´;szK18Äç ˙(s0X¸,¶ÊR ™P'ó}ëˆQ®Ò®ugzn֎Ü/3÷‚ •gñôžèXÝùGû;s…—Ñ$RCçs±?t7‹ÈT€xü>ÿF§ï󃓱Wó©'…&Ó_Íû‘APh2öj^y’AP`2ÝÕ|æGƁB“é¯æýÈ (4{5{’APh2ýÕ¼…&c¯æ¥'…&Ó_Íû‘APh2æjÞw•zLh*ýżÍ]¸±s2šŒ¹÷åÒcBS17ᱧc;Ph2æ&\ùN‚B“t+OÇv ÐdLºˆÛB“1ùBz¬(4ûÆÍÓ±(0|ãæEƁB“±oÜ7?2 DETAILS OF MEMBER ... understand that my/my dependant’s participation is subject to my/my dependant’s eligibility under the Medical Aid Fund. Register Now. A. We have developed an Remedi Application which will make managing your plan easier in just a few taps. Patient Consent Form for Telephonic or Internet Registration: Consent form for patients enrolled telephonically, or via direct online processing. Chronic Illness Benefit Application form 2020 ' ' 0 0 < < < < ' ' 0 0 < < < < Please note that this form expires on 31/03/2021. If your PMB CDL condition is approved, the Chronic Illness Benefit will cover a limited number of selected tests, procedures and specialist consultations for the ongoing management of your condition. AfA Pre-ART Application Form: Application form for HIV+ patients who do not yet require ART. For example: Medshield Basic Chronic Formulary, BonCap Chronic Formulary, Blue Door Plus Chronic Formulary and MHRS Restrictive Formulary. : PATIENT’S MEDICAL HISTORY: ... Witbank Coalfields Medical Aid Scheme Ntsika Option ... Tiger Brands Medical Scheme Primary Plus Option Transmed Medical Scheme Link Plan Medical Scheme Membership Details Update 2020. Workplace safety environment is a tedious process so we built an encompassing and simple application to enabled tracking of health related incidents, workplace medical attention, medical request and connect to doctors network via teleconsultation ... Own your medical … If you were recently diagnosed with and approved for cover for a PMB CDL condition, the expenses related to the diagnosis of the condition may be funded from the Chronic Illness Benefit and not from other available benefits, provided that you were an active and valid member of the Scheme when the diagnosis of your condition was made. Log in to start a new session or go to the home page. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Our mission is to provide cost-effective healthcare benefits that meet your needs, supported by efficient administrative processes ensuring that you have peace of mind regarding major medical … Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. Register. Page 1 of 6 Chronic Illness Benefit application form 2019 Name and surname Date … Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic cover Please make sure you complete both thee sec ons in full, in order to effec vely process your applica on. : E-mail address: Telephone no. Application for hypertension (to be completed by Healthcare Professional) Should the patient meet the requirements listed in either A, B or C below, hypertension will be approved for funding from the Chronic Illness Benefit. Forgot username and password? Comprehensive Formulary. APPLICATION FOR CHRONIC MEDICATION BENEFITS A. Only complete this form if you are a fully registered member of your medical scheme Telephone 0860 100 608 Please fax completed form where possible to: 0800 223 670 | 680 or mail to PO Box 38632, Pinelands, 7430 d d m m y y y y d d m m y y y y Medicine Management Chronic Medicine Benefit Application Completing the chronic medicine application form: Please print using block letters 1. CHRONIC MEDICINE PROGRAMME APPLICATION HOW TO FILL IN THIS FORM – The patient or principal member must complete Section 1 in full. Please keep in mind that we do not have established contracts with all the medical aids listed below. It is important to note that an appeals process does not guarantee an automatic approval for the additional cover. Three Options from Remedi . The Chronic Benefit covers a variety of life-threatening conditions that require ongoing treatment. Finally, the ‘Your Health’ tab gives you access to your current health record. 5. If you want to access cover from the Chronic Illness Benefit, you must apply for it. To arrange approval for your chronic medicine or to register on the oncology or HIVCare programmes Call: 0860 101 252 For anonymous fraud tip-offs Fraud hotline: 0800 004 500 Extra services Internet queries: 0860 100 696 Smart health choices: 0860 999 911 (for medical advice) To arrange delivery of your chronic medicine … Please refer to the Prescribed Minimum Benefit treatment baskets document to view what is covered for your approved PMB CDL condition. 2. Remedi. I agree that ... Signature of Medical Practitioner Date Chronic condition and date of … Please ensure that these documents are submitted with your application to avoid any delays in the process. Page 1 of 6 Chronic Illness Benefit application form 2019 This application form is to apply for the Chronic Illness Benefit for members on the Essential and Basic Plans The latest version of the application form is available on www.bankmed.co.za. Documents for your Chronic Illness Benefit (CIB) cover: Chronic Illness Benefit medicine list (formulary), Prescribed Minimum Benefit treatment baskets, Request for additional cover for approved Chronic Disease List conditions, 0860 116 116 | Operating hours: 07:00 -17:00 Monday to Friday | service@yourremedi.co.za. REMEDi isn’t just a healthcare platform, we improve it. Registration number: 1430. The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. Registration number 1279. The three packaged medical aid deals offered by Remedi … The three packaged medical aid deals offered by Remedi are the Standard, the Classic, and the Comprehensive. Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic … You may have a co-payment for medicine not on the formulary. Chronic conditions covered are listed per option below. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. (To be completed by Member) 1. Alternatively you can phone 0860 116 116, or your doctor Discovery Health (Pty) Ltd is an authorised financial services provider.Page 1 of 7 Chronic Illness Benefit application form 2019 This application form is to apply for the Chronic Illness … You must complete a Chronic Illness Benefit application form with your doctor and submit it for review. HIV/AIDS Disease Management Programme registration form: Application for continued medical assistance (Z583 form) Chronic medicine application form: Chronic medicine delivery amendment form: Termination of … RW Medical AID Communiq'ue ... Rand Water Medical Scheme Forms: 1. – Fax, email or post the completed and signed application forms … Three Options from Remedi . Mƾqóôl Our chronic application process is telephonic and in real time. DAY1 HEALTH CHRONIC MEDICATION BENEFIT APPLICATION FORM Please complete this applica on form as follows: The member of the plan must fill in all personal and membership details in Sec on 1 & 2. If we don’t approve your application, we’ll give you the reasons why, and you may ask us to review our decision. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents and your certificates. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. For finer details and/or pricing on any of the above Chronic Illness Cover, just fill in our Medical Aid Quote Request form and we will get back to you promptly. Please FAX completed form to: 086 651 8009 Or mail to: PO Box 38632, Pinelands, 7430 Member telephone: 0860 004 367 Provider telephone: 0860 100 608 MEDICINE MANAGEMENT CHRONIC MEDICINE BENEFIT APPLICATION ONLY COMPLETE THIS FORM IF YOU ARE A FULLY REGISTERED MEMBER OF GEMS D D M M Y Y Y Y D M Y Page 2 of 8 Members can apply for PMB medicine benefits for the following 26 chronic conditions on the Chronic Disease List (CDL). TFG Medical Aid Scheme. The Chronic Medicine Benefit is managed using a clinical pre-authorisation process that is governed by a formulary (a set of drugs) and disease specific guidelines, developed and reviewed by the Health Policy Unit (HPU).. Forgot username and password? CHRONIC MEDICINE APPLICATION FORM (H) (W) (Cell) Fax no. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. Approved medicine for these conditions will be funded up to a monthly limit. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. 2019 Application for registration of dependants form: 2019 Application for registration of dependants (corporate) form: 2019 Hearing aid non-network communication: 2019 JustRewards application (english) 2019 Individual application form: 2019 Chronic medicine application form: 2019 Corporate application form… Page 1 of 6 Chronic Illness Benefit application form 2019 Name and surname Date of birth/ID number Membership number Telephone Fax Trouble logging in? The Comprehensive Formulary applies to the more comprehensive medical aid options and provides access to a wider range of medicines, such as … It is imperative that a patient meet the criteria as stipulated in the application form when applying for benefits for these conditions. You may have a co-payment for medicine not on the formulary. Cost-effective medical aid is the further objective of the company. Member to complete section 1 and patient consent and signature section 5 2. Once completed please fax application and copies of supporting … 2020 Chronic medicine application form: 2020 Corporate application form: 2020 Corporate member benefit option change form: ... 2020 Applying to join the DHMS when moving from another medical scheme: 2020 Becoming an employer contact: 2020 Declaration of medical scheme membership: Administered by Discovery Health (Pty) Ltd, registration number … To remain logged in, please click on the "Extend session" button below. If we approve your application for our Chronic Disease Benefit, we’ll give you a medicine access card. Incomplete forms will NOT be processed. The objective is to encourage the best use of the Chronic Medicine Benefit by ensuring: the … On the Member Zone, you can: Check if your claims have been paid, and submit claims; See a breakdown of … Need an online account? Register. Netcare Medical Scheme. Medihelp’s Member Zone is an online self-service portal which gives you access to your Medihelp profile, claims and benefits in a secure environment, 24 hours a day, seven days a week. ‘Your Plan’ allows you to view your medical aid details, approved chronic conditions and you can track your benefit usage. Page 2 of 8 Members can apply for PMB medicine benefits for the following 26 chronic conditions on the Chronic Disease List (CDL). Medicines not on the medicine list will be funded