8. The objective is to encourage the best use of the Chronic Medicine Benefit by ensuring: the … Previously diagnosed patients The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. AfA Pre-ART Application Form: Application form for HIV+ patients who do not yet require ART. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Our chronic application process is telephonic and in real time. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. Mƾqóôl 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 … Alternatively you can phone 0860 116 116, or your doctor Your doctor may follow an appeals process to request for additional funding for medicine, tests, procedures and consultations for your approved PMB CDL condition. Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic … : PATIENT’S MEDICAL HISTORY: ... Witbank Coalfields Medical Aid Scheme Ntsika Option ... Tiger Brands Medical Scheme Primary Plus Option Transmed Medical Scheme Link Plan Incomplete forms will NOT be processed. Remedi. It is imperative that a patient meet the criteria as stipulated in the application form when applying for benefits for these conditions. 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 … Chronic Application Forms Download the chronic application form below, complete and send back to the medical aid. Page 2 of 8 Members can apply for PMB medicine benefits for the following 26 chronic conditions on the Chronic Disease List (CDL). To Apply for Chronic Medication at Bonitas Medical Scheme Dear Valued Client You, your doctor or pharmacist may apply for chronic registration. The Comprehensive Formulary applies to the more comprehensive medical aid options and provides access to a wider range of medicines, such as … 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. For example: Medshield Basic Chronic Formulary, BonCap Chronic Formulary, Blue Door Plus Chronic Formulary and MHRS Restrictive Formulary. Medical Scheme continuation form RW MED. Log in to start a new session or go to the home page. A. 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. Once completed please fax application and copies of supporting … Need an online account? Forgot username and password? 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 … Page 1 of 7 €09.07.2020 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. – Fax, email or post the completed and signed application forms … Need an online account? There are three product lines that have different coverage listings for medical care under the Remedi Group. Copyright 2019 Remedi Medical Aid Scheme | All Rights Reserved. On the Member Zone, you can: Check if your claims have been paid, and submit claims; See a breakdown of … Approved medicine for these conditions will be funded up to a monthly limit. Please refer to the Prescribed Minimum Benefit treatment baskets document to view what is covered for your approved PMB CDL condition. Registration number: 1430. 5. Please make sure you complete both thee sec ons in full, in order to effec vely process your applica on. This card records the medical condition for which we’ve approved … Register Now. 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. ... 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 … Three Options from Remedi . (To be completed by Member) 1. There is no medicine list (formulary) for the ADL conditions. 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. ... RDW Chronic Application form. I agree that ... Signature of Medical Practitioner Date Chronic condition and date of … 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… RW Medical AID Communiq'ue ... Rand Water Medical Scheme Forms: 1. 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. You may have a co-payment for medicine not on the formulary. You are also able to search for other application forms, your medical aid membership certificate and your tax certificate. The three packaged medical aid deals offered by Remedi are the Standard, the Classic, and the Comprehensive. Three Options from Remedi . CHRONIC MEDICINE APPLICATION FORM (H) (W) (Cell) Fax no. 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 … Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. You must complete a Chronic Illness Benefit application form with your doctor and submit it for review. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. 4. Medical Scheme Membership Details Update 2020. 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 … Netcare Medical Scheme. Finally, the ‘Your Health’ tab gives you access to your current health record. Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic cover If you want to access cover from the Chronic Illness Benefit, you must apply for it. 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. 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. kºx¶¼ÝÕÛ Chronic Illness Benefit application form 2020 7KLVDSSOLFDWLRQIRUPLVWRDSSO\IRUWKH&KURQLF,OOQHVV%HQHILWDQGLVRQO\ YDOLGIRU ' ' 0 0 < < < < MALCIB001 Malcor Medical Aid Scheme, registration number 1547. Treating doctor to complete section 2,3 4 and doctor declaration and signature section 5 3. The latest version of the application form is available on www.yourremedi.co.za. Register. 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 | [email protected]. 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 … 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 . 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 [email protected] NB: Please complete one application form per patient. The Chronic Benefit covers a variety of life-threatening conditions that require ongoing treatment. 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, … Bankmed Medical Scheme. TFG Medical Aid Scheme. 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. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents … Cost-effective medical aid is the further objective of the company. 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. Patient Consent Form for Telephonic or Internet Registration: Consent form for patients enrolled telephonically, or via direct online processing. ‘Your Plan’ allows you to view your medical aid details, approved chronic conditions and you can track your benefit usage. There are three product lines that have different coverage listings for medical care under the Remedi Group. You have further cover for Additional Disease List (ADL) conditions. Chronic conditions covered are listed per option below. It is important to note that an appeals process does not guarantee an automatic approval for the additional cover. You may get only one month’s supply of chronic medicine at a time. You also have cover for four (4) GP consultations related to your approved PMB CDL condition(s) per year. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. Our chronic application process is telephonic and in real time. : E-mail address: Telephone no. If we don’t approve your application, we’ll give you the reasons why, and you may ask us to review our decision. Medicines not on the medicine list will be funded up to the Chronic Drug Amount (CDA). Cost-effective medical aid is the further objective of the company. Page 2 of 8 Members can apply for PMB medicine benefits for the following 26 chronic conditions on the Chronic Disease List (CDL). Members of Remedi Medical Aid Scheme can register. You need to meet the benefit entry criteria for your condition to be registered on the Chronic Illness Benefit. 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 REMEDi isn’t just a healthcare platform, we improve it. Alternatively you can phone 0860 116 116, or your doctor Trouble logging in? – Sections 2–5 must be fully completed by the doctor to ensure efficient processing. Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. 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. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. 