Prosthesis, medical apparatus, appliances and supports
What is covered under this benefit?
Different benefits may be available on different Scheme options and are subject to a sub–limit, which also vary between options. The monetary (Rand) amount available is usually an annual limit. This benefit is pro–rated for new members and depends on the month of joining the option. For certain items the funding is specified for a specific time period or as a once–off funding approval. Some items are not covered in certain options. Contact the scheme at the number provided to verify the item and amount applicable for a specific Scheme option. The items covered under this benefit can be categorized under the following headings:
- Medical apparatus such as glucose testing devices
- Internal prosthesis (implanted during gynaecological/urological, cardio–vascular and spinal procedures, etc.)
- External prosthesis (e.g. artificial limbs)
- Hearing aids
- Wheel chairs
- Oxygen therapy
- CPAP machines
- Stoma products
- Crutches/supports/elastic stockings
What information is required to obtain these benefits?
- Clinical motivation by the treating doctor
- Funding will be considered in accordance with Scheme funding guidelines and protocols.
- At least two quotations must be submitted
- Specific information is required for some benefits e.g.:
- Oxygen therapy: a copy of the blood gas analysis, motivation and a prescription from the doctor is required. For re–approval of oxygen therapy, a compliance report has to be submitted.
- CPAP machine: summary of a polysomnography evaluation required.
- Glucometer: the type of diabetes and a clinical status report from the treating doctor is required.
Where can one get information on prosthesis, appliances and medical apparatus?
Telephone number: 086 000 2378
E–mail address: service@bestmed.co.za |