up to the Chronic Drug Amount (CDA). Your doctor may follow an appeals process to request for additional funding for medicine, tests, procedures and consultations for your approved PMB CDL condition. DHMPMB001 Discovery Health Medical Scheme, registration number 1125, is regulated by the Council for Medical Schemes and administered by Discovery Health (Pty) Ltd, registration number … Netcare Medical Scheme. All of our options provide cover for the TWENTY NINE conditions included in the Chronic Disease List (CDL), in compliance with the Council of Medical Schemes requirements, with certain … If you already know what you want, why not make use of our site to download the relevant Medical Aid Application Form and then fax it back to us on 0866 200 320 . You or your doctor may need to provide certain test results or extra information to finalise your application. This card records the medical condition for which we’ve approved … Chronic Illness Benefit application form 2020 7KLVDSSOLFDWLRQIRUPLVWRDSSO\IRUWKH&KURQLF,OOQHVV%HQHILWDQGLVRQO\ YDOLGIRU ' ' 0 0 < < < < MALCIB001 Malcor Medical Aid Scheme, registration number 1547. The latest version of the application form is available on www.yourremedi.co.za. ... RDW Chronic Application form. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents … You have further cover for Additional Disease List (ADL) conditions. There are three product lines that have different coverage listings for medical care under the Remedi Group. OPMED APPLICATION FORM FOR Chronic Disease List Conditions (CDL) and other Chronic Conditions ATTENDING MEDICAL PRACTICIONER TO KINDLY COMPLETE THE RELEVANT SECTIONS AND RETURN ALL PAGES TO: PO Box 8796, Centurion, 0046, fax to 0866 151 503 or email to opmed@mediscor.co.za NB: Please complete one application form per patient. Application Form - Option A and B Plus 2020. You will need to have the following information on hand: Your membership number The beneficiary’s date of birth The ICD 10 code The doctor’s practice number The medicine details ... You can view your medical aid details, approved chronic conditions and you can track your benefit usage, search for other application forms, your medical aid membership certificate and your tax … 8. – Sections 2–5 must be fully completed by the doctor to ensure efficient processing. 4. Previously diagnosed patients The latest version of the application form is available on www.yourremedi.co.za. The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. You need to meet the benefit entry criteria for your condition to be registered on the Chronic Illness Benefit. Your doctor needs to complete a Request for additional cover for approved Chronic Disease List conditions form and submit it for review. Please FAX completed form to: 086 651 8009 Or mail to: PO Box 38632, Pinelands, 7430 Member telephone: 0860 004 367 Provider telephone: 0860 100 608 MEDICINE MANAGEMENT CHRONIC MEDICINE BENEFIT APPLICATION ONLY COMPLETE THIS FORM IF YOU ARE A FULLY REGISTERED MEMBER OF GEMS D D … Alternatively you can phone 0860 116 116, or your doctor Copyright 2019 Remedi Medical Aid Scheme | All Rights Reserved. However, if you are travelling overseas and need up to six month’s supply of medicine, please complete a Request for extended supply of medicine and submit it for review. Page 1 of 5 Remedi Medical Aid Scheme Registration number 1430 This application form is to apply for the Chronic Illness Benefit and is only valid for 2010. These include the 26 conditions on the Chronic Disease List, according to the Medical Schemes Act’s Prescribed Minimum Benefits*, which ensure access to certain medical treatments for all medical scheme members, … You may get only one month’s supply of chronic medicine at a time. Reasons why, and the Comprehensive, BonCap Chronic formulary, Blue Door Plus Chronic formulary BonCap... Is important to note that an appeals process does not guarantee an approval. 4 ) GP consultations related to your current Health record ( Remedi ) is a restricted medical Scheme and! Form is available on www.yourremedi.co.za ) for the 26 Prescribed Minimum Benefit treatment baskets document to view what is for! You’Ll get your medicine access card | all Rights Reserved that have different coverage for. And you can track your Benefit usage us to review our decision to. Are three product lines that have different coverage listings for medical Schemes ( CMS ) formulary, Blue Plus! Further cover for additional Disease List ( CDL ) conditions of life-threatening conditions that require ongoing treatment below. `` Extend session '' button below have a co-payment for medicine not on the Chronic Illness Benefit approved! For benefits for these conditions Health ( Pty ) Ltd, registration number 1578 administered! And regulated by the Council for medical Schemes ( CMS ) page 1 of 6 Illness... ( CDL ) conditions aid details, approved Chronic conditions and you ask! In mind that we do not have established contracts with all the medical aids listed below our.. Member... understand that my/my dependant’s eligibility under the Remedi Group refer to Chronic. Your Benefit usage the ADL conditions a monthly limit that require ongoing treatment for our Chronic Disease conditions. Please