Few people plan for the financial impact of multiple sclerosis (MS), along with other severe illnesses that affect the lives of patients and their families.
As World Multiple Sclerosis Day is marked on May 29, consider the implications of MS, a disease that continues to baffle doctors.
For the most part, medical aids do not cover costs such as the loss of income when you are no longer able to work; funds needed to adapt your home or transport; alternative medical care; rehabilitation; or the need for caregivers.
Many insurance companies offer a benefit called severe illness cover. These solutions are designed to pay out a benefit when the person who is insured is diagnosed with one of the severe illnesses listed in the contract.
But consumers who take out this kind of cover should be aware that a degenerative disease such as MS does not pay out upon diagnosis as it does with most severe illness cover; rather, it depends on the level of the disability.
This is because the payout is supposed to assist in any lifestyle adjustments required as a result of the diagnosis and its associated complications.
With a degenerative illness you may still be able to perform all other activities of daily living upon diagnosis and your disability level is not severe enough for a benefit payment, as lifestyle adjustments may still not be required until a later stage.
Jaco Gouws, risk product marketing manager at Old Mutual, explains how payments for degenerative illnesses work and what consumers should be aware of when taking out severe illness cover.
“People are often under the impression that medical aid cover is enough to cover all additional costs associated with MS and other similar severe illnesses,” says Gouws.
“MS, like muscular dystrophy, Alzheimer’s and rheumatoid arthritis, is a degenerative illness where a patient’s health deteriorates over a period of time. This affects your quality of life and is taxing on your mental and physical wellbeing."
Gouws adds that the average age of diagnosis of MS is 30 years, with the average life expectancy of 30 years from the date of diagnosis, depending on how rapidly progressive the disease is.
Severe illness cover can kick in when a certain level of disability or impairment is reached. If you need help with bathing and cannot eat or dress yourself at all, or fail any two activities of daily living, a claim qualifies for a payment from a medical point of view.
“Earning ability cover offers additional benefits, which could provide you with the financial support you need from as early as initial diagnosis,” says Gouws.
“These should include benefits specifically linked to both occupational disability and functional impairment.
"An occupational disability benefit will pay out when your ability to work is impacted to such an extent that you are no longer able to do so.
"For example, a common occurrence in MS sufferers is a condition called optic neuritis, which is an inflammation of the nerve to the eye, impacting your ability to see.
"You can most probably still bath and dress yourself, meaning that your life quality score does not qualify for the severe illness benefit payment.
"However, your occupational disability benefit will, in all likelihood, pay out, ensuring you an income when you are no longer able to work,” says Gouws.
The same applies to the functional impairment benefit when, for example, your left arm is paralysed. You may still be able to work, which means that you cannot claim an occupational disability benefit, and you may not qualify for payment either under a severe illness benefit either.
However, you will most probably qualify under the functional impairment benefit.
“The most comprehensive solution will ensure that your quality of life is maintained at various stages of your illness,” says Gouws.
TRIARC is an authorised financial services provider FSP45009. TRIARC insurance products underwritten by Guardrisk Life FSP76. Council of Medical Scheme
Number ORG 4040.