The Adherence Programme.
A key requirement for the Advantage Life or Advantage Life Disability policy is your commitment to being adherent.
AllLife’s definition of adherence is included with our life insurance policy documents and / or application form. You need to accept this definition, and commit to being adherent in terms of this definition. Adherence to proper monitoring and treatment is still the only proven way to maintain optimal health for people living with HIV.
Further information to assist you with adherence can be found in About HIV.
Definition of Adherence.
For clients who are not enrolled on antiretroviral therapy (ART), the life insured must commit to taking a CD4+ blood test at least once every 6 months, and to provide a copy of these results to us. Should the life insured register a CD4+ count of below 200 cells/mm3 in any CD4+ test, they further commit to start appropriate ART within 60 days and to follow this treatment as prescribed.
For clients who are enrolled on antiretroviral therapy (ART), or for clients who enroll on ART subsequent to inception of their policy, the life insured commits to taking both a CD4+ count and RNA Viral Load tests at least once every 6 months, and to provide a copy of these results to us.
Note that all blood tests are for the life insured’s own account (generally paid for by medical aid or the public health sector).
Where an individual enrolled on ART registers two consecutive blood tests showing a reduction in CD4+ count, or a Viral Load above 1000 copies/ml in any single test, AllLife will issue an adherence warning to the client, and request that the life insured takes the necessary steps to remain adherent.
AllLife recommends adherence monitoring and ART intervention as per the guidelines of the Southern African HIV Clinicians Society which will be in line with most treating healthcare providers’ guidelines.
How to remain adherent.
Policyholders commit to take scheduled CD4+ blood tests and to initiate antiretroviral therapy immediately upon registering a CD4+ result of below 200 cells/mm3. The antiretroviral therapy will be as prescribed by the policy holder’s healthcare practitioner and/or managed healthcare company.
- Once on ART, adherence means taking the ART drugs daily as per the prescribed regime.
- Once daily means precisely at the same time everyday.
- Twice daily means precisely every 12 hours (e.g. 6:00am and 6:00pm)
- Three times daily means precisely every 8 hours (e.g. 6:00am, 2:00pm, 10:00pm)
Blood test results need to show that you are taking your drugs properly. Once enrolled on ART, adverse test results may indicate that treatment is not working. This may be due to you not taking the medication properly, or because you are becoming resistant to the prescribed ART regime. If you are not taking your medication correctly you will need to take appropriate steps to rectify the situation, or you may be classified as non-adherent. Should you become resistant to your prescribed ART regimen, you must change your ART regimen within 6 months. Failure to take appropriate action will result in you being designated non-adherent.
In addition, if no blood test is conducted within the stipulated period (every 6 months), then the insured is deemed to be non-adherent. If you are designated non-adherent then payout benefits will be automatically reduced to accident only cover and any disability benefit will be suspended.