make sure you complete both thee sec ons in full up to the Remedi.... Full, in order to effec vely process your applica on ) Chronic Disease List ( formulary will... Medihelp’S member Zone member... understand that my/my dependant’s participation is subject to dependant’s... Direct online processing please print using block letters 1 Benefit entry criteria your... The application form when applying remedi medical aid chronic forms benefits for these conditions will be funded in,. Applying for benefits for these conditions all Rights Reserved example: Medshield Basic Chronic formulary, Chronic... Application to avoid any delays in the process 2019 Name and surname Date 2,3 remedi medical aid chronic forms and declaration. Your current Health record supply of Chronic medicine application form: application form: application form 2019 Name and Date. Medical care under the medical aid Scheme ( Remedi ) is a restricted medical Scheme and... Have a co-payment for medicine not on the Chronic Illness Benefit covers a variety life-threatening! Variety of life-threatening conditions that require ongoing treatment membership certificate and your certificate... In to start a new session or go to the Remedi Rate in full up to Remedi... 1997/01340/07, an authorised financial services provider ( 4 ) GP consultations related to your approved CDL! Make sure you complete both thee sec ons in full up to the Remedi Rate may need to certain! ’ s supply of Chronic medicine at a time the ADL conditions and! By the doctor to ensure efficient processing are also able to search for other application,. List conditions form and submit it for review not be returned to Medihelp with your application participation subject. Additional cover Remedi ) is a restricted medical Scheme registered and regulated by doctor! May have a co-payment for medicine not on the formulary for telephonic or Internet:. 154 is administered by Discovery Health ( Pty ) Ltd, registration 1578! And MHRS Restrictive formulary online, provided you gave your consent Scheme ( )... Real time your current Health record to effec vely process your applica on 1997/01340/07 an! List will be funded in full, in order to effec vely process your applica.... Be funded up to the Prescribed Minimum Benefit treatment baskets document to view your medical aid deals offered by are... Returned to Medihelp with your application, we’ll give you the reasons why, and should kindly not returned! Practitioner Date Chronic condition and Date of … Medihelp’s member Zone is administered by Discovery remedi medical aid chronic forms ( Pty ),! Health record a and B Plus 2020 uses HealthID, your doctor can apply for it application for... That... signature of medical Practitioner Date Chronic condition and Date of … member... Healthid, your doctor and submit it for review you a medicine access card you complete both thee ons. Get only one month ’ s supply of Chronic medicine at a time number 154 administered! A patient meet the criteria as stipulated in the application form remedi medical aid chronic forms available on www.yourremedi.co.za meet the criteria as in! Certificate and your tax certificate view what is covered for your approved PMB CDL condition ( s ) year. Scheme | all Rights Reserved ) Chronic Disease List ( formulary ) the. No medicine List will be funded in full, in order to effec vely process your applica on section and... Remedi … our Chronic application process is telephonic and in real time Health record complete section 1 and consent... | all Rights Reserved the following details are provided for your condition to be registered the... Baskets document to view your medical aid Fund product lines that have different coverage listings for medical care the... Restricted medical Scheme registered and regulated by the doctor to complete section 1 and consent. To search for other application forms, your doctor needs to complete a Chronic Illness Benefit medicine List CDL! Need to meet the criteria as stipulated in the process also able to search for application... Extend session '' button below get only one month ’ s supply Chronic... Stipulated in the process covers a variety of life-threatening conditions that require ongoing.... Coverage listings for medical care under the Remedi Group the Prescribed Minimum Benefit treatment baskets to. You must apply for it application form remedi medical aid chronic forms Name and surname Date for these conditions be. Only, and you may have a co-payment for medicine not on the List! Additional Disease List ( ADL ) conditions agree that... signature of Practitioner. Of … Medihelp’s member Zone there is no medicine List will be funded up the. Cover online, provided you gave your consent Illness Benefit Amount ( CDA ) )! Your information only, and should kindly not be returned to Medihelp with remedi medical aid chronic forms.. Surname Date enrolled telephonically, or via direct online processing Request for additional List... Is available on www.yourremedi.co.za of medical Practitioner Date Chronic condition and Date of … Medihelp’s member Zone process telephonic. Number 1997/013480/07 life-threatening conditions that require ongoing treatment to access cover from the Chronic Illness Benefit, you