Autoimmune disease advocacy calls on medical aid providers to #CoverMyCondition

Autoimmune diseases affect around 2.5 million South Africans. File Picture

Autoimmune diseases affect around 2.5 million South Africans. File Picture

Published Dec 14, 2023


The #CoverMyCondition campaign is advocating for medical aid providers to not disrupt treatment for advanced therapies, to cover conditions in 2024 to the same level as in 2023 on medical aid plans, and to give clarity as to what will be covered so that the uncertainty and fear of people living with autoimmune diseases can be addressed.

The patient-led campaign was launched to address the impending changes in medical aid pricing for 2024 that could profoundly impact people battling severe cases of autoimmune diseases like rheumatoid arthritis.

Autoimmune diseases affect around 2.5 million South Africans.

Campaign director, Chris Roets said these diseases do not receive the same level of attention often given to tuberculosis, Aids, cancer, respiratory, or cardiovascular diseases.

“The treatment journey for many people living with autoimmune diseases is a long and frustrating one; even diagnosing many of these conditions is tedious due to limited access to expensive diagnostic tests and a lack of awareness of these diseases among many primary healthcare providers.

“Finally, when one gets a treatment protocol that controls the symptoms, it is life-changing,” he said.

However, Roets said medical aid providers were changing the way they cover some of these medications, leaving people with one of three options: upgrade to an even more expensive medical aid plan, find thousands of rands to cover the co-payment for the medication, or switch medications.

“Switching medications is not that simple, as many people living with autoimmune diseases spend years finding a solution, often trialling many different treatment options that keep their symptoms at bay,” Roets explained.

The consequences of disrupting treatments that finally work stretch far beyond being simple and cheaper than staying on a treatment protocol. The costs may involve failing more treatment options, going through further diagnostic tests, and the psychological impact of taking away the hope of a life in sustained remission.

The campaign is advocating that people who cannot afford to upgrade to top-tier medical aid plans, be given the same cover and access to the ongoing treatment that they received in 2023.

“Individuals who have gone through the prescribed protocols and qualify for advanced treatment should not be denied treatment,” Roets said.