What is the WHO benefit?
The WHO Global Outbreak Benefit is available to all members of Discovery Health Medical Scheme (DHMS) during a declared outbreak period. This benefit offers cover for out-of-hospital management and appropriate supportive treatment of global World Health Organization (WHO) recognised disease outbreaks and out-of-hospital healthcare services related to COVID-19.
The following criteria need to be met before claims will be paid from the WHO Outbreak Benefit:
- The disease needs to be a WHO recognised outbreak disease;
- Cover is for diseases during a declared outbreak period
- May be subject to use of preferred providers, where applicable;
- Subject to completing the Scheme’s risk assessment and referral process for testing;
- Subject to the Scheme’s treatment guidelines and protocols.
These healthcare services are covered from the WHO Global Outbreak Benefit up to a maximum of 100% of the Discovery Health Rate. This cover does not affect your day-to-day benefits. Note that your plan’s prescribed networks still apply (do you still need to use the hospital on the network list, if that’s applicable to your plan).
- Screening consultations with a network GP (either virtual consultations, telephone or face-to-face) and personal protective equipment (PPE) used during a COVID-19 consultation
- COVID-19 PCR screening tests if referred by a network GP following completion of the Discovery risk assessment
- A defined basket of pathology tests for COVID-19 positive members
- A defined basket of x-rays and scans for COVID-19 positive members
- Supportive treatment, including medicine and a home monitoring device to track oxygen saturation levels for at
risk members who meet the clinical entry criteria
- Accommodation in accredited isolation facilities
You may apply for additional cover from the Scheme, where clinically appropriate.
Any recommended treatment and healthcare services that are not included in the above basket of care are covered according to the benefits available on your chosen health plan or in accordance with Prescribed Minimum Benefits where applicable. In-hospital treatment related to COVID-19 for approved admissions is covered from the Hospital Benefit based on your chosen health plan and in accordance with Prescribed Minimum Benefits (PMB) where applicable.
Other links about Discovery Health and Covid-19:
- Covid-19: Everything you wanted to know about Discovery’s WHO Global Outbreak benefit
- How to get tested for Covid-19
- Covid-19 and waiting periods
- Covid 19-Isolation Funding
- Covid-19 and Home monitoring
- Covid-19 and International Travel Benefit
This information was sourced directly from a Discovery Health publication, and does not reply on our own independent research. Always consult your scheme and broker to confirm benefits and regulations, and do not treat any information on rehealth.co.za as a “final say” on any matter.