Medicine

Acute medicine, inclusive of dental medication

Formulary medicine only, to be obtained at a network GP, dentist or pharmacy.

Pharmacy Advised Therapy (PAT)

R360 per family per year (R120 per purchase up to a maximum of 3 purchases per beneficiary).
Formulary medicine only, to be obtained at network GP, dentist or pharmacy.

Contraceptives

Contraceptive medicine is subject to Family Hospital Limit and a limit of R2 700 per qualifying beneficiary.

Medicine for Prescribed Minimum Benefits (PMB) chronic conditions

The Scheme will pay for formulary medicine for the 26 PMB chronic conditions. One month's supply of the medicine is to be obtained at a network pharmacy. Call 0861 665 665 to register on the chronic condition management programme to obtain authorisation.

PMB chronic conditions

Addison's Disease
Asthma
Bipolar Mood Disorder
Bronchiectasis
Cardiac Failure
Cardiomyopathy
Chronic Renal Disease
Chronic Obstructive Pulmonary Disease
Coronary Artery Disease
Crohn's Disease
Diabetes Insipidus
Diabetes Mellitus Type 1
Diabetes Mellitus Type 2

Dysrhythmias
Epilepsy
Glaucoma
Haemophilia
Hyperlipidaemia
Hypertension
Hypothyroidism
Multiple Sclerosis
Parkinson's Disease
Rheumatoid Arthritis
Schizophrenia
Systemic Lupus Erythematosus
Ulcerative Colitis