Sappi Medical Aid provides its services to a number of different clients. Staffs of Sappi are automatically registered as members of the scheme. Sappi is targeting most of the diverse groups including pensioners, widowers and their family members who are eligible for the scheme. The company has always been concerned with the wellbeing of its members. This is why it is looking forward to improve on its line of products and services. In order to receive the most satisfactory experience when dealing with Sappi, clients are advised to update their information. Keeping updated information ensures speedier services and it can even save lives when it involves critical or traumatic cases.
Scope of Coverage
Clients are covered under two schemes, i.e. the core and routine benefit plan. Under the core benefit plan, Sappi covers the expenses for major and unexpected cases. The coverage may include expenses due to clients being hospitalised, getting medications for chronic illnesses, undergoing chemotherapy sessions, going through renal dialysis and other required major medical expenses. The company covers an array of different medications for chronic illnesses, up to 26 chronic conditions altogether. Apart from that, basic coverage is also given to certain medical needs including dentistry, optometry and a few others. Transport issues are taken care of by Netcare 911, and the service is extended to both land and air transportation. A pre-authorisation is needed though, before the services and products covered under the core benefit plan can be given.
Under the routine benefit plan, members are given generous access to day-to-day GP consultation sessions. Regular supplies of acute medications are also provided to members. If members wish to use alternative medical services including chiropody and homeopathy, the expenses will be taken from the routine benefit plan. Unused funds available in the routine benefit plan are not able to be transferred to the following year. Therefore, members are encouraged to spend the expenses on homeopathy and chiropody treatments if they haven’t used the funds to cover for major and chronic medical expenses.
One of the privileges given to members is the chronic medication benefit. Members who have been diagnosed with chronic diseases are able to get access to ongoing supply of medications. Normally, chronic conditions are life-threatening in nature and thus patients need to get continued supply of medications to sustain life. In order to get access to chronic medication benefits, patients need to go to a panel doctor appointed by Sappi and ask him to issue an authorization. The doctor needs to call the appointed pharmacist so that the chronic medication can be authorized. Issue of authorization can also be applied through writing.
Sappi also covers for psychiatric hospitalisation expenses. The benefit is even extended to period of staying in rehabilitation centres. Expenses on consultation sessions for psychiatric patients are also covered. Psychiatric cases may include mental disorder conditions such as drug addiction, alcoholism, bulimia and anorexia. Sappi does not forget to include coverage for auxiliary services. Auxiliary services may include physiotherapy, speech therapy, work-related and remedial therapy as well as services provided by social workers.
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