South Africa: Medical Scheme members should keep emergency details at hand
Come December, our minds seem to automatically shift from work to play mode. While we can hardly wait to switch off, relax and enjoy the holidays, it’s also the season to be extra cautious as year-end festivities often tend to result in seasonal scrapes, aches and pains and sometimes life-threatening emergencies.
Amid frenzied holiday preparations, few of us actually think about the possibility that we could be seriously injured somewhere along the way, and making provision for such an eventuality is furthest from our minds.
“While the December holiday season is certainly a time for well-deserved relaxation and enjoyment, unfortunately it’s often also a time for medical emergencies,” says Andrew Edwards, Executive Principal Officer for Liberty Medical Scheme (LMS). “Many South Africans take to the roads, trek to their respective holiday destinations and indulge in sporting activities for which they do not necessarily have the required training or skills.”
Edwards adds that accidents often happen when you least expect them, so it is vital that medical scheme members are up to speed with all the relevant information and details about away-from-home cover in the event of an emergency. “This is particularly important for those travelling abroad,” says Edwards.
Abandoning your normal daily routine and taking on new and sometimes strenuous adventures, can – and often does – unexpectedly take a toll, Edwards says. Keeping a cool head and meticulously following a check list of all the important medical information you need to have on hand in an emergency can go a long way to averting stress and ensuring a fun-filled, joyous time, Edwards advises.
Your holiday medical check-list should typically include the following points for you to act on and to keep in mind:
Familiarise yourself thoroughly with all of your casualty benefits. This should include your cover for emergency room visits, medical treatment for physical injuries, such as the stitching of deep wounds and setting of broken bones, x-rays resulting from external force, facility fees and any consultations associated with you or your dependant’s admission to an emergency room or casualty ward.
· Ensure that you are fully aware of all exclusions on your medical scheme option. Check the extent and duration of your cover, and your cover for non-emergency care, such as a routine check-up.
· Make sure you are covered for any hazardous or extreme sporting activity you plan to take part in. If not, rather play it safe and steer clear.
· Remember, medical scheme members require pre-authorisation for any planned or emergency procedure, or a stay in hospital. Pre-authorisation is also required for certain non-hospital procedures, such as scans. Check your option summary to familiarise yourself with these.
Ensure that, as required, you get pre-authorisation at least 48 hours before an admission for a planned procedure.
You will need to inform your medical scheme and seek authorisation within 48 hours of being admitted for treatment at a casualty facility or hospital. Alert family members to this fact so that they can call for authorisation on your behalf, if you are unable to do so.
If an emergency procedure or unplanned stay in hospital falls over a weekend or on a public holiday, make sure that you follow the authorisation procedure and notify your scheme on the first working day after the weekend or public holiday. If you don’t, your claim won’t be paid.
· If you’re travelling overseas, ensure that you obtain sufficient international travel cover. This is included in most top medical scheme options through dedicated travel insurance companies, such as ER24 and Europ Assist. Both of these companies, as well as banks, provide a range of travel insurance products to cover you in the event or illness or injury while travelling abroad. Should you feel the need for more cover, you can get a top-up option at an additional cost. This can be taken out directly with your service provider.
· Make a list of all the relevant contact numbers and make copies of your documentation. Keep it on hand during your holiday and make a copy for a relative who can be contacted at all times.
“By ensuring they have all the relevant medical scheme information pertaining to emergency treatment/hospitalisation, pre-authorisation and travel insurance at hand, those South Africans leaving for ‘greener pastures’ this holiday season can enjoy a well-deserved break, while enjoying the peace of mind that they are equipped to deal with any eventuality,” says Edwards.
