Natasha suffers from Crohn's disease, which she's been battling to manage. Last month, she spent eight days in hospital for malnutrition and while her hospital stay was covered by her scheme Fedhealth, part of her doctor's bill and her medicines amounting to R6,500 were not. The deterioration of her condition and admission to hospital, as well as the unrecouped costs, are the result of her not receiving or following the treatment protocol developed by her scheme. Fedhealth principal officer Jeremy Yatt says Natasha's case highlights the apathy of members who fail to understand their medical scheme, and especially disease management programmes. "There's this perception that the scheme is trying to make you jump through hoops [to obtain benefits]. We want the member to get the most effective treatment at the best price." Yatt says it often happens that members with chronic conditions don't register their conditions with the scheme, use designated service providers (DSPs) to avoid co-p...
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