The spread of the new coronavirus is now a serious health concern in South Africa, with the number of infected people growing daily. If you have medical aid, you likely have questions about what your scheme will cover if you need to be tested or treated for the COVID-19 virus.
After the news of the first coronavirus cases in South Africa first broke, the Council for Medical Schemes (CMS) released a statement to confirm that most medical aids will pay for testing. If you test positive, the cost will not come out of your medical savings. However, if you test negative, the cost will be deducted from your medical savings.
What happens if you test positive for the Coronavirus?
If you test positive, most schemes will cover your consultations and certain supportive treatments and medicines.
If you contract the COVID-19 virus and develop complications such as pneumonia or respiratory failure, you will be covered under Prescribed Minimum Benefit (PMB) regulations. PMBs ensure that medical aid members have access to essential health services, no matter their benefit option.
In a recent press release on the Coronavirus outbreak in South Africa, the CMS confirmed that medical aids are legally required to pay for the diagnosis and treatment of PMB conditions in full.
If you have a mild case of the COVID-19 virus that does not develop into a PMB condition, your medical scheme’s specific rules will determine what costs are covered under your benefit option.
The safest way to determine exactly what your medical aid will cover is to contact them directly. You can also visit your medical scheme’s website to find out more about how it is responding to the Coronavirus outbreak in South Africa.
If you suspect you might have the COVID-19 virus, call your healthcare provider. Calling ahead prevents you from spreading – or being infected by – the Coronavirus and allows your healthcare provider to direct you to the right facility.