You suspect you may have COVID-19 – now what?
If you belong to a medical aid, it is important to understand exactly how you will be covered for COVID-19 testing, hospitalisation, and treatment to avoid unexpected out-of-pocket medical expenses
Fortunately, Medihelp medical aid ensures that its members have access to quality medical care during these uncertain times.
Click here for more information from Medihelp.
COVID-19 is a prescribed minimum benefit
In terms of legislation, COVID-19 testing qualifies for prescribed minimum benefits (PMB), which means that medical aids must cover these tests regardless of the medical aid plan on which their members are enrolled should the tests meet certain criteria.
Medihelp provides comprehensive cover in and out of hospital on all its benefit options from the core benefits for COVID-19 tests, regardless of the test result, if the clinical criteria for testing are met. Read more
What are the clinical criteria for COVID-19 testing?
The qualifying criteria are as follows:
- You must be screened and referred by a medical doctor; and
- The test must be submitted under the applicable clinical codes for COVID-19.
- The test must furthermore be requested for a suspected COVID-19 case; or
- The test must be requested for a patient at high risk for COVID-19.
High-risk patients include those who have been in close contact with a confirmed or suspected COVID-19 case, who have travelled to high-risk COVID-19 areas, or been to a healthcare facility where patients with the virus were being treated.
Will I be covered if I’m hospitalised?
In the unfortunate event that you need to be hospitalised for treatment of severe COVID-19 symptoms, Medihelp will cover your COVID-19 treatment from the benefit that we have created specifically for this purpose. Fortunately, most patients recover at home.
Will I have access to a private hospital despite my chosen medical aid plan?
Yes. All our plans cover hospitalisation in quality private hospitals nationwide.
Will I be covered should I be admitted to a temporary hospital, for example at Nasrec?
Yes. Medihelp will also cover hospitalisation at temporary hospitals and at state facilities.
If I am a member of a network option and I am admitted to a non-network hospital, will I have to make a co-payment?
If no hospital bed is available at a network hospital, you will not have to make a co-payment.
If there are no beds available and I have to recover at home using oxygen, will Medihelp fund the oxygen?
Yes. All members have benefits for oxygen used at home.
Make sure to take care of your health during the COVID-19 pandemic by getting the right medical aid cover. Medihelp’s range of plans is tailored for varying healthcare needs and is especially attractive for families. Visit medihelp.co.za to find out more.
This article was published in partnership with Medihelp.