Covid-19: Palliative Care and your Medical Aid

Recommendations for how medical aids should fund Covid-19 palliative care, and which aspects and treatments fall under this recommendation
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Palliative care is a multifaceted, integrated approach to improving the quality of life of adults and paediatric patients, and their families facing the problems associated with life-threatening illness such as COVID-19. The recommendation for PMB level of care for confirmed cases of COVID-19 is for patients presenting with severe disease. You can also see how your medical aid plan covers non-PMB palliative care by finding your scheme/plan in the menu.

Palliative care includes but not limited to:

  • complex symptom management
  • advance care planning or goals of care conversations
  • complex discussions with patient, and more often with family:
    – diagnoses and current/future care plans,
    – when a patient’s condition deteriorates, or withdrawal of treatment decisions needs to be made
    – family’s own (mental)health
  • integration of psychosocial support especially for families on the outside:
    – isolation causing mayor distress and mental health issues with patients and families
    – primary physicians do not have capacity to always keep loved ones updated or discuss when difficult decisions need to be made quickly
    – bereavement support to families
  • Palliative care includes a multi-disciplinary team approach. The team may consist of doctors (GPs and specialists), psychologists, social workers, palliative care home nurses. Palliative care can be provided in different settings including:
    – in the home (even if severe and patient so wishes e.g. frail elderly or people with dementia),
    – long term care facilities,
    – hospices,
    – and in hospital including general ward, ICU and high care
  • CMS (Council of Medical Schemes) recommends the funding of palliative care. Where a multi-disciplinary team is involved in the treatment and care of COVID-19 patients, the primary provider should submit an initial treatment plan to the scheme for pre-authorisation and weekly updates to allow the scheme to make informed continued funding decisions.

View our other articles on Covid-19 and PMB Level of care or Covid-19 in general.

Source: This information is sourced directly from Council of Medical Schemes website, and their document titled PMB definition guideline: COVID-19 v5 and does not rely on our own independent research

Image: “coronavirus-covid-19” by Nursing Schools Near Me is licensed under CC BY 2.0

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