ANNUAL GENERAL MEETING

Transcription

1 NEWSLETTER 2nd edition 2018 HAVE YOUR SAY AT THIS YEAR S ANNUAL GENERAL MEETING Our Annual General Meeting (AGM) is coming up in August. Attending the AGM gives you the opportunity to find out who the newly elected Trustees are, learn about LA Health s financial standing as well as changes that can affect your membership. It s also your chance to ask questions about how LA Health is managed and start discussions about matters that affect the Scheme. All you need to do is formally send us the matters you want discussed (motions) and attend the meeting at your own cost. When and where Date: 15 August 2018 Time: 14:00 Place: Southern Sun Elangeni and Maharani, Durban Meet your new Trustees The Board of Trustees manages LA Health Medical Scheme on your behalf. They are responsible for making important decisions that affect your benefits and the Scheme. In May s trustee election, you voted who you wanted to make decisions on your behalf for the next six years. KMPG, our external auditor, has counted the votes and we will announce your new Trustees at the AGM. Agenda 1 Welcome and quorum 2 Note and approve the Minutes of the Annual General Meeting held on 16 August Annual Financial Statements and Auditor s Report for the year ended 31 December Board of Trustees Annual Report (as per Section 37(1) of the Medical Schemes Act 131 of 1998) 5 Appointment of KPMG as the Scheme s external auditors 6 Consideration: Notices of Motion for referral to the Board of Trustees for final decision 7 Introduction to the Chairperson s Report Topics for discussion You have the right to send us a motion (formally suggest a matter to discuss at the meeting). A motion is not for discussing your personal experience of the Scheme (for example, to ask why a claim was not paid); it is to discuss matters that affect the running of the Scheme. You need to let the Principal Officer know of any motions you would like to discuss at least seven days before the AGM. Your submission must reach the Principal Officer before 12:00 on Wednesday, 8 August 2018 so factor in extra time if you want to send it by post. motions to rdutoit@lahealth.co.za, or post it to PO Box , Benmore 2010.

2 FIGHT FRAUD TO KEEP THE COST OF HEALTHCARE DOWN TAX CERTIFICATES IN TIME FOR TAX SEASON We recently sent you your tax certificate for the 2017/2018 tax year by . The certificate is useful for tax season. You can claim some of the medical expenses you paid yourself back from the South African Revenue Service (SARS) and your certificate from us is proof. I didn t get the If the address we have on file ends in.gov.za, you won t receive our s because the server blocks bulk s from LA Health. To make sure you receive important s and information about your benefits, please update your contact details with your personal address. Log in to choose Update Your Details and follow the prompts. Otherwise call If you receive communication from us by post and you did not receive your tax certificate, please call us on to request that we send you another one. You can also follow the steps below to print one from our website. What if I lose the ? Don t worry if you filed your tax certificate in a safe folder or accidentally delete the . You can always download your tax certificate from Simply log in, click on Medical aid, Find a document and choose Get your tax certificate. Since fraud drives up medical inflation fraud affects everyone. This means medical care and your medical scheme contributions go up more than they would otherwise. Most members and healthcare providers are honest; only a few dishonest people are responsible for the problem. Fraud is a serious matter! LA Health s board of trustees has a Zero tolerance policy towards fraud and has recently terminated several memberships due to fraud. We hope you will join us in stamping out this crime! It is your medical scheme money that they are stealing. Fraud happens when someone intentionally lies or twists the truth for financial gain. Unfortunately, this happens to medical schemes when, for example, a doctor claims for a service they did not deliver or a pharmacist charges for a brand-name medicine but gives you the generic instead and keeps the extra money. People who commit fraud don t just steal from LA Health, they steal from you and other members. We put your monthly contributions together and pay claims from the pool. Help us pay as many claims as possible by reporting fraud. You don t have to give your name, you just have to tell us if you suspect fraud. Be on the lookout for these kinds of fraud Merchandising By law, a medical scheme can only pay for specific healthcare items such as medicine and prescription glasses. Claiming for general wellness items like sunglasses, nappies and sport supplements or other items from a medical scheme is a crime.

3 Card farming We only budget for our members medical expenses. It is illegal to allow a non-member to use a member s card for medical treatment or medicine. Cosmetic surgery Most medical schemes don t pay for cosmetic surgery because they are optional procedures that don t directly affect members health. It is unlawful to claim for cosmetic surgery under another procedure code. ATM scams A healthcare provider and a member can work together to attempt to steal money from LA Health. The provider sends a claim for a service the member didn t receive or overcharges for the service they gave, and they pay the member for taking part in fraud. This is called an ATM scam because the member withdraws money from the Scheme. What can you do to fight fraud? Check your claims and statements. Ask your healthcare provider for a copy of your claim and read the claim to make sure that it only lists services you ve received. View and update your personal information regularly to make sure you always get payment notifications from us. Log in to choose Update Your Details and follow the prompts. Otherwise call Keep your membership card safe. Don t give your card to anyone who is not a member. Be careful if a healthcare provider says they can make a plan. Don t accept any offers to make the amount you have to pay yourself less on any service or item. If you ve just joined the Scheme, tell us about any medical conditions you already have. Tell us if someone approaches you with an idea to steal money from the Scheme or if you know of someone who is committing medical aid fraud. Use our anonymous fraud hotline to report fraud We don t have to know who you are to take your report seriously you can call our fraud hotline anonymously. References Money Marketing. Fighting fraud in the healthcare industry, 17 October Accessed 28 June 2018 Personal Finance. Medical scheme s fight against fraud and abuse is paying off, 25 March Accessed 28 June 2018 Times Live. Discovery uncovers more than R500m in fraud, 19 January Accessed 28 June 2018 Fraud happens when someone intentionally lies or twists the truth for financial gain.