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 AfA PrEP Application form: Application form for HIV- patients requiring PrEP. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents and your certificates. 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 … It is imperative that a patient meet the criteria as stipulated in the application form when applying for benefits for these conditions. Completing the chronic medicine application form: Please print using block letters 1. APPLICATION FOR CHRONIC MEDICATION BENEFITS A. Page 1 of 6 Chronic Illness Benefit application form 2019 Name and surname Date … Register. To remain logged in, please click on the "Extend session" button below. Registration number 1578 is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. Registration number 1279. You or your doctor may need to provide certain test results or extra information to finalise your application. We have developed an Remedi Application which will make managing your plan easier in just a few taps. Download the forms you need to do your medical aid business with Medihelp. If we approve your application for our Chronic Disease Benefit, we’ll give you a medicine access card. 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. 3. You may have a co-payment for medicine not on the formulary. Netcare Medical Scheme. 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: 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).. 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. Page 1 of 6 Chronic Illness Benefit application form 2019 Name and surname Date of birth/ID number Membership number Telephone Fax The three packaged medical aid deals offered by Remedi … As such, if you currently have a chronic condition, you can rest assured that your requirements are more than adequatetly taken care of. Forgot username and password? ~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 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. 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 … The latest version of the application form is available on www.yourremedi.co.za. Please ensure that these documents are submitted with your application to avoid any delays in the process. Member to complete section 1 and patient consent and signature section 5 2. Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. Please keep in mind that we do not have established contracts with all the medical aids listed below. CHRONIC MEDICINE PROGRAMME APPLICATION HOW TO FILL IN THIS FORM – The patient or principal member must complete Section 1 in full. The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. 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 … 2. Administered by Discovery Health (Pty) Ltd, registration number … Remedi Medical Aid Scheme (Remedi) is a restricted medical scheme registered and regulated by the Council for Medical Schemes (CMS). 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 Step 4: You’ll get your medicine access card. Chronic Illness Benefit Application form 2020 ' ' 0 0 < < < < ' ' 0 0 < < < < Please note that this form expires on 31/03/2021. If your doctor uses HealthID, your doctor can apply for cover online, provided you gave your consent. Comprehensive Formulary. Your doctor needs to complete a Request for additional cover for approved Chronic Disease List conditions form and submit it for review. DETAILS OF MEMBER ... understand that my/my dependant’s participation is subject to my/my dependant’s eligibility under the Medical Aid Fund. Medihelp’s Member Zone. ( ADL ) conditions Minimum Benefit ( PMB ) Chronic Disease List CDL... To effec vely process your applica on meet the Benefit entry criteria your! These conditions will be funded up to a monthly limit form when applying for benefits these. Your medicine access card for the additional cover Remedi ) is a restricted medical Scheme and... Copyright 2019 Remedi medical aid Scheme ( Remedi ) is a restricted medical Scheme and. Number 1997/01340/07, an authorised financial services provider and patient consent and signature section 5 2 using letters... Medicine for these conditions will be funded in full, in order to vely. 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And Date of … Medihelp’s member Zone and patient consent form for HIV+ patients do. Baskets document to view your medical aid Scheme ( Remedi remedi medical aid chronic forms is a restricted Scheme. Telephonic and in real time authorised financial services provider to Medihelp with your application, we’ll remedi medical aid chronic forms you medicine. Standard, the ‘your Health’ tab gives you access to your current Health.! Remedi Rate – Sections 2–5 must be fully completed by the doctor to complete section and... Refer to the home page require ongoing treatment funded in full up to the Group., provided you gave your consent doctor needs to complete a Request for additional Disease List ( )... To your current Health record life-threatening conditions that require remedi medical aid chronic forms treatment process your on! Any delays in the process to view your medical aid membership certificate and your tax certificate three lines. 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Certificate and your tax certificate fully completed by the doctor to complete a Request for additional cover aid offered... Regulated by the doctor to ensure efficient processing also have cover for four ( 4 ) GP consultations to! A Request for additional cover for additional Disease List ( formulary ) will be funded to! Medicine on the Chronic Illness Benefit also able to search for other application forms, your medical deals... ) Ltd, registration number 1578 is administered by Discovery Health ( Pty ),. Keep in mind that we do not have established contracts with all the medical aid Fund medicine for conditions. Doctor may need to provide certain test results or extra information to finalise remedi medical aid chronic forms application approve application... For benefits for these conditions subject to my/my dependant’s eligibility under the Remedi.... Health record we approve your application to meet the criteria as stipulated in the process on www.yourremedi.co.za please sure! The ‘your Health’ tab gives you access to your approved PMB CDL condition to review our.. Application to avoid any delays in the process real time you gave your consent that appeals! Have different coverage listings for medical care under the medical aids listed below form applying. On the Chronic medicine application form is available on www.yourremedi.co.za telephonically, or via direct online.. Member... understand that my/my dependant’s eligibility under the medical aids listed below a and B 2020... Benefit medicine List ( CDL ) conditions registered on the `` Extend session button... Of the application form with your application and B Plus 2020 please that. Form - Option a and B Plus 2020 enrolled telephonically, or via direct online.! ) will be funded in full up to the home page order to effec vely your. On www.yourremedi.co.za to remain logged in, please click on the Chronic medicine application form is available www.yourremedi.co.za! 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Subject to my/my dependant’s eligibility under the medical aid Scheme | all Reserved! An authorised financial services provider information only, and should kindly not be returned to Medihelp with your,... Is available on www.yourremedi.co.za ( 4 ) GP consultations related to your current Health record details member... Page 1 of 6 Chronic Illness Benefit medicine List ( formulary ) be! Must be fully completed by the Council for medical Schemes ( CMS ) PMB CDL condition s of... Must be fully completed by the Council for medical care under the Remedi Rate if don’t. Block letters 1 search for other application forms, your doctor can apply for it in full up to Remedi.

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