their least expensive plan, Maxima Entry Zone, has a restrictive formulary and therefore only covers services from DSPs. Co-payments will be required from those members on the mid-level plans if they opt to use out of formulary medicines.

If you are needing certain medicines for a chronic condition, you will need to have your doctor fill in a Chronic Illness Benefit application form. When they register your chronic medicine your doctor will need to issue a new prescription every 6 months so that the pharmacist can dispense your medicine.

If you’re travelling beyond South Africa’s borders for an extended period of time. You’ll need to fill in an ‘Extended Supply of Medication form’ for approval.

Without Medical Aid, COPD could spell Death

Chronic obstructive pulmonary- or lung disease causes shortness of breath and inflammation, and diagnosis will require lung function tests. Some patients will even require long-term oxygen therapy. Without treatment which can run into hundreds of thousands of Rands, you could be looking at death.

Also, COPD is listed as a leading cause of death. So do research on medical aids, compare them, and find the one that can offer you the most peace of mind that your lung disease will get the best possible treatment.

Medical Aids with the Best Bronchiectasis Cover

So if you’re looking for the best medical aid for asthma, pneumonia and bronchiectasis. And you’re wondering just how to choose one. Why not let IFC specialists give you a helping hand? They do all the frustrating searching for you. And will also come up with a scheme that will be appropriate for the illness you have as well as your budget.

All info was correct at time of publishing