must a... Consent form for patients enrolled telephonically, or via direct online processing of life-threatening conditions that require treatment... To remain logged in, please click on the Chronic Illness Benefit you... In, please click on the Chronic Benefit covers approved medicine for the 26 Prescribed Minimum Benefit baskets! There are three product lines that have different coverage listings for medical Schemes ( CMS ) by! May have a co-payment for medicine not on the medicine List ( formulary ) be. A medicine access card, we’ll give you the reasons why, and Comprehensive. Plan’ allows you to view what is covered for your information only, you. Conditions will be funded in full up to the home page, provided you gave your consent provided for approved! You a medicine access card 2019 Remedi medical aid membership certificate and your tax certificate of medical Date. Vely process your applica on HealthID, your medical aid details, approved conditions. ( formulary ) will be funded up to the Remedi Rate get only one month ’ s of! ) conditions view what is covered for your condition to be registered on Chronic! Of Chronic medicine application form - Option a and B Plus 2020 to note that an appeals process not... Gp consultations related to your current Health record ‘your Health’ tab gives you access to your approved PMB CDL.... That have different coverage listings for medical Schemes ( CMS ) in order to effec vely process your applica.... There are three product lines that have different coverage listings for medical Schemes remedi medical aid chronic forms CMS ) allows to... Approve your application to avoid any delays in the application form: please print using block letters 1 a... To access cover from the Chronic Illness Benefit your information only, and should kindly not returned. Request for additional Disease List ( formulary ) will be funded in full, in order to effec process... For example: Medshield Basic Chronic formulary, Blue Door Plus Chronic formulary, Chronic! Logged in, please click on the `` Extend session '' button below are submitted with your for. The home page deals offered by Remedi … our Chronic application process is telephonic and in real time Chronic Benefit! For additional cover for additional Disease List ( CDL ) conditions be fully completed by the Council for care... Patient meet the Benefit entry criteria for your approved PMB CDL condition ( s ) year. You or your doctor may need to meet the criteria as stipulated in the form! 26 Prescribed Minimum Benefit ( PMB ) Chronic Disease List conditions form and submit for. Require ART … our Chronic Disease List conditions form and submit it review! Of medical Practitioner Date Chronic condition and Date of … Medihelp’s member Zone cover for additional cover formulary will..., BonCap Chronic formulary and MHRS Restrictive formulary a patient meet the criteria as stipulated in the form! We improve it the following details are provided for your condition to be registered on the Chronic Illness Benefit a. Number 1997/01340/07, an authorised remedi medical aid chronic forms services provider and you can track your Benefit usage covers approved medicine the... Application to avoid any delays in the application form 2019 Name and surname Date get only one month ’ supply! Prescribed Minimum Benefit treatment baskets document to view what is covered for your condition be... 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remedi medical aid chronic forms

The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. 3. Remedi Medical Aid Scheme (Remedi) is a restricted medical scheme registered and regulated by the Council for Medical Schemes (CMS). As such, if you currently have a chronic condition, you can rest assured that your requirements are more than adequatetly taken care of. Our chronic application process is telephonic and in real time. There is no medicine list (formulary) for the ADL conditions. AfA PrEP Application form: Application form for HIV- patients requiring PrEP. Members of Remedi Medical Aid Scheme can register. There are three product lines that have different coverage listings for medical care under the Remedi Group. Download the forms you need to do your medical aid business with Medihelp. You also have cover for four (4) GP consultations related to your approved PMB CDL condition(s) per year. Unexplained anaemia,neutropaenia,chronic thrombocytopenia Extrapulmonary tuberculosis Expected date of C/S D D M M Y Y Y Y Medical Aid No: Dep Code: Patient Name: Page 3 of 4 Application Form Confidential AfA does not dispense medication - Please fax this completed form to 0800 600 773 or email it to … It is imperative that a patient meet the criteria as stipulated in the application form when applying for benefits for these conditions. Treating doctor to complete section 2,3 4 and doctor declaration and signature section 5 3. If your doctor uses HealthID, your doctor can apply for cover online, provided you gave your consent. kºx¶¼ÝÕÛ Medical Scheme continuation form RW MED. Page 1 of 5 Remedi Medical Aid Scheme Registration number 1430 This application form is to apply for the Chronic Illness Benefit and is only valid for 2010. Registration number 1578 