Is Your Medical Aid Prepared For A Viral Outbreak?

In a country where almost 16% of the population is covered by a medical aid scheme, the growing threat of a Corona Virus outbreak in South Africa may have you wondering about the impact outbreaks of this magnitude might have on your medical aid.

CEO of Profmed Medical Scheme Craig Comrie says, “Every scheme holds reserves specifically for events like this. The problem is, if an outbreak is sustained for too long then those reserves will deplete quickly.”

Comrie warns that it is essential that a coordinated approach is supported between the private sector and government to assist any who are infected. Funding the treatment for a widespread pandemic will place significant financial burdens on individuals, medical schemes and the government.

When it comes to these type of unusual events, Comrie recommends that you carefully evaluate what benefits your scheme provides while considering the financial health of your scheme which is reflected in what is called the “solvency level”. Schemes are required to keep a minimum of 25% solvency which effectively is equal to 3 months worth of premiums. Restricted schemes like Profmed tend to have higher solvency levels above 40% while open schemes are usually very close to the minimum requirements.

Although, Comrie said that in his two decades of experience in the healthcare industry he can’t remember having to ever dig into the reserves however we have extensive experience with other infectious diseases like tuberculosis. South Africa has been insulated from most global pandemics however careful planning is still needed for these types of events.

Even if the Coronavirus hits South Africa, Comrie says that your medical scheme should be able to operate as normal. “The health of our members is why we exist and our benefits will cover you if you land up requiring treatment for a viral infection, be it the flu, pneumonia, or even Corona.”

However, since there is no current cure or vaccine for Corona, all medical schemes will take a keen interest in containment and treatment strategies in partnership with the public health sector.

For many who travel overseas, Profmed offers its members free 90-day international travel insurance as a scheme benefit.

“Those who travel to high-risk areas like China will have to consider additional travel insurance. South Africans are extensive travellers and it is interesting that specific Corona cover is already available in the market,” says Comrie.

“There is no doubt that the Coronavirus is spreading quickly, and we should all be concerned,” says Comrie. “But, since this is a virus, people should stick to the tried and true methods of prevention.”

According to Comrie prevention methods include:

• Avoiding close contact with people who are infected
• Regularly wash your hands with soap and water for 20 seconds or more, or use an alcohol-based sanitizer with 60% alcohol or higher if you can't get to a sink If you're sick, avoiding interacting with other people
• Don't go to work if you're sick
• When you sneeze, cover your nose and mouth
• Try not to touch your eyes, nose, and mouth
• Regularly clean and disinfect surfaces and objects that could be contaminated with germs (like your phone)

If you suspect you may have the coronavirus, or have recently returned from travelling in China, seek medical attention immediately.

• Call your GP or the emergency room before you arrive
• Wear a face mask
• Do not leave your home unless you need medical care.