After seven years of challenging medical aids, the Infertility Awareness Association of South Africa announces the inclusion of treatment by Discovery Health.
South Africa (06 October 2020) – In February of 2020, we shared the story and podcast of how a group of women took on their medical aids to challenge the exclusion of fertility treatment. One of the women was kicked out of her medical aids AGM because of infertility!
One in six couples in South Africa is facing fertility issues, making it a far-reaching issue.
Infertility happens when a couple cannot conceive after having regular unprotected sex. It may be that one partner cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.
The World Health Organization (WHO) considers infertility to be “a disease of the reproductive system”, but South African Medical Aids do not have any provision to help their members during this debilitating time.
That is, until now! Discovery has added fertility treatment to their cover! A massive win for couples struggling to conceive.
Established in 2013, the Infertility Awareness Association of South Africa (IFAASA) was founded with two main objectives in mind: Firstly, to inform the public of infertility and secondly to tackle the mammoth task of getting medical aids to pay for infertility treatment. IFAASA has worked for seven years to make the treatment of infertility a reality.
“Infertility is a prescribed minimum benefit disease meaning that irrespective of the medical aid plan that you are on, you are covered. However, the treatment of infertility is excluded and is the only prescribed minimum benefit disease on the exclusion list of most medical aids. Diagnosis will be paid for by open medical aids, however once you have been diagnosed with infertility, the treatment of such will not be paid for. With our founding members being on Discovery Medical Aid, IFAASA dived straight in at their 2013 AGM, however made no progress. The following year, IFAASA gathered thousands of proxi’s and presented accordingly at the 2014 Discovery AGM who in turn requested a round table discussion. That discussion again hit a brick wall, with the only noteworthy progress being that an individual would be allowed to use his/ her savings for their treatments.”
“Credit must go to the public because it wasn’t long until I received a call from Discovery wanting to meet. In partnership with Dr Sulaiman Heylen, President of SASREG as well as Vice President of SASREG Dr Jack Biko, we had countless calls and zoom meetings with Discovery throughout lockdown. Whilst Discovery will announce the exact details regarding the cover of the treatment of infertility, I am delighted with our “win” in this regard and must thank all those who contributed including Meggan Zunckel, Dr Heylen and Dr Biko. This is a huge breakthrough for those who have been on the Discovery Comprehensive and Executive plans for 2 years or more and we are honoured to have played our part. However, it’s is not the end of the road for our battle, as we feel that the benefit should be available on more plans and the other medical aids do need to follow suit or risk possible member decreases. However we have always known that this is a marathon and not a sprint and at last, the 1 in 6 couples who suffer from infertility, are beginning to get the recognition they deserve.” – Saskia Williams, IFAASA Founding Member and CEO
So how do you qualify to have fertility treatment?
According to Saskia Williams, you need to have been on a Comprehensive or Executive plan at Discovery Health for a minimum of 2 years, the medical scheme will cover up to two cycles of Assisted Reproductive Therapy (ART) including In-Vitro Fertilisation (IVF), Intra-Uterine Insemination (IUI), Embryo Transfer (FET) and Intra-Cytoplasmic Sperm Injection (ICSI) starting in 2021. All treatments will have to be done at a SASREG Centre of Excellence. Further T’s & C’s and co-payments do apply, so ensure that you check the full benefit details with Discovery Health Medical Scheme, before embarking on treatment.
But there you have it, this is a win and step in the right direction for families that need fertility treatments.
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