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Medicine
Prescribed (acute) medicine
Prescribed (acute) medicine is covered at 100% of the medicine price, subject to the overall day-to-day limit, with specific limits for members, adult dependants, and child dependants.
Chronic medicine
If you're diagnosed with a chronic health condition covered by the Scheme, you can receive special benefits to help manage your health. Coverage for the 26 Chronic Disease List (CDL) conditions is unlimited, with no co-payments or fees, as long as the medicine is on the Scheme's approved medicine list and its price matches or is below the chronic drug amount or reference price. If the medicine isn't on the approved medicine list, a co-payment may be required.
How to apply for chronic medicine
- Click here to access an application form. Alternatively, you can contact the client services team on 0860 100 078 and an application form will be emailed on request.
- Complete the applicant's section of the chronic medicine application form.
- Ask your doctor to complete the practitioner's section of the form.
- Check that the application form is correctly completed and accompanied by test results or specialist reports as indicated on the application form. (An incomplete form will delay the processing of your application).
- Send the application form, together with the requested information, to the chronic medicine department by emailing it to CIB.app.forms@medipos.co.za
IMPORTANT
When members or healthcare providers contact us, it is important to have the:
- membership number
- date of birth of the person applying
- copy of the current prescription
- ICD 10 code
- doctor's practice number
To authorise certain medicine, you may also need to supply your:
- previous medicine details
- clinical examination data, e.g. weight, height, BP readings, smoking status, allergy information
- test results, e.g. Lipogram results, Hba1c, lung function tests
- motivation provided from your prescribing doctor
How to obtain your medicine
To obtain your authorised medicine, show both the medicine authorisation letter and the doctor's handwritten prescription to the dispensing pharmacist or doctor.
If you pay cash, please submit the receipt and a copy of your doctor's prescription to the Scheme to ensure that you are refunded.
If your doctor wishes to add or discontinue the use of certain medicine or change the strength or dosage of your medicine, your doctor is required to submit the updated prescription to CIB.app.forms@medipos.co.za. We may require additional information from your doctor or pharmacist to authorise treatment. Based on this information your chronic condition will be registered and the appropriate medicine will be authorised. You will also be informed if you are liable to pay any co-payment/s or if the medicine is not covered on your benefit option.
Medicine for HIV or AIDS
We have a special HIVCare Programme and it is very important that you contact us before you have treatment for HIV or AIDS. Our HIVCare team respects your right to privacy and will deal with you in complete confidentiality.
The HIVCare team will only speak to you as the patient, or your treating doctor, about any HIV-related query.
To authorise HIV medicine, you need to:
- Register on the HIVCare Programme to access these benefits.
- Click here to access an application form. Alternatively, you can contact the client services team on 0860 100 078 to register or request an application form. Email the completed application form to hiv@medipos.co.za
- If you are already registered on the HIVCare Programme you can email your script directly to hiv@medipos.co.za
- If your condition meets our requirements (benefit entry criteria) for cover, you will have cover for antiretroviral medicine.
- This includes supportive medicine and medicine for prevention of mother-to-child transmission, treatment of sexually transmitted infections and HIV-related (or AIDS-defining) infections that are on our HIV medicine list (formulary).