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Medicine

Acute medicine, inclusive of dental medication

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

Pharmacy Advised Therapy (PAT)

R345 per family per year (R115 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 635 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
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