Your cover for asthma treatment

Having a chronic condition isn’t fun. But having a diagnosis means that you can start breathing easier. Once you and your treating Healthcare Professional find the right medication for you to get your asthma under control, you can start focussing more on your ambitions and less on your condition, as Richard Rawbone has done.

Tell Bankmed you have asthma

We don’t automatically register you on the Chronic Illness Benefit when you’re diagnosed with asthma.

As long as you and your treating Healthcare Professional register your asthma with us, Bankmed pays for the diagnosis, ongoing treatment and care of asthma from the Chronic Illness Benefit. This means that we don’t use your day-to-day benefits to pay for the care of this chronic condition.

We have to approve your application to register your asthma on the Chronic Illness Benefit for us to pay from this benefit. To get full cover, you have to:

• Visit a Healthcare Professional in the Bankmed network
• Use medication on our Chronic Illness Benefit medicine list (formulary)
• Get your medication from a network pharmacy
• Let us know if your medication or dose changes.

You and your treating Healthcare Professional have to fill in a Chronic Illness Benefit application form to apply for cover for asthma if you are a member on the Basic or Essential Plans. If you are on the Core Saver, Traditional, Comprehensive and Plus Plan, you can ask your Healthcare Professional or pharmacist to call Bankmed’s Chronic Managed Care Department on 0800 132 345 or 0800 BANKMED (0800 226 5633) to obtain authorisation for your chronic medication.

Details of how we pay for your specific treatment will be communicated to you once we approve your request.

What to do if you need treatment in hospital

Not breathing is a medical emergency. If you are having a severe asthma attack and your inhaler isn’t relieving it, it could be an emergency. In a medical emergency, you must go to the nearest hospital. You have cover for emergency medical treatment in any hospital. You or the hospital must let Bankmed know that you have been admitted to hospital within 48 hours of the admission.

Please contact us for authorisation before any planned hospital visit. Tell us about your hospital visit as soon as you and your Healthcare Professional confirm the date. Inform us by any one of these methods:

• Call 0800 BANKMED (0800 226 5633)
• Send an e-mail to treatment@bankmed.co.za, or
• Send a fax to 021 527 1928

If your Healthcare Professional arranges your hospital authorisation, make sure that they give you the information about what we do and don’t cover, whether the Healthcare Professional and hospital are Designated Service Providers, and if not, whether or not you can expect a co-payment.