Daily Sun – November 2022
Endometriosis affects one in 10 women of childbearing age, an astounding 176 million women across the world, but diagnosis of the disease can take years because surgery is often required for a diagnosis. Women suffering with the disease experience a range of symptoms that are physically debilitating as well as taking a toll mentally and emotionally. There is no ‘cure’ and it is a progressive condition that requires ongoing treatment, and frequently repeated surgery. Without the right medical aid and gap cover in place, these treatments could end up being financially crippling, and yet without them, women suffer immensely.
Living in pain
Endometriosis is a condition in which cells that make up the lining of the uterus (the endometrium) grow outside of the uterus. This commonly affects the fallopian tubes and the ovaries, as well as the tissue lining the pelvis, but it can also involve the bladder, intestines, colon, rectum, and even move into the lungs and the diaphragm. Risk factors include a family history of endometriosis, advancing age, delayed childbirth, and alcohol use.
The disease causes pain that can be significant and affect everyday ability to function, as well as scarring and heavy menstrual bleeding. Other symptoms include lower abdominal and back pain, pain during and/or after sex and pain during and/or after urination and bowel movements. Women with endometriosis may struggle to function during their menstrual cycle or when they are affected by symptoms, especially without treatment. This chronic condition also often causes feelings of anxiety and depression, and it cannot be cured.
The cost of care
A diagnosis of endometriosis can take several years, for a number of reasons. Firstly, women’s symptoms are commonly dismissed as being ‘normal’ by doctors and the severity of the pain they are living with is downplayed. Secondly, regular gynaecological checks such as a vaginal examination and ultrasound cannot detect the disease. The only definitive ways to diagnose endometriosis are through laparoscopic surgery or an MRI. These procedures are both costly, and while the MRI is less invasive it can only help to detect smaller sites of endometriosis, and surgery remains the diagnostic tool of choice.
The cost of a diagnosis is often a detracting factor for many women who need treatment for this disease. Surgery often involves out of pocket expenses, shortfalls on doctors, anaesthetists, and co-payments, especially for scans like an MRI, not to mention the downtime required to recover from a surgical procedure. After diagnosis, there is also frequently further treatment, such as additional surgery to remove the tissue. As it is a progressive condition, repeated surgery is often required for ongoing treatment. The cost of this can be crippling, resulting in women simply not getting the care they need.
Looking after physical and financial wellbeing
Gap cover is an essential solution to augment medical aid in South Africa and ensure women can access quality private healthcare to help them deal with this crippling illness. Shortfalls in coverage on treatment can be significant, up to R45,000 just for the gynaecologist without taking the anaesthetist or hospital into account.
Co-payments can range from R4,500 all the way up to R35,000 depending on the hospital, the doctor, and the patient. This can have a massive financial impact that adds to the already significant burden of a woman living with this disease. As a chronic condition, these shortfalls and co-payments are also likely to be recurring, which can ruin your financial health at the expense of your physical health.
To ensure you can get the treatment you need and deserve, gap cover is critical to cover these medical expense shortfalls. However, it is important to remember that gap cover has waiting periods for pre-existing conditions, which must elapse before you will be covered for treatment. Considering how common endometriosis is, a smart move would be to have gap cover in place to cover this and a range of other conditions that can affect women of child-bearing age. As always, speak to your financial advisor to find the best solution to meet your needs as well as your budget.
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Client Testimonials
I have been on Turnberry for almost 18 years and have always been impressed with the promptness of claims process. I have always recommended Gap Cover, and feel it is necessity, which you cannot afford not to have in SA . Bryan Thomas
Gap cover stepped in where my medical aid fell short for two different procedures.
That gap money was a life saver as I had to pay that out of my savings that I was building up to buy a home! I’ve been paying gap cover for 15 years and not needed it until 2022. But as the saying goes, it never rains it pours. And in 2022 I needed to claim for two completely different procedures within two months of each other. So, you can imagine what that did to my savings… When I did need it, I was so grateful that I had it. Mandy Stanto