CAPE TOWN – South African women have opened up about their struggles with medical aid cover for much-needed operations and medication.
It became a talking point this past week when Goodluck lead singer Juliet Harding shared her experience.
Eyewitness News spoke to Harding who said she was recovering well after her breast reduction operation.
“I am doing great and my session went really well. I am already up and about, and I am recovering fast.”
Breast reduction surgery is considered cosmetic surgery by medical aids and is not covered by schemes.
But the reality for many women is that large breasts can lead to neck, shoulder and back pain and, as Harding explained, an operation.
The vocalist took to social media last week and said she needed to have the breast reduction operation as she was in pain, but had to pay for it herself.
“Clearly these rules have been written by men because if they had half an idea of what it’s like and how debilitating the pain can be, then I don't think this would be the case,” she said in the post.
I wasn't sure if I was going to make this public but I've decided to. So yesterday I had breast reduction surgery which...Posted by GOODLUCK on Wednesday, 29 January 2020
She challenged her scheme, Momentum, as well as Discovery and other medical aids, to consider changing their policies to assist women.
Harding met with Momentum on Monday after reaction to her social media post. On Tuesday, she said Momentum committed to reviewing their policy on breast reductions following their meeting.
“I went in there to push an agenda, but I was open to listening. Two things came out of the meeting for me and the first thing was very positive. They’ve acknowledged the post shone a spotlight on something they hadn’t realised was an issue.
“They’ve acknowledged that their systems on what is considered exclusionary need to be looked at. So, their benefits are going to be reviewed. They are reviewed year-on-year, but what has come to the front is that women surgeries and certain exclusionary procedures that pertain to women need to be brought out in the next benefits cycle review.”
Update on 'boob-gate' (as some people are calling it 🤣) I'm healing up super fast and trying to rest as much as possible...Posted by GOODLUCK on Saturday, 1 February 2020
Many women said they shared Harding’s pain. One woman said she needed the same operation, but her medical aid rejected her claim.
“The same thing happened to me. I had letters and motivations upon motivations, but still, my claim was denied. So, yes, I’ll be saving for this too as it is quite as painful, as you say.”
Another woman shared that her daughter had the same problem, but her family could not afford to pay for the operation.
“My daughter has the same problem, but we just cannot afford it. It’s sad that it is not covered!”
Some women also have to fork out extra money because their medical aid won’t pay for certain medication.
One woman told EWN that she often had to pay more for medication when menstruating as her medical aid would not pay for it.
“My medical aid, Discovery, doesn’t pay for contraceptives at all. I think it’s something that they should do. There’s pain medication, like Nurofen, that has a product that specifically targets period pain, but the medical aid doesn’t cover that either. They fully cover mental health conditions, something everyone does not have, but they don’t cover natural female issues adequately.”
Women have also praised Harding for using her platform to raise awareness on the issue and women's healthcare.
“Almost as many people who have commented have also shared this. This is a real struggle for many women. Thank you for sharing.”
The singer on Monday urged medical aids to deal with breast reduction cover and other operations for women on a “case to case basis” before denying women's’ claims.
“What this has really brought to the surface is that it’s not just breast reductions. There are a lot of conditions and procedures pertaining to women that are exclusionary from all policies. I understand that certain procedures are cosmetic, but I think just for them to be reviewed on a case to case basis would be a win.”
Harding has urged women to study their medical aid plans to ensure they get the best cover possible.
“I have learnt a lot about how the procedures work and how the process works with medical aids. I think the one thing we don’t do enough is to educate ourselves on our medical aid plans. We don’t educate ourselves on how the policy works and what’s included or excluded.”
Harding said she'd discuss the matter with Discovery medical scheme.
Discovery said its Health Medical Scheme funds breast reduction surgery for members on higher plans who have specific clinical needs. “This funding has been in place for many years. DHMS does not pay for this surgery where it is solely for aesthetic purposes, as all cosmetic surgery is considered a General Scheme Exclusion for open schemes in South Africa.”
Discovery added it provides cover for a range of female-related health conditions including pregnancy, menopause, screening and treatment for breast and cervical cancers, treatment of uterine fibroids and endometriosis.
“Depending on the required treatment, the cover provided is in line with the member’s chosen health plan benefits and complies with the legal funding requirements in all cases. Cover for cystitis and pain during menstruation is from the member’s day-to-day benefits, accumulating to above threshold risk benefits, in line with the chosen plan. This is consistent with the funding of all day-to-day healthcare expenses on these plans.”
This article first appeared on EWN : ‘This a real struggle for women’: SA women open up on breast reduction