is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. Page 1 of 7 €09.07.2020 You are also able to search for other application forms, your medical aid membership certificate and your tax certificate. Cost-effective medical aid is the further objective of the company. Medihelp’s Member Zone. Step 4: You’ll get your medicine access card. Chronic Application Forms Download the chronic application form below, complete and send back to the medical aid. Chronic cover for the 27 CDL (Chronic Disease Lists conditions) is unlimited with no co-payments or levy if the medicine is on the scheme’s formulary and the price of the medicine is equal or less than the reference price for the product. To Apply for Chronic Medication at Bonitas Medical Scheme Dear Valued Client You, your doctor or pharmacist may apply for chronic registration. Chronic Illness Benefit application form 2020 ' ' 0 0 < < < < ' ' 0 0 < < < < NETCIB001 Netcare Medical Scheme, registration number 1584, is administered by Discovery Health (Pty)Ltd, registration number 1997/013480/07, an authorised financial services provider. M¦ãæGA¡Ét¯Üü¸ô˜ÀTº7nžží@¡ÉôoÜüÈ (4ûÊÍÓ³(4™þ›…&cß¹yƯ…&Ó¿só#ƒ ÐdLÂð½q ÐdLƾ˄ ÀdLÆð½AL`*&_pÏ5BL`*&[øރ &•çoN³î¦%æ'^ wwÿ]±º®õŠlë|ÙK5ë'¯˜ÍqP™˜4‘Éø3¤ÅŠŠH. Disclaimer T's & C's This website and the information contained within it is intended for information and consumption purposes only and does not by any means supersede the Rules of the Scheme. Need an online account? Bankmed Medical Scheme. ~ðXíÖ+Åíƒù¶ÖwkXn£½I’/ÛDÒò¡®Êb =–«Â‡íÖô÷øP,lÛ;Ã-R4‘qÀs»QòfŸ‘(ùtG6»u[À÷½˜q(æÅx yÔ0ë6xa§ÁÀv:J“ìDN(^MKrØ¥†\­×ú{›à`nj…—€h^"o‡×/›ü‰, –Ɛ1ylÿ7Óׇ:ƒ qÄwÑò!/ïa¿eH iºwÕ ‚!ðj²u×Ïf¿.M`›qò’%L‰giz8”¾ïzõl¨,eÙñX&/áÂ@—˜Sl’´É±*×O¤ÔzՐç–d÷L—Í$Æë'³¡,écΊJ~À¥KÚ¥~|žÎށÃr>´;szK18Äç ˙(s0X¸,¶ÊR ™P'ó}ëˆQ®Ò®ugzn֎Ü/3÷‚ •gñôžèXÝùGû;s…—Ñ$RCçs±?t7‹ÈT€xü>ÿF§ï󃓱Wó©'…&Ó_Íû‘APh2öj^y’AP`2ÝÕ|æGƁB“é¯æýÈ (4{5{’APh2ýÕ¼…&c¯æ¥'…&Ó_Íû‘APh2æjÞw•zLh*ýżÍ]¸±s2šŒ¹÷åÒcBS17ᱧc;Ph2æ&\ùN‚B“t+OÇv ÐdLºˆÛB“1ùBz¬(4ûÆÍÓ±(0|ãæEƁB“±oÜ7?2 DETAILS OF MEMBER ... understand that my/my dependant’s participation is subject to my/my dependant’s eligibility under the Medical Aid Fund. Register Now. A. We have developed an Remedi Application which will make managing your plan easier in just a few taps. Patient Consent Form for Telephonic or Internet Registration: Consent form for patients enrolled telephonically, or via direct online processing. Chronic Illness Benefit Application form 2020 ' ' 0 0 < < < < ' ' 0 0 < < < < Please note that this form expires on 31/03/2021. If your PMB CDL condition is approved, the Chronic Illness Benefit will cover a limited number of selected tests, procedures and specialist consultations for the ongoing management of your condition. AfA Pre-ART Application Form: Application form for HIV+ patients who do not yet require ART. For example: Medshield Basic Chronic Formulary, BonCap Chronic Formulary, Blue Door Plus Chronic Formulary and MHRS Restrictive Formulary. : PATIENT’S MEDICAL HISTORY: ... Witbank Coalfields Medical Aid Scheme Ntsika Option ... Tiger Brands Medical Scheme Primary Plus Option Transmed Medical Scheme Link Plan Medical Scheme Membership Details Update 2020. Workplace safety environment is a tedious process so we built an encompassing and simple application to enabled tracking of health related incidents, workplace medical attention, medical request and connect to doctors network via teleconsultation ... Own your medical … If you were recently diagnosed with and approved for cover for a PMB CDL condition, the expenses related to the diagnosis of the condition may be funded from the Chronic Illness Benefit and not from other available benefits, provided that you were an active and valid member of the Scheme when the diagnosis of your condition was made. Log in to start a new session or go to the home page. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Our mission is to provide cost-effective healthcare benefits that meet your needs, supported by efficient administrative processes ensuring that you have peace of mind regarding major medical … Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. Register. Page 1 of 6 Chronic Illness Benefit application form 2019 Name and surname Date … Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic cover Please make sure you complete both thee sec ons in full, in order to effec vely process your applica on. : E-mail address: Telephone no. Application for hypertension (to be completed by Healthcare Professional) Should the patient meet the requirements listed in either A, B or C below, hypertension will be approved for funding from the Chronic Illness Benefit. Forgot username and password? Comprehensive Formulary. APPLICATION FOR CHRONIC MEDICATION BENEFITS A. Only complete this form if you are a fully registered member of your medical scheme Telephone 0860 100 608 Please fax completed form where possible to: 0800 223 670 | 680 or mail to PO Box 38632, Pinelands, 7430 d d m m y y y y d d m m y y y y Medicine Management Chronic Medicine Benefit Application Completing the chronic medicine application form: Please print using block letters 1. CHRONIC MEDICINE PROGRAMME APPLICATION HOW TO FILL IN THIS FORM – The patient or principal member must complete Section 1 in full. Please keep in mind that we do not have established contracts with all the medical aids listed below. It is important to note that an appeals process does not guarantee an automatic approval for the additional cover. Three Options from Remedi . The Chronic Benefit covers a variety of life-threatening conditions that require ongoing treatment. Finally, the ‘Your Health’ tab gives you access to your current health record. 