Opinion Piece: If you can’t trust your gut, make sure you have cover for scopes and scans
Having gap cover in place can protect you from the medical expense shortfalls and co-payments that typically arise.
The importance of the gut in your overall health is a subject of much research, especially in recent years.
Hand in hand with our increased understanding of the importance of gut health, we have also seen significant increases in incidents of gut health problems, even among otherwise seemingly healthy individuals.
When it comes to diagnosing and treating this area of your health, it often becomes essential to have one or more scopes and/or scans, which are frequently not fully covered by medical schemes.
Having gap cover in place can protect you from the medical expense shortfalls and co-payments that typically arise.
The significance of the gut
The gut plays a significant role in overall health and wellbeing and is critical in many different and essential bodily functions. In fact, experts now refer to the gut as our ‘second brain’, due to the importance of the Enteric Nervous System (ENS), which links digestion, mood, health and even the way we think.
The gut is intrinsically linked to digestion, metabolism, immune function, brain function and regulating inflammation, which in itself can contribute to other illnesses such as allergies, autoimmune diseases and even cancer.
Gastrointestinal health is a growing area of study, as there have been increased incidents of gut issues, partly due to increased awareness, but also due to a range of lifestyle factors. Changes in our diet are especially a common problem.
With many people consuming diets high in processed and refined foods, it can be difficult for the gut to digest and may disrupt the balance of bacteria. In addition, diets low in fibre can lead to constipation and other digestive issues.
This combined with the overuse of antibiotics, an increasingly sedentary lifestyle and lack of physical activity, as well as high stress, all of which can disrupt the balance of the gut and cause a variety of health problems.
Gut problems lead to other health problems
An imbalance in gut bacteria can lead to immune dysfunction, which can increase the risk of infections and other health problems, mental health problems like anxiety and depression, as well as obesity and metabolic disorders.
It can also cause chronic inflammation in the gut and other parts of the body, which has been linked to a range of health issues, including autoimmune diseases, allergies, and cancer.
There are also many things that can go wrong along the digestive tract that can cause significant distress, discomfort, and illness.
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Diagnosing these issues is often challenging, and frequently requires one or more scopes and scans, including gastroscopies, colonoscopies and imaging like CT or MRI scans.
Once a diagnosis has been made, treatment may include medications, lifestyle changes and, with increasing frequency, surgery.
The scopes, scans and medical procedures often result in significant medical expense shortfalls, as they are not fully covered by medical schemes.
Some stomach-churning statistics
Gastrointestinal issues often go hand-in-hand with large medical expenses. Many medical aids will not pay for scopes and scans out of hospital, which means that unless a gap cover policy specifically covers this, they will be for the member’s own account – typically sums of R10,000 and more.
Even if they are covered, they frequently have co-payments attached, and these alone can be several thousand Rands.
If surgery becomes necessary, then patients run into a variety of medical expense shortfalls, including doctors’ fees, surgeons, anaesthetists, specialists and more, who may charge many times the medical aid rate for their services.
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We have had many high claims for gastrointestinal illness – for example, we have paid out R55,376 for treatment of gastro-oesophageal reflux disease with oesophagitis, R49,352 and R44,554 for obstruction of bile duct, R36,203 for ventral hernia with obstruction without gangrene and R36,203 ventral hernia with obstruction without gangrene.
These are just the shortfalls that medical aid did not cover – they are significant and life-changing sums of money, and without gap cover, these members would have been left to pay these bills out of their own pocket.
Look after your physical and financial health
Many gut health problems are related to lifestyle, which makes it essential to prevent them as much as possible.
This means eating a healthy and balanced diet, reducing consumption of inflammatory foods like alcohol and ultra-processed foods, getting regular exercise, and making an effort to reduce stress as much as possible.
When you do find yourself needing treatment, make sure you have considered your financial health as well. Talk to your financial advisor or broker to make sure you have the right gap cover in place.
