The all new Assisted Reproductive Therapy Benefit, which is available on the Comprehensive and Executive plans, brings much needed support to couples struggling to conceive.
The diagnosis of infertility and a defined list of linked investigations, and medical and surgical treatments are classified under Prescribed Minimum Benefit (PMB) conditions. This means that all medical schemes are obliged to fund infertility in line with the stipulated regulations.
PMB cover, however, does not make provision for Assisted Reproductive Technologies (ART) such as in vitro fertilisation (IVF) and embryo transfer (ET). “Now, Discovery Health Medical Scheme offers richer benefits and cover for assisted reproductive therapies. This is done in collaboration and close consultation with the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG),” explains Dr Ryan Noach, CEO of Discovery Health.
Infertility may result from a medical problem in either partner or from a combination of factors that prevent pregnancy.
“Fortunately, there are many safe and effective treatment options that can improve your chances of getting pregnant,” adds Dr Noach. “Some of these treatments include lifestyle changes, medicine, surgery or assisted reproductive therapy. With medical advances in the field of infertility management, the majority of fertility cases can now be treatable with assisted reproductive technologies.”
Assisted Reproductive Technologies include medical treatment and procedures carried out in the process of infertility management:
The new Discovery Health Medical Scheme Assisted Reproductive Therapy Benefit provides cover for a defined basket of care for up to two cycles of assisted reproductive therapy. For each cycle, this basket of care includes:
Female Discovery Health Medical Scheme members aged 25 to 42 who are on the Executive and Comprehensive Plans will have access to the benefit. They will receive cover for up to two cycles of ART if they meet scheme benefit and clinical entry criteria.
We pay up to up to 75% of the Discovery Health Rate for your treatment up to a limit of R110 000 per person per year. You will need to pay 25% of the cost of your treatment and any other costs not covered by the benefit.
This benefit is available in our network of SASREG accredited facilities and is subject to clinical criteria, protocols and treatment guidelines.
Access our network provider list.
If you are aged from 25 to 39, you have access to two cycles of assisted reproductive therapy. If you are aged 40 to 42, you have access to one cycle of assisted reproductive therapy.
You can activate the Assisted Reproductive Therapy Benefit if you are a female member, aged 25 to 42, and you are on an Executive or Comprehensive plan.
ACTIVATE ASSISTED REPRODUCTIVE THERAPY BENEFIT
The Discovery Health Medical Scheme is an independent non-profit entity governed by the Medical Schemes Act, and regulated by the Council for Medical Schemes. It is administered by a separate company, Discovery Health (Pty) Ltd, an authorised financial services provider.
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