Medical cover for healthy holidays
There are few things that could ruin your well-deserved year-end holiday more than a serious health event that requires hospitalisation and treatment. Liberty Medical Scheme advises that you check these five things with your medical scheme before you go on your summer break.
Casualty cover
There is no denying the statistics regarding the number of accidents on our roads. The festive season in particular sees an increase in accidents due to more vehicles on our roads. Prevention is always better than cure and road users must exercise due caution and drive responsibly. However, we recognise that despite our best efforts accidents do happen. It is important that as a medical scheme member, you ensure that you have your medical scheme details available in the car with you whenever you travel. Should you be in an accident, it is critical that emergency staff are able to easily access this information. The easiest way to do this is to ensure that your medical scheme membership sticker is applied somewhere which is highly visible or easy to find.
“A sticker with your membership number and emergency contact details stuck onto the sun visor is a good idea or on the back left hand triangular window,” says Executive Principal Officer of Liberty Medical Scheme, Andrew Edwards. “If you plan on using public transport such as taxi or bus, make sure your medical scheme membership card is in your possession – in your wallet or in your pocket for example.”
Edwards says that if your children are travelling anywhere without you, remember to send a copy of your membership card with them as well.
On most of its options, Liberty Medical Scheme offers a Casualty Benefit that is not paid out of savings and which covers emergency transport, the facility fee, consultations, medications, radiology and pathology associated with admissions into the emergency room or casualty ward of a private hospital.
“Although the responsibility to obtain a pre-authorisation rests ultimately with you, if you are admitted to hospital in an emergency situation and cannot phone your medical scheme, the hospital or family member may also do so on your behalf,” says Edwards. Remember to notify your scheme of your admission within 48 hours of the event or on the first working day thereafter.”
Liberty Medical Scheme also offers an additional benefit of R1 435/day for after hours treatment (7pm-7am) and if you are further than 200km from your normal residence while you are on holiday on some options. “But decide if you really need emergency care – if you can see a GP, for example, then do so, because claims for non-emergency care such as earache will not be covered under the Casualty Benefit.”
Extreme activities
After a year of hard work, treating yourself to an action-packed holiday may be just the way to unwind. But have you considered that you may not be covered if you engage in extreme sports such as skiing, mountain biking, paragliding or scuba diving?
“By their nature, extreme sports are risky and can result in serious injuries,” says Edwards. “Make sure you have enough cover to ensure you get access to the best healthcare and surgery should you need it.”
Some schemes may not pay your medical bill if you participate in an extreme sport, but most Liberty Medical Scheme options cover treatments within the rules of the Scheme. “This is not an additional benefit – it’s part of your normal benefits,” says Edwards.
International travel
Paris, New York, Zanzibar – wherever you are jetting off to for the festive season, make sure you have enough cover to fund the costs of a health event. “It’s one thing paying for a GP visit in rands, but if you fall seriously ill or are injured, hospitalisation and emergency transport back to South Africa can literally bankrupt you,” says Edwards.
While some credit card companies cover travel insurance, check with your medical scheme what they will cover should you get sick outside of South Africa’s borders.
Liberty Medical Scheme has partnered with ER24 to provide international medical cover when members travel outside the borders of South Africa for leisure. The policy provides cover of up to R5 million per trip, for up to 90 days per trip, irrespective of how many trips are made during the year. The Traditional Ultimate option covers up to R10 million per trip, for up to 90 days per trip. “This is option-specific, so you would need to check your medical scheme benefits,” says Edwards.
Those who are travelling for longer than 90 days and are over the age of 80 require additional insurance.
Crime trauma benefits
Just because you’re on holiday, doesn’t mean you’re immune to crime. Check whether your medical scheme covers the costs of services such as counselling by psychologists, psychiatrists and social workers and HIV prophylaxis in the case of rape.
Liberty Medical Scheme offers crime trauma benefits to victims of hijackings, attempted murders, assaults, rape or robberies, and you will need to report the crime at a police station. These benefits are paid from the scheme’s risk pool and not from members’ savings. “You will need the case number and name of the relevant police station when you claim,” says Edwards.
Some people suffer from post-traumatic stress disorder months after the event, so the benefit is available for a period of 12 months from the date of the event.
GP and hospital networks
If you are on a network option, which means you can only use designated group of hospitals, usually in the area where you live, check the list of network hospitals, day-clinics and GPs in your destination area. “Obviously for emergency treatment, you can go to any hospital and there are exceptions, so you can seek some non-emergency treatments at hospitals outside of your network, although you will need to phone through for pre-authorisation first,” says Edwards.
“With a little forward thinking and planning ahead, South Africans can go away and truly enjoy their well-deserved break with peace of mind that they are well-equipped to deal with any eventuality,” says Edwards.
