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Should you wish to query your medical aid benefits or update your details, please click here.

Contact Details

Customer Call Centre:
0860 002 163

Private Bag X35
Claremont
7735

Be aware of the dangers of cardiovascular disease

September is Heart Awareness Month and we're calling on all our Liberty Medical Scheme members to take the health of their hearts seriously. Dr Vash Mungal-Singh, CEO of the Heart and Stroke Foundation South Africa (HSFSA), points out that cardiovascular disease kills 200 people in South Africa every day. "This equates to 13 minibus loads of people! Moreover 5.5 million South Africans are at risk because of their high cholesterol levels, so we're sitting on a time bomb," he says.

Heart disease can be prevented by making lifestyle changes, but you need to know what to change and where your risks lie. The theme of Heart Awareness Month 2011 is "One world, one home, one heart, one test" and the Heart & Stroke Foundation of South Africa is encouraging all South Africans to have at least one heart health test this month. Such tests include a simple BMI (Body Mass Index) which will indicate if you are overweight, a cholesterol test to indicate if you are at risk from raised cholesterol, or a blood pressure test which will highlight hypertension, a common cause of heart attack and stroke.

Cholesterol tests are covered as part of your Preventative Care Benefit, and are quick and painless. Get tested today and show you value the health of your heart.

Use formulary medication

We're constantly looking for ways to help you contain your medical costs, and one easy way of this is by using our formulary lists of medication. A formulary is a list of medicines approved for chronic conditions, provided you are registered on the Chronic Medicine Management Programme and have met certain clinical criteria. Because many of them are generics, they save you money.

It's important to familiarise yourself with what's on the formulary, so you can ask your doctor to match your prescription to it, if possible. Most people only discover they've been prescribed something that's not on the formulary (and therefore that they have to make a co-payment) when they get to the pharmacy.

The formulary has been compiled using funding protocols. A team of clinical experts has used evidence-based medicine principles in defining these protocols, to ensure that members have access to the most clinically appropriate therapeutic options for managing their specific conditions.

Get the formulary for your condition by visiting the 'Members' section of the LMS website www.libmed.co.za, or click here.

Tips on managing your healthcare costs

There is much you can do to manage the cost of your healthcare and avoid having to make co-payments. Different healthcare service providers charge very different rates for treatment, consultations and pathology tests, and it is possible to 'shop around' to find those providers whose costs won't mean you incur co-payments. Enquire about the costs of services and tests before these are undertaken, and compare them with the cover provided by Liberty Medical Scheme. You can then make informed choices about the service providers you wish to use – and avoid nasty surprises on your medical bills.

Remember to submit your claims within four months

When you're ill it's easy to forget about admin, but it's very important that members don't forget to submit their claims in time for them to be processed. From the date you received treatment, you have four months in which to do so – this is the standard time period for all members of all medical schemes.

If you submit your claims after this time period, they will be automatically rejected by the system and cannot be considered for payment.

However, if a claim is submitted within the four-month period and is rejected for payment, we will inform you and/or your healthcare provider, via a claims statement, within 30 days of receiving the claim. You will then have the opportunity to correct and resubmit the claim within 60 days from the date we informed you it was not payable – even if this extra time period falls outside of the four months. But remember, this only applies if the original claim was submitted within four months of treatment date.

So remember to pay attention to your claims statement, and ensure that all your claims have been submitted – whether by you or your healthcare service provider. It is your responsibility, as a member, to ensure that all claims are submitted to avoid having stale claims.

Different sets for various 'life stages'

Each Liberty Medical Scheme option comes with a different set of benefits, designed to best suit the needs of different people and families at different 'life stages'.

These benefits are available to you the member, but when claiming them, some may be required to go through the relevant approval procedures, which take into account various clinical protocols before approval is granted.

We urge you to please take the time to read your member guide. If you are uncertain about any benefit, please contact the Client Services Department at 0860 002 163.