What if you could access exactly the right support and cover for your health condition? Well, that’s exactly what Discovery Health Medical Scheme’s (DHMS) specialised care programmes are there for – to offer enhanced support and extra benefits to members living with diabetes, heart disease, kidney disease, depression and HIV disease.
If you live with a health condition, you’re not alone. Conditions, such as hypertension and diabetes, are on the rise both here in South Africa and across the world. These conditions can have very serious health consequences that can significantly affect our quality of life if we aren’t managing them well. At Discovery Health Medical Scheme, we understand that the right support improves your ability to manage a health condition. That is why our specialised care programmes help you and your doctors to actively manage and monitor your conditions by giving you more support and benefits. Here’s what you need to know about our care programmes for people living with diabetes, cardiovascular disease, kidney disease, depression and HIV disease.
Diabetes Care Programme
The Diabetes Care Programme is based on established clinical and lifestyle guidelines. The programme will help you and your Premier Plus GP to actively manage your diabetes.
You can join the Diabetes Care Programme by following these easy steps:
- Register for the Chronic Illness Benefit. You and your nominated Premier Plus GP must complete and submit a Chronic Illness Benefit application form to register you on the Chronic Illness Benefit for type 1 or type 2 diabetes. Your doctor can also apply for cover online, using HealthID at the time of your diagnosis. Through the Chronic Illness Benefit, you will have cover for:
- Medicine
- Disease monitoring tests
- Consultations with your GP and certain specialists
- Your GP can then enrol you on the Diabetes Care Programme using HealthID.
This will unlock extra benefits unique to your journey, including:
- A personalised dashboard with your unique diabetes management score. You and your GP can agree on goals and track your progress on the dashboard. This will help to identify areas that need attention and identify steps you must take to manage your condition and stay healthy over time.
- A diabetes educator to guide you on key areas that include daily glucose monitoring and timing of medicine.
- Extra blood glucose test strips per year
- A biokineticist consultation as monitoring your daily glucose is important in tailoring your nutrition, activity and medicine.
- An extra dietitian consultation to help you with nutrition.
If you are on a KeyCare or Smart plan, make sure you choose a Premier Plus GP who is in your plan’s network.
For more information and plan-specific details, visit the Diabetes Care Programme benefit page.
Cardio Care Programme
The Cardio Care Programme is designed to offer optimal cover to Discovery Health Medical Scheme members living with hypertension (high blood pressure), hyperlipidaemia (high cholesterol) and coronary artery disease (problems with the heart vessels).
You can join the Cardio Care Programme by following these easy steps:
- Register for the Chronic Illness Benefit, your Premier Plus GP must register you on the Chronic Illness Benefit for one of the above conditions. You and your Premier Plus doctor must complete and submit a Chronic Illness Benefit application form. Your doctor can also apply for cover online, using HealthID at the time of your diagnosis.
- Your Premier Plus GP can now enrol you on the Cardio Care Programme. This programme allows your GP to manage and treat your conditions with the support of a multidisciplinary care team.
If you are on a KeyCare or Smart plan, make sure you choose a Premier Plus GP who is in your plan’s network.
Kidney Care Programme
The Kidney Care Programme makes it easier for our members on chronic dialysis to manage their condition and treatment.
When starting chronic dialysis, your treating specialist must make sure that you have applied for all your medicine through the Chronic Illness Benefit. Your treating doctor must also submit a Prescribed Minimum Benefit application detailing with which mode of chronic dialysis you are being treated.
This will give you access to the yearly, calendar-based basket of care for chronic dialysis. This will cover all the blood tests that you need while on chronic dialysis. The Kidney Care Programme will give you extra support, which will include:
- Yearly confidential medical reports based on your blood tests.
- Educational material and information to help you better understand and manage your condition and treatment.
Mental Health Care Programme
The Mental Health Care Programme is for members who’ve been diagnosed with episodic depression. Your nominated Premier Plus GP or a psychologist in our network can enrol you on the Mental Health Care Programme.
The Mental Health Care Programme runs over a period of six to twelve months. It unlocks the following extra benefits to monitor and manage your condition:
- Up to three consultations with your Premier Plus GP.
- Antidepressant medicine.
- Up to three psychotherapy consultations or nine group therapy sessions.
- Digital mental health care with internet-based cognitive behavioural therapy (iCBT).
For more information and plan-specific details, see the Mental Health Care Programme benefit page.
If you are on a KeyCare or Smart plan, make sure you choose a Premier Plus GP who is in your plan’s network.
Visit our mental health information hub for articles, podcasts and videos that can help you with your mental health and wellbeing.
HIV Care Programme
The HIV Care Programme gives comprehensive support to members living with HIV and AIDS to help them better manage their condition.
You can join the HIV Care Programme by following these easy steps:
- Your nominated Premier Plus GP or a GP in the Discovery Health GP Network must register you for the condition by completing HIV Care Programme application form first
- You need to give your Premier Plus GP a consent on HealthID to be enrolled on the HIV Care Programme
- Your Premier Plus GP can now enroll you on the HIV Care Programme
When you have been enrolled on the HIV Care Programme, you and your Premier Plus GP can agree on key goals and track your progress on a personalised dashboard. You will receive an additional consult with a social worker.
If you are on a KeyCare or Smart plan, make sure you choose a Premier Plus GP who is in your plan’s network.
Disease Prevention Programme for those at risk of diabetes or cardiovascular disease
The Disease Prevention Programme supports Discovery Health Medical Scheme members who are at risk of developing diabetes. The goal of the programme is to reduce your risk of developing type 2 diabetes.
Our predictive model assesses your risk based on your Health Check results (blood pressure, waist circumference, body mass index (BMI) and family history. If you meet the criteria for the Disease Prevention Programme, your nominated Premier Plus GP can enrol you on it. A health coach will then get in touch with you to explain how the programme works.
Once you are enrolled on the programme, you have access to:
- Two consultations with your Premier Plus GP to set your goals for reducing your risk of developing type 2 diabetes.
- Two consultations with a network dietitian for personalised nutrition advice.
- Blood tests for monitoring your progress in reducing your risk.
- Medicine if prescribed.
- A health coach for tracking and improving your health.
For more information, see the Disease Prevention Programme webpage.
Discovery Health Medical Scheme, registration number 1125, is regulated by the Council for Medical Schemes and administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider. Vitality is a separate wellness product, sold and administered by Discovery Vitality (Pty) Ltd, registration number 1999/007736/07. Limits, terms and conditions apply.