Have you checked your chronic benefits?
If you live with a chronic condition, now is a good time to check what your medical aid plan makes available to you and make sure your routine care is up to date.
Your chronic-care benefits are there to help you monitor your condition, review treatment and identify changes early. What is covered — and how often — depends on your medical aid scheme, plan, condition and clinical need.
For plans whose benefit cycle resets at year-end, it is worth checking whether there are consultations, tests or screenings you still need to complete.
What might be included?
Chronic consultations
Routine reviews help your doctor monitor symptoms, treatment response, medicines and your overall care plan.
Blood tests
Your plan may make certain pathology tests available for monitoring, depending on your condition and benefit rules.
ECG monitoring
Some patients may have annual or bi-annual ECG benefits where this forms part of appropriate chronic monitoring.
Lung function testing
Where clinically relevant, lung function testing may form part of chronic respiratory monitoring.
Benefit rules differ. Check your medical aid app, website or member services for your exact benefits, limits, authorisation requirements and network rules.
Check your screening and risk benefits too
Even if you do not have a chronic condition, your medical aid plan may include screening or risk benefits. Depending on your plan and eligibility, these may include services such as blood tests, cervical screening or Pap smears, mammograms and other preventive health checks.
Use the benefits available to you
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1
Check your benefits.
Use your scheme’s app, website or member services to see what is still available.
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2
Check the requirements.
Confirm whether authorisation, a network provider or a specific benefit code is required.
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3
Book your appointment.
Book the appropriate consultation or screening rather than leaving routine care until the next benefit cycle.
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4
Bring the details with you.
If your scheme gave you an authorisation or benefit reference, keep it handy for the practice team.
Book your chronic review
Let’s make sure your routine monitoring and preventive care are up to date.
Book an appointmentImportant
Medical aid benefits vary by scheme and plan and may be subject to limits, clinical criteria, authorisation and network rules. Mentioned tests and screenings are examples only and are not guaranteed benefits. Your doctor will recommend investigations and follow-up according to your individual clinical needs.