27 August 2012

Women and medical benefits

Women need to make sure that their medical schemes are there for them when they need it the most.


It pays to be prudent about your changing health needs as a woman.

As we pay tribute to the strength and resilience of women this month, it's also worth bearing in mind that the stresses and strains of balancing work, family and household can take their toll.

Given the crucial role women play not just in their families but also in society as a whole, it is vital to nip potential health issues in the bud, says Dr James Arens, clinical operations executive at Pro Sano Medical Scheme.

"We need to make sure that women enjoy optimal health at all times," says Arens, noting that the female anatomy and women's child-bearing capacity make them more susceptible than men to certain conditions.

Conditions more prevalent in women

Mental illnesses are a case in point. And because female hormones play a major role in the onset of depression, women are especially vulnerable to this condition, especially at times such as after pregnancy.

The dreaded premenstrual monster, also caused by hormones, is a further reality for many women. "These mental effects are related to physiological changes, and can be so severe that they lead to strains in family relations. In some cases, professional intervention may be required," says Arens.

Each age group tends to have its own sensitive spots. "Pregnancy and its related risk are typically uppermost on the minds of women aged up to 35," says Arens. After all, every new mother wants to be certain that both she and her baby will receive the very best care. 

Arens identifies a number of other conditions which may also affect women in this age group. "Serious issues may be caused by unsafe sex or even sex related violence," he says.

A worrying age

Naturally, these health concerns change as women get older. The ages between 35 and 50 can be particularly worrisome, as it this is the stage at which most cancers or other rare conditions, like lupus and multiple sclerosis, begin to surface.

Women are more vulnerable to such diseases, as well as others like osteoporosis and rheumatoid arthritis. Unique cancers - like breast, cervical and ovarian cancer - are other potential problems.

After the age of 50, Arens says post-menopausal changes, degenerative changes and cardiovascular disease become issues to be on the lookout for.This is why it is essential to choose a medical scheme that can give you the the comprehensive care you need - especially if you have a family to look after.

This tricky thing about this is that you may be at a different life stage to your partner and children, with correspondingly different needs. It really does make sense to look at a medical scheme not just in terms of what you can afford now, but also how well it can accommodate your health profile's changing needs, says Arens.

"If your profile changes at a later stage, it might be difficult to purchase additional cover."

Ask about pregnancy and degenerative diseases

For instance, some medical schemes consider pregnancy a financial risk, and could therefore have stringent rules "that may be an inconvenience for women who need to claim for pregnancy shortly after joining the scheme", Arens points out.

And women who have a degenerative musculoskeletal disease may be at a disadvantage because the costly treatments for these conditions may not be covered by their scheme's basket of prescribed minimum benefits. Even if your scheme does pay for these treatments, it may not be obliged to cover them in full.

He suggests that you consult a scheme with a dedicated customer service to help you unpack you and your family's medical needs, while flagging any potential challenges.

We all know how daunting the rules and regulations can be, and a broker or a consultant will be able to explain how your medical scheme's savings account works, or what in-hospital benefits it offers.

"Take your time learning about the various products and the benefits they offer," advises Arens.


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