Medical aid comes up trumps over kidneyComment on this story
Johannesburg - A Joburg woman who found herself caught up in the red tape between her medical aid and her doctors is well on the road to receiving a desperately needed kidney transplant.
Nola Ogle was diagnosed with polycystic kidney disease in May last year. The genetic disorder sees cysts growing on one’s kidneys, inhibiting their role of filtering waste substances and excess fluid out of the blood.
Ogle has been receiving dialysis three times a week, every week, since then. But what she needed was a kidney transplant. And she had a match - her son.
But Ogle’s medical aid, Hosmed, said they would pay the full costs of the operation only at a state hospital, apparently due to a balancing act to get the most out of their limited resources, The Star reported in May.
Ogle, meanwhile, had been referred to the Wits Donald Gordon Medical Centre. Her surgeon allegedly refused to operate anywhere else.
Hosmed would cover only Ogle’s costs. The thousands it would cost to harvest her son’s kidney would not be included. But it was a bill neither Ogle nor her son could afford.
Fast-forward to the present day, and the family’s troubles are behind them.
After a meeting between hospital and medical aid administrators, a deal was struck that will see Ogle and her son’s full medical costs covered - at Donald Gordon.
“They phoned me and said they’d like to have a meeting,” she said. “Then they gave me a letter saying they would pay for my son’s full costs, his tests and the operation. And they’ve kept me up-to-date with everything since then.”
Dr Mangaliso Mahlaba, chief operating officer of Hosmed administrators’ Thebe Ya Bophelo Healthcare Administrators, said the medical aid and hospital had come to an agreement. He had previously said it could cost up to R200 000 more to do a transplant at a private hospital.
“[Ogle] is not the only patient we’re dealing with,” he explained. “It’s a big cost to do a transplant, and we have to do it in the most cost-effective way. We were able to negotiate with Donald Gordon to do the operation at quite a comparable rate.”
For now, Ogle’s son is undergoing final tests to ensure he is the best match for the transplant, after which a surgery date will finally be booked.
“I’m excited but nervous at the same time,” said Ogle, who turns 56 next month. “I’ve got a feeling it’s going to be my birthday present.” - The Star