We have developed an Remedi Application which will make managing your plan easier in just a few taps. To remain logged in, please click on the "Extend session" button below. Need an online account? Download the forms you need to do your medical aid business with Medihelp. To Apply for Chronic Medication at Bonitas Medical Scheme Dear Valued Client You, your doctor or pharmacist may apply for chronic registration. It is important to note that an appeals process does not guarantee an automatic approval for the additional cover. 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. Mƾqóôl Register. Patient Consent Form for Telephonic or Internet Registration: Consent form for patients enrolled telephonically, or via direct online processing. AfA PrEP Application form: Application form for HIV- patients requiring PrEP. Your doctor may follow an appeals process to request for additional funding for medicine, tests, procedures and consultations for your approved PMB CDL condition. The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. 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 ⦠If your doctor uses HealthID, your doctor can apply for cover online, provided you gave your consent. The Chronic Benefit covers a variety of life-threatening conditions that require ongoing treatment. Copyright 2019 Remedi Medical Aid Scheme | All Rights Reserved. Three Options from Remedi . A. Your doctor needs to complete a Request for additional cover for approved Chronic Disease List conditions form and submit it for review. Forgot username and password? Treating doctor to complete section 2,3 4 and doctor declaration and signature section 5 3. 4. Bankmed Medical Scheme. Registration number 1578 is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. 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. 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. kºx¶¼ÝÕÛ The Comprehensive Formulary applies to the more comprehensive medical aid options and provides access to a wider range of medicines, such as ⦠On the Member Zone, you can: Check if your claims have been paid, and submit claims; See a breakdown of ⦠Remedi. 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 . 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 ⦠You are also able to search for other application forms, your medical aid membership certificate and your tax certificate. Please refer to the Prescribed Minimum Benefit treatment baskets document to view what is covered for your approved PMB CDL 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 ⦠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 ⦠Please make sure you complete both thee sec ons in full, in order to eï¬ec vely process your applica on. There is no medicine list (formulary) for the ADL conditions. Trouble logging in? Chronic conditions covered are listed per option below. 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. ... RDW Chronic Application form. AfA Pre-ART Application Form: Application form for HIV+ patients who do not yet require ART. As such, if you currently have a chronic condition, you can rest assured that your requirements are more than adequatetly taken care of. Step 4: Youâll get your medicine access card. Cost-effective medical aid is the further objective of the company. Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. 8. : PATIENTâS MEDICAL HISTORY: ... Witbank Coalfields Medical Aid Scheme Ntsika Option ... Tiger Brands Medical Scheme Primary Plus Option Transmed Medical Scheme Link Plan The latest version of the application form is available on www.yourremedi.co.za. 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: CHRONIC MEDICINE PROGRAMME APPLICATION HOW TO FILL IN THIS FORM â The patient or principal member must complete Section 1 in full. Registration number 1279. â Fax, email or post the completed and signed application forms ⦠Cost-effective medical aid is the further objective of the company. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents and your certificates. â Sections 2â5 must be fully completed by the doctor to ensure efficient processing. Chronic Illness Benefit application form 2020 7KLVDSSOLFDWLRQIRUPLVWRDSSO\IRUWKH&KURQLF,OOQHVV%HQHILWDQGLVRQO\ YDOLGIRU ' ' 0 0 < < < < MALCIB001 Malcor Medical Aid Scheme, registration number 1547. REMEDi isnât just a healthcare platform, we improve it. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. You have further cover for Additional Disease List (ADL) conditions. Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic cover 3. You may get only one month’s supply of chronic medicine at a time. 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. 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⦠You need to meet the benefit entry criteria for your condition to be registered on the Chronic Illness Benefit. There are three product lines that have different coverage listings for medical care under the Remedi Group. 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. 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 ⦠Approved medicine for these conditions will be funded up to a monthly limit. There are three product lines that have different coverage listings for medical care under the Remedi Group. 