South Africa: New Top-End benefit option ensures ultimate in healthcare
Liberty Medical Scheme (LMS) has introduced a new, top-end option this month which offers members the very best in healthcare supported by exceptional service which further ensures that the scheme continues to cater for all its members at every life stage.
“When care is at the heart of what we do, it means taking the time to listen to our members and to respond meaningfully. With the introduction of our Prestige option, LMS has demonstrated once again that it heeds the call of members who have indicated that they want the very best medical cover – and service – that money can buy,” says Executive Principal Officer, Andrew Edwards.
This comprehensive option with its range of extraordinary benefits and preferential service approach brings the number of options available to LMS members to 11.
According to Edwards, Prestige is the ‘Rolls Royce’ of medical options, giving members access to the best quality healthcare every day of the year. “Unlike other options with a savings component, Prestige covers all benefits from risk. This means the member will never have to worry about savings running out,” he points out.
Prestige’s major medical benefits include hospitalisation, disease management, chronic benefits including HIV/Aids and maternity benefits.
In terms of hospitalisation, not only will LMS cover the cost of admissions to private hospitals, including the hospital and associated costs such as consultation, pathology and radiology fees, the member can also choose any hospital or any GP or specialist. Specialist fees will be covered at 300% of the LMS rate and GPs at 200% of the LMS rate.
LMS also provides cover for alternatives to hospitalisation, should the Prestige member be in need of terminal care or rehabilitation following an accident.
In addition, Prestige covers the 27 conditions listed on the Chronic Disease List (CDL), as well as 41 other chronic conditions, while maternity benefits include: ante-natal classes per pregnancy, private wards for maternity admissions, pregnancy scans, delivery by a GP or specialist, services of the attendant paediatrician and/or anaesthetists and post-natal care and consultations by a GP or specialist, among other things.
Medical expenses incurred as a result of crime trauma (hijacking/attempted hijacking, assault, robbery, attempted murder and rape) will also be covered from this benefit. In terms of casualty admission, Prestige will cover the facility fee, consultations, medications, radiology and pathology associated with admission into the emergency room or casualty of a registered casualty facility.
In light of the growing need for preventative benefits, Prestige makes provision for a variety of preventative annual screening and diagnostic tests and procedures and specific vaccines, including mammograms, cholesterol and prostate tests, flu injections and immunisations for babies and toddlers.
Prestige will also cover the cost of diagnostic and minor surgical procedures which can be performed in the doctor’s room, attached theatre or day clinic, as well as funding two out-of-hospital MRI/CT scans per beneficiary, with no co-payment but subject to certain conditions.
On top of this, Prestige members will be assigned a dedicated Prestige Service Consultant who will be available 24 hours a day, 7 days a week and who will attend to their and their family’s needs. The service consultant will make intermittent courtesy calls in order to establish any requirements on the part of the member, or to deploy a nurse to perform preventative screening tests such as basic blood glucose screening, cholesterol testing and blood pressure, all free of charge.
For the convenience of members, they (or their personal assistants on their behalf) can access a dedicated 24-hour Prestige service centre, seven days a week. In addition, Prestige members will have the exclusive use of a LMS medical concierge service to collect claims should no scan or fax facilities be available to them.
To further ensure that Prestige members have an exceptional service experience, LMS has established a consolidated contact point for all third party suppliers, ensuring a single, consistent contact for services ranging from ER24, international travel cover and a baby programme, among many others.
“In designing Prestige, every care possible has been taken to ensure that members enjoy a complete and exceptional service experience with access to the highest quality healthcare, once again demonstrating the LMS promise of ‘We Care. For You’,” concludes Edwards.
