CareChamp works with Medical Aids
We offer care to patients covered for home care and home nursing through medical aid.
We work with most medical aids where an in-home care benefit is available, including advanced illness benefits, in-lieu-of-hospitalisation benefits, post-operative support, and certain frail care benefits offered by closed schemes.
CareChamp is an official Discovery Health Designated Service Provider (DSP) for home-based nursing and care services. We assist eligible Discovery members with authorised in-home care and can guide families with AIB-related processes where applicable.
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The examples below provide a general indication of possible care support. Benefits and approval requirements may vary depending on your specific medical aid plan and cover. Care can usually only be claimed through an approved agency with a valid practice number.
DISCOVERY BENEFITS (maximum 4 weeks)
Nurture@Home support for eligible NICU-discharge families
Specialised wound care
Palliative and end-of-life care
Postnatal nursing care
Intensive Care Programme home visits
Virtual home assessments and multidisciplinary care support
ANNUAL FRAIL CARE BENEFITS
Bankmed Frail Care Benefit - Bankmed Comprehensive & Plus Plans: R600 per day & Bankmed Traditional Plan: R575 per day. New Authorisations need to be received yearly.
Anglo Medical Scheme (AMS) Annual Benefit - Accounts for frail care are paid from the Hospital Benefit up to 100% of the scheme reimbursement rate and is subject to the annual limit of R90 215 per beneficiary with a max. benefit of R317.60/day
Profmed also has an annual frail care benefit.
Alignd Palliative Care Benefit
The Alignd Palliative Care Benefit is available to qualifying Bonitas and Fedhealth members.
This benefit may cover:
Up to 336 hours of cancer care or palliative care, where approved
Up to 168 hours for transitional care, where approved
Bi-weekly Registered Nurse visits
The application FORM must be completed by the patient’s treating doctor.
Bonitas
Bonitas members may have access to home nursing through the Hospital Benefit Management Programme, also known as the HBM Programme.
Home nursing may be approved in lieu of hospitalisation, subject to the member’s available benefits and medical aid approval.
Out-of-Hospital Benefit for Home Care / Nursing
The following medical aids may provide cover for home care or nursing through an Out-of-Hospital Benefit, subject to the member’s plan and available benefits:
Fedhealth
Polmed
GEMS
Barloworld
Profmed
Sizwe Hosmed
SABC Medical Scheme
CompCare
CAMAF
Moto Healthcare
As a medical aid member you are not automatically qualified for care. Medical Aid needs to provide a letter of authorisation that clearly states the level of care covered. Usually in order to do so, the medical aid will require a letter of motivation from the Nursing Agency (Us) after a compulsory initial nursing assessment. Additionally you need a letter of motivation from your Doctor including ICD-10 code(s).
Support paid for OR subsidised by medical aids varies depending on program. The approved funds can be stretched out longer - claiming care on and off / basically creating relief care for families over an extended period of time.
For patients that want to explore their choices of Medical Aid Benefits and programs:
Based on the clinical information received we will evaluate the medical condition and diagnosis and render whether it is covered in terms of the underwriting terms and conditions of the Medical Aids.
Potential client need to please provide name, address, ID, Medical aid name and number, and dependent code as well as a doctors letter including ICD-10 codes.
Please contact us for assistance and we will get back to you .
Should you require urgent assistance - you can always opt to pay upfront to us directly and try to claim back thereafter.