Diabetes mellitus is one of the most common chronic conditions in South Africa these days. The rise in the number of diabetics has practically made it an epidemic in S.A., possibly linked to the rise in the number of middle class South Africans. Diabetes can have a host of financial consequences as a result of a diabetic’s medical needs. Without medical aid, diabetics cannot always afford private medical treatment in the country.

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Pre-Existing Diabetes

If you are looking at signing up for medical aid and already have diabetes, then there are a couple points that you need to be aware of. Firstly, your pre-existing condition will not be covered for a period of 12 months. This simply means that your medical aid will not pay for any claims related to the diagnosis, treatment and/or management of diabetes. It is not only diabetes that is subjected this waiting period. It applies to all pre-existing conditions.

However, this waiting period should not discourage you from signing up for medical aid cover. Remember that you will need the cover at some point so it is best to overcome the waiting period as soon as possible. In the 12 month interim, you will have to pay for your diabetes-related medical claims or use a public health facility if you cannot afford the cash payments. At the end of 12 months you can enjoy full medical aid cover for your diabetes, depending on the benefits in your plan.

Diabetes Medication

Diabetes is a chronic condition that is incurable. It can be well managed with antidiabetic medication like metformin, or insulin where necessary.  These drugs will be covered by your chronic benefit. Normally your chronic benefit has an annual limit. Since diabetes is a prescribed minimum benefit (PMB) condition, the benefit to manage this condition will be  unlimited throughout the year.

However, diabetes management extends well beyond drugs. It requires dietary and lifestyle changes that can help your glucose control. Regular monitoring is also crucial. This requires specialist medical advice and supervision from a team of healthcare professionals, including a dietitian, an endocrinologist and your family doctor (general practitioner) among others. Medical aid will pay for the services of these practitioners, depending on your plan and level of benefits.

Blood Tests for Diabetes and Monitoring

Your medical aid ensures that you are getting the best diabetes management possible. To ensure that your diabetes is well controlled your medical aid and the practitioners overseeing your management will request regular blood tests. Ideally you should be conducting a finger-prick blood glucose test at home on a regular basis. Most medical aids subsidise these home glucose meters and strips.

Every 6 months you will also need to undergo blood tests with a pathology laboratory as requested by your doctor and medical aid. The HbA1c test is usually conducted. It measures the amount of glucose within your red blood cells and is an indicator of how your blood glucose levels fared over the past 3 to 6 months. If you have not been taking your medication regularly, eating as advised for a diabetic or exercising regularly, the HbA1c will reveal your average blood glucose levels over a period of several months.

References

  1. South Africa’s diabetes epidemic. Times Live

Last updated on September 4, 2018.

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