Asthma patients: have you checked your chronic benefits?
If your asthma is registered on your medical aid’s chronic benefit, lung-function testing may form part of your ongoing care. Many benefit structures provide periodic testing, and some allow up to two lung-function tests per year. Your exact cover depends on your scheme, plan, treatment basket and authorisation rules.
Asthma symptoms can change from day to day, and symptoms do not always tell the whole story. Lung-function testing gives your healthcare practitioner an objective measurement of how well air is moving through your lungs.
That makes the first good-quality test especially useful: it helps establish a baseline or personal reference point against which future results can be compared.
Why lung-function testing matters in asthma
Establish your baseline
Your first reliable result gives the clinical team a reference point. Later tests can be compared with your previous readings and your personal best, rather than being viewed in isolation.
Spot deterioration earlier
A meaningful fall in lung function can help identify worsening airflow limitation, even when your day-to-day symptoms have not changed dramatically.
See whether treatment is helping
Repeat testing can show whether lung function improves after treatment is started or adjusted and helps place your symptoms in better clinical context.
Track change over time
Keeping comparable results over months and years gives your practitioner a clearer picture of whether your lung function is stable, improving or declining.
What is a lung-function test?
Spirometry is a common lung-function test. You breathe forcefully into a measuring device so that values such as FEV1 (how much air you can force out in the first second) and FVC (the total amount you can force out) can be measured.
In asthma assessment, testing may also be repeated after a bronchodilator to see whether airflow improves. These measurements help support diagnosis, assess airflow limitation and monitor asthma over time.
Your symptoms and your lung-function result are both important. A person can feel relatively well while objective lung function is lower than expected, which is one reason periodic testing adds value to routine asthma reviews.
Why repeat the test if you already have asthma?
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1
Establish a reliable starting point.
At diagnosis or the start of treatment, lung-function testing provides an objective baseline against which later results can be compared.
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2
Find your personal best.
After treatment has had time to work, repeat testing helps establish the best lung function you achieve on appropriate therapy. This can be more useful clinically than comparing only with population-predicted values.
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3
Compare future results.
If later readings fall meaningfully below your previous best, the change may prompt the practitioner to look at asthma control, treatment adherence, inhaler technique, triggers, recent exacerbations or other causes.
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4
Monitor more closely when needed.
Patients with exacerbations, higher-risk asthma or concern about declining lung function may need testing more often than patients whose asthma is stable.
Asthma is a Prescribed Minimum Benefit chronic condition
In South Africa, asthma is included on the Chronic Disease List under the Prescribed Minimum Benefits framework. This means medical schemes must provide the diagnosis, treatment and ongoing care required for the condition, including relevant consultations and tests, subject to the applicable treatment protocols and scheme rules.
The practical benefit available to you can still differ by scheme and option. Your medical aid may require chronic registration, pre-authorisation, specific benefit codes or use of a Designated Service Provider (DSP). Some plans provide a defined annual treatment basket that includes a limited number of lung-function tests.
Before you pay from day-to-day benefits or cash: check whether your asthma is registered on chronic and ask your scheme whether lung-function testing can be claimed from your chronic/PMB treatment basket.
Your clinical need and your benefit are not always the same thing
Current international asthma guidance recommends measuring lung function at diagnosis or the start of treatment, again after several months of inhaled corticosteroid-containing treatment to establish the patient’s personal best, and periodically thereafter. For many adults this may be at least every one to two years, with more frequent testing when the patient is at higher risk or the clinical situation requires it.
Your medical aid may fund testing more frequently than that clinical minimum. If your plan provides up to two tests per year, using those benefits can create a much clearer longitudinal record for your treating practitioner.
Book your lung-function test
If you are registered for asthma on chronic, check your benefit and book your routine lung-function assessment.
Book an appointmentImportant
Medical aid benefits vary by scheme, option and treatment basket and may be subject to chronic registration, clinical criteria, authorisation and DSP/network rules. The number of funded lung-function tests is not identical across all medical aids. Clinical testing frequency should be determined by your treating practitioner, not by benefit availability alone.