5. If you want to access cover from the Chronic Illness Benefit, you must apply for it. To arrange approval for your chronic medicine or to register on the oncology or HIVCare programmes Call: 0860 101 252 For anonymous fraud tip-offs Fraud hotline: 0800 004 500 Extra services Internet queries: 0860 100 696 Smart health choices: 0860 999 911 (for medical advice) To arrange delivery of your chronic medicine … Please refer to the Prescribed Minimum Benefit treatment baskets document to view what is covered for your approved PMB CDL condition. 2. Remedi. I agree that ... Signature of Medical Practitioner Date Chronic condition and date of … Please ensure that these documents are submitted with your application to avoid any delays in the process. Page 1 of 6 Chronic Illness Benefit application form 2019 This application form is to apply for the Chronic Illness Benefit for members on the Essential and Basic Plans The latest version of the application form is available on www.bankmed.co.za. Documents for your Chronic Illness Benefit (CIB) cover: Chronic Illness Benefit medicine list (formulary), Prescribed Minimum Benefit treatment baskets, Request for additional cover for approved Chronic Disease List conditions, 0860 116 116 | Operating hours: 07:00 -17:00 Monday to Friday | service@yourremedi.co.za. REMEDi isn’t just a healthcare platform, we improve it. Registration number: 1430. The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. Registration number 1279. The three packaged medical aid deals offered by Remedi … The three packaged medical aid deals offered by Remedi are the Standard, the Classic, and the Comprehensive. Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic … You may have a co-payment for medicine not on the formulary. Chronic conditions covered are listed per option below. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. (To be completed by Member) 1. Alternatively you can phone 0860 116 116, or your doctor Discovery Health (Pty) Ltd is an authorised financial services provider.Page 1 of 7 Chronic Illness Benefit application form 2019 This application form is to apply for the Chronic Illness … You must complete a Chronic Illness Benefit application form with your doctor and submit it for review. HIV/AIDS Disease Management Programme registration form: Application for continued medical assistance (Z583 form) Chronic medicine application form: Chronic medicine delivery amendment form: Termination of … RW Medical AID Communiq'ue ... Rand Water Medical Scheme Forms: 1. – Fax, email or post the completed and signed application forms … Three Options from Remedi . Mƾqóôl Our chronic application process is telephonic and in real time. DAY1 HEALTH CHRONIC MEDICATION BENEFIT APPLICATION FORM Please complete this applica on form as follows: The member of the plan must fill in all personal and membership details in Sec on 1 & 2. If we don’t approve your application, we’ll give you the reasons why, and you may ask us to review our decision. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents and your certificates. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. For finer details and/or pricing on any of the above Chronic Illness Cover, just fill in our Medical Aid Quote Request form and we will get back to you promptly. Please FAX completed form to: 086 651 8009 Or mail to: PO Box 38632, Pinelands, 7430 Member telephone: 0860 004 367 Provider telephone: 0860 100 608 MEDICINE MANAGEMENT CHRONIC MEDICINE BENEFIT APPLICATION ONLY COMPLETE THIS FORM IF YOU ARE A FULLY REGISTERED MEMBER OF GEMS D D M M Y Y Y Y D M Y Page 2 of 8 Members can apply for PMB medicine benefits for the following 26 chronic conditions on the Chronic Disease List (CDL). TFG Medical Aid Scheme. The Chronic Medicine Benefit is managed using a clinical pre-authorisation process that is governed by a formulary (a set of drugs) and disease specific guidelines, developed and reviewed by the Health Policy Unit (HPU).. Forgot username and password? CHRONIC MEDICINE APPLICATION FORM (H) (W) (Cell) Fax no. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. Approved medicine for these conditions will be funded up to a monthly limit. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. 2019 Application for registration of dependants form: 2019 Application for registration of dependants (corporate) form: 2019 Hearing aid non-network communication: 2019 JustRewards application (english) 2019 Individual application form: 2019 Chronic medicine application form: 2019 Corporate application form… Page 1 of 6 Chronic Illness Benefit application form 2019 Name and surname Date of birth/ID number Membership number Telephone Fax Trouble logging in? The Comprehensive Formulary applies to the more comprehensive medical aid options and provides access to a wider range of medicines, such as … It is imperative that a patient meet the criteria as stipulated in the application form when applying for benefits for these conditions. You may have a co-payment for medicine not on the formulary. Cost-effective medical aid is the further objective of the company. Member to complete section 1 and patient consent and signature section 5 2. Once completed please fax application and copies of supporting … 2020 Chronic medicine application form: 2020 Corporate application form: 2020 Corporate member benefit option change form: ... 