Can Aids sufferers get Gap cover? In South Africa, it is illegal for medical schemes to deny clients benefits based on their HIV/ Aids status.
Medical schemes, by law, must also offer HIV clients prescribed minimum benefits.
What this means is that medical schemes are obliged to pay out when it comes to the diagnosis and treatment of the disease. And all clients, no matter what level of cover they choose, have the same protection. Gap cover providers are also not allowed to discriminate against those with HIV/ Aids.
Can Aids sufferers get Gap cover?
Yes they can. The law prescribes basic benefits, but that does not mean you can choose to go wherever you want to for treatment. Most medical schemes have their own network of providers.
If your doctor is not on this network, you will probably be liable to pay extra. The basic benefits include treatment relating to the immuno-suppressant effect of the disease.
Extra education programmes Offer lifestyle Advice
HIV suffers can delay the onset of Aids if they follow a healthy eating plan and lifestyle.
The healthier you are, the slower the progression of the disease.
Most medical aid plans offer education programs in addition to the basic benefits to enable their clients to remain healthier.
Usually, these will include:
- Treatments that prevent the transmission of the disease from mother to child
- A helpline that is available 24/7
- Access to a management program that helps to monitor the illness and how far it has progressed.
Discovery Medical Aid plan
Discovery pays for treatment to stop transmission of the disease between a mother and her child on all plans. This also includes the provision of formula to feed the baby.
They also pay for treatment when you have been assaulted or accidentally exposed to the virus. The chronic benefit comes in on the day to day treatment needs.
Discovery does not have limits on hospital care in regards to PMB for treatment for the immuno-suppressant effects of the disease. You must have all stays in hospital pre-authorised, though.
The program does pay for certain tests and consultations.
Momentum Medical Aid Plan
Momentum clients have access to the treatment for conditions related to the immuno-suppressant effects of the disease. They will pay for some anti-retroviral products. How much they pay for is plan-dependant.
Momentum provides a management and education programme free of charge. This includes diagnosis, management and disease prevention. The company will also pay for medication, pathology, doctor’s charges and psychology fees as part of the PMB.
With Momentum, you have a level of cover. But this is dependent on using their network or paying the difference. HIV/ Aids sufferers do not pay a loaded premium for gap cover. Gap cover will pay the difference your medical aid won’t.
When Aids sufferers get Gap cover they are able to concentrate on the management of the disease and maintaining good health. They don’t have to worry about paying large medical bills or, should the worst happen, leaving their families to pay them.
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All info was correct at time of publishing