4 RECOGNISING MEDICAL EMERGENCIES In a medical emergency, phone immediately. The operator will tell you how to handle the emergency and send an ambulance if needed. This article aims to give you an idea of the signs to be aware of and does not replace medical advice rather it offers some tips on spotting medical emergencies as well as common mistakes to avoid. Keep safe The first person to keep safe is yourself. If you cannot safely stop and help someone, the best thing to do is find a safe place and call an ambulance. If you do not know the person, call to reach the public ambulance service. Chest pains could mean a heart attack The sooner you act if you think someone is having a heart attack, the better their chance of surviving. Take chest pain seriously. A person having a heart attack stays awake and keeps on breathing, but their heart is being damaged by not getting blood. Although there are many causes of chest pains, including acid reflux and anxiety, it s essential to take symptoms seriously. The person having a heart attack often experiences sudden chest pain which can spread to the arm and neck. They can also feel nausea and have cold, wet, greyish skin. Here s what not to do: Don t wait to see if the symptoms go away Don t let the person walk around Don t let the person lie down flat on the floor as this makes it harder to breathe. Rather let them sit and make sure their head and shoulders are supported. Choking can be an emergency If the person is coughing and talking, it means they can breathe. You can encourage them to cough or drink water, but don t hit them on the back; it can force food further down the throat. It s an emergency if a person isn t making noise and their face becomes red. They will usually hold their hands around their throat. According to ER24, you can help someone who is not breathing by standing behind them and wrapping your arms around their waist. (If it is a child, kneel down behind them). Make a fist with one hand and position it just above the person s bellybutton. Grab your fist with your other hand and press hard into the abdomen, as if you are trying to lift the person up. Repeat until the obstruction is dislodged, or the person loses consciousness. Burns large and small need first aid Even if it s a small burn, starting treatment as soon as possible will help prevent further damage and assist with the healing process. If someone is burned, remove warm or burnt clothing. But if the clothes stick to the skin, don t pull them off. Remove all jewellery and belts as burns can swell quickly. Keep the burned skin under cool (not cold) running water for at least 10 minutes. You can treat small burns at home, but call for any burn that involves the eyes, is larger than the person s hand or involves extreme pain. Here s what not to do: Don t put ice on the burn as it can cause damage and more pain Don t break blisters as this can lead to infection Don t use butter, coffee, toothpaste or ointments not meant for burns Fainting could be sign of underlying problems People faint when their brains temporarily don t get enough blood due to low blood pressure. Usually, you should let them lie on their sides and not let them get up too quickly after they wake up. People can faint for many reasons including standing too long, being dehydrated, diabetes and heart problems. If you know someone has diabetes and they faint, you should call the ambulance. Stroke, react FAST Sometimes a stroke is called a brain attack. It happens when the blood flow in the brain is interrupted. FAST is a simple way to remember the signs of stroke that show you need to get medical help right away. The sooner you get help for a stroke, the less damage the stroke does and the better your chances of recovery are. Stay with the person until help arrives. Face: Ask the person to smile. Does their face droop or does one side not move as well as the other? Arms: Ask the person to lift both arms above their head and keep them there. Does one arm not move or slowly come down? Speech: Ask the person to repeat a short sentence (eg It is a sunny day in Cape Town ). Did the person use the right words without slurring? Time: If you spot any of these signs, call emergency services and make a note of when the symptoms started.

5 DO YOU FEEL THE PRESSURE? Have you ever joked about stress pushing your blood pressure through the roof? You re not wrong. We live at a hectic pace and stress at work and at home releases hormones that make your blood pressure spike. It s not clear if high blood pressure in the short term leads to hypertension (high blood pressure in the long term) but we do know stress can lead to bad habits like poor diet, excessive alcohol use and smoking, which can increase your risk of high blood pressure and heart disease. High blood pressure causes the heart to work harder than normal, which is dangerous and can cause blindness. High blood pressure is a leading cause of heart attacks, strokes, kidney failure and premature death. Know your measurements In South Africa more than one in three adults live with high blood pressure and it is responsible for one in every two strokes and two in every five heart attacks. LA Health covers screening tests like a blood pressure measurement from your Screening and Prevention Benefit. You have cover for one Health Check (a set of wellness tests) a year at a pharmacy in the Discovery Wellness Network. This will not affect your day-to-day benefits. If your blood pressure is higher than 140/90 mm Hg, you may have hypertension. Since hypertension is a Prescribed Minimum Benefit condition, you have cover on any LA Health Option once you are registered for hypertension on the Chronic Illness Benefit. Medicine is only one part of the solution. Follow a healthy diet and do regular exercise to lower your blood pressure and any associated risks. References Seven tips for managing or avoiding hypertension The Heart and Stroke Foundation has these tips for managing or preventing high blood pressure: 1 Eat a healthy diet with limited salt, plenty of fruit and vegetables, and some dairy products 2 Exercise at least 30 minutes a day 3 Stop smoking 4 Manage your stress 5 Stay at a healthy weight 6 Cook with less salt and look for Heart Mark products 7 Keep on testing regularly so your blood pressure never catches you by surprise! American Heart Association. Manage stress to control high blood pressure. Accessed 29 June 2018 Southern African Hypertension Society. What is hypertension? Accessed 29 June 2018 The Heart and Stroke Foundation South Africa. Blood pressure. Accessed 29 June 2018 University of the Witwatersrand. SA has highest blood pressure in southern Africa. Accessed 29 June 2018 WebMD. Stress and high blood pressure: What s the connection? Accessed 29 June 2018

6 Client Services Fax LA Health Medical Scheme. Registration number LA Health Medical Scheme is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. Discovery Health (Pty) Ltd is an authorised financial services provider. GM_54079DLA_01/08/2018_V4