Your medical scheme could be using custom medicine lists, or formularies, to determine how your medicine benefit will be managed. This could be a Mediscor formulary (called Extended, Standard, Basic or Essential) or a formulary from another organization. To see if your medicines are included in the formulary, choose the relevant formulary below (listed next to your particular chronic disease), where you will find an alphabetical list of all the medicine covered by that formulary.
If your medicine is included in the applicable formulary, and you have registered your condition, your medicine will be covered as a CDL condition. However, for certain medicines you may still have to obtain authorization. If your medicine is marked with a “YES” under the “Authorization Required” column, then you need to obtain authorization from ChronilineTM at 086 011 9553. If there is a “NO” in the column, the medicine is covered and no further procedures are necessary. The medicines can simply be obtained from your pharmacist. Please note: Medicine for PMBs are in some instances supplied by appointed providers (DSPs) and not by your usual supplier. Please acquaint yourself with your schemes rules regarding DSPs.
If the medicine is not on the list, then it will not be covered as a CDL condition. It may be covered by another benefit, or not covered at all, subject to your scheme’s applicable rules.
*Please note that members from the following Medical Schemes will need to obtain authorisation for all their CDL medicines:
· CSIR
· Clicks
Condition | Mediscor CDL PMB Formularies 2008 |
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Addison’s Disease |
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Asthma | ||||
Bipolar Mood Disorder |
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Bronchiectasis |
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Cardiac Failure |
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Cardiomyopathy |
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COPD |
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Chronic Renal Disease |
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Coronary Artery Disease |
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Crohn's Disease |
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Diabetes Insipidus | ||||
Diabetes Mellitus Type I |
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Diabetes Mellitus Type II |
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Dysrhythmias |
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Epilepsy |
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Glaucoma |
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Haemophilia |
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Hyperlipidaemia |
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Hypertension |
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Hypothyroidism |
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Multiple Sclerosis |
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Parkinson’s Disease |
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Rheumatoid Arthritis |
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Schizophrenia |
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Systemic Lupus | ||||
Ulcerative Colitis |