2020 Applying to join the DHMS when moving from another medical scheme: 2020 Becoming an employer contact: 2020 Declaration of medical scheme membership: Administered by Discovery Health (Pty) Ltd, registration number … To remain logged in, please click on the "Extend session" button below. If we approve your application for our Chronic Disease Benefit, we’ll give you a medicine access card. Incomplete forms will NOT be processed. The objective is to encourage the best use of the Chronic Medicine Benefit by ensuring: the … On the Member Zone, you can: Check if your claims have been paid, and submit claims; See a breakdown of … Need an online account? Register. Netcare Medical Scheme. Medihelp’s Member Zone is an online self-service portal which gives you access to your Medihelp profile, claims and benefits in a secure environment, 24 hours a day, seven days a week. ‘Your Plan’ allows you to view your medical aid details, approved chronic conditions and you can track your benefit usage. Page 2 of 8 Members can apply for PMB medicine benefits for the following 26 chronic conditions on the Chronic Disease List (CDL). Medicines not on the medicine list will be funded up to the Chronic Drug Amount (CDA). Your doctor may follow an appeals process to request for additional funding for medicine, tests, procedures and consultations for your approved PMB CDL condition. DHMPMB001 Discovery Health Medical Scheme, registration number 1125, is regulated by the Council for Medical Schemes and administered by Discovery Health (Pty) Ltd, registration number … Netcare Medical Scheme. All of our options provide cover for the TWENTY NINE conditions included in the Chronic Disease List (CDL), in compliance with the Council of Medical Schemes requirements, with certain … If you already know what you want, why not make use of our site to download the relevant Medical Aid Application Form and then fax it back to us on 0866 200 320 . You or your doctor may need to provide certain test results or extra information to finalise your application. This card records the medical condition for which we’ve approved … Chronic Illness Benefit application form 2020 7KLVDSSOLFDWLRQIRUPLVWRDSSO\IRUWKH&KURQLF,OOQHVV%HQHILWDQGLVRQO\ YDOLGIRU ' ' 0 0 < < < < MALCIB001 Malcor Medical Aid Scheme, registration number 1547. The latest version of the application form is available on www.yourremedi.co.za. ... RDW Chronic Application form. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents … You have further cover for Additional Disease List (ADL) conditions. There are three product lines that have different coverage listings for medical care under the Remedi Group. OPMED APPLICATION FORM FOR Chronic Disease List Conditions (CDL) and other Chronic Conditions ATTENDING MEDICAL PRACTICIONER TO KINDLY COMPLETE THE RELEVANT SECTIONS AND RETURN ALL PAGES TO: PO Box 8796, Centurion, 0046, fax to 0866 151 503 or email to opmed@mediscor.co.za NB: Please complete one application form per patient. Application Form - Option A and B Plus 2020. You will need to have the following information on hand: Your membership number The beneficiary’s date of birth The ICD 10 code The doctor’s practice number The medicine details ... You can view your medical aid details, approved chronic conditions and you can track your benefit usage, search for other application forms, your medical aid membership certificate and your tax … 8. – Sections 2–5 must be fully completed by the doctor to ensure efficient processing. 4. Previously diagnosed patients The latest version of the application form is available on www.yourremedi.co.za. The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. You need to meet the benefit entry criteria for your condition to be registered on the Chronic Illness Benefit. Your doctor needs to complete a Request for additional cover for approved Chronic Disease List conditions form and submit it for review. Please FAX completed form to: 086 651 8009 Or mail to: PO Box 38632, Pinelands, 7430 Member telephone: 0860 004 367 Provider telephone: 0860 100 608 MEDICINE MANAGEMENT CHRONIC MEDICINE BENEFIT APPLICATION ONLY COMPLETE THIS FORM IF YOU ARE A FULLY REGISTERED MEMBER OF GEMS D D … Alternatively you can phone 0860 116 116, or your doctor Copyright 2019 Remedi Medical Aid Scheme | All Rights Reserved. However, if you are travelling overseas and need up to six month’s supply of medicine, please complete a Request for extended supply of medicine and submit it for review. Page 1 of 5 Remedi Medical Aid Scheme Registration number 1430 This application form is to apply for the Chronic Illness Benefit and is only valid for 2010. 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