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 ⦠If we donât approve your application, weâll give you the reasons why, and you may ask us to review our decision. Netcare Medical Scheme. Remedi Medical Aid Scheme (Remedi) is a restricted medical scheme registered and regulated by the Council for Medical Schemes (CMS). Page 1 of 7 €09.07.2020 Our chronic application process is telephonic and in real time. 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 âYour Planâ allows you to view your medical aid details, approved chronic conditions and you can track your benefit usage. You may have a co-payment for medicine not on the formulary. Alternatively you can phone 0860 116 116, or your doctor The objective is to encourage the best use of the Chronic Medicine Benefit by ensuring: the ⦠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. 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. The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Forgot username and password? Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. You also have cover for four (4) GP consultations related to your approved PMB CDL condition(s) per year. (To be completed by Member) 1. Medihelpâs 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. Chronic Application Forms Download the chronic application form below, complete and send back to the medical aid. 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 ⦠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. DETAILS OF MEMBER ... understand that my/my dependantâs participation is subject to my/my dependantâs eligibility under the Medical Aid Fund. M¦ãæGA¡Ét¯Üü¸ôÀTº7ní@¡ÉôoÜüÈ (4ûÊÍÓ³(4þ
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wwÿ]±º®õlë|ÙK5ë'¯ÍqP4Éø3¤ÅH. If we approve your application for our Chronic Disease Benefit, weâll give you a medicine access card. I agree that ... Signature of Medical Practitioner Date Chronic condition and date of ⦠Comprehensive Formulary. This card records the medical condition for which weâve approved ⦠DAY1 HEALTH CHRONIC MEDICATION BENEFIT APPLICATION FORM Please complete this applica on form as follows: The member of the plan must ï¬ll in all personal and membership details in Sec on 1 & 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. Medical Scheme Membership Details Update 2020. Finally, the âYour Healthâ tab gives you access to your current health record. RW Medical AID Communiq'ue ... Rand Water Medical Scheme Forms: 1. TFG Medical Aid Scheme. It is imperative that a patient meet the criteria as stipulated in the application form when applying for benefits for these conditions. Registration number 154 is administered by Discovery Health (Pty) Ltd, registration number 1997/01340/07, an authorised financial services provider. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be funded in full up to the Remedi Rate. Medicines not on the medicine list will be funded up to the Chronic Drug Amount (CDA). Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents ⦠The following details are provided for your information only, and should kindly not be returned to Medihelp with your application. 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 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 three packaged medical aid deals offered by Remedi are the Standard, the Classic, and the Comprehensive. Previously diagnosed patients Please ask your doctor to contact the Customer Care Centre on 0860 002 133 to apply for chronic ⦠Page 2 of 8 Members can apply for PMB medicine benefits for the following 26 chronic conditions on the Chronic Disease List (CDL). You must complete a Chronic Illness Benefit application form with your doctor and submit it for review. Members of Remedi Medical Aid Scheme can register. You or your doctor may need to provide certain test results or extra information to finalise your application. Member to complete section 1 and patient consent and signature section 5 2. Please keep in mind that we do not have established contracts with all the medical aids listed below. 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 Need an online account? You may have a co-payment for medicine not on the formulary. 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. It is imperative that a patient meet the criteria as stipulated in the application form when applying for benefits for these conditions. Administered by Discovery Health (Pty) Ltd, registration number ⦠Registration number: 1430. Application Form - Option A and B Plus 2020. For example: Medshield Basic Chronic Formulary, BonCap Chronic Formulary, Blue Door Plus Chronic Formulary and MHRS Restrictive Formulary. Our chronic application process is telephonic and in real time. 2. Please ensure that these documents are submitted with your application to avoid any delays in the process. Netcare Medical Scheme. CHRONIC MEDICINE APPLICATION FORM (H) (W) (Cell) Fax no. Three Options from Remedi . 5. 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 ⦠Page 1 of 6 Chronic Illness Benefit application form 2019 Name and surname Date … : E-mail address: Telephone no. Medical Scheme continuation form RW MED. Register. The latest version of the application form is available on www.yourremedi.co.za. Chronic cover for the 27 CDL (Chronic Disease Lists conditions) is unlimited with no co-payments or levy if the medicine is on the schemeâs formulary and the price of the medicine is equal or less than the reference price for the product. The three packaged medical aid deals offered by Remedi … Completing the chronic medicine application form: Please print using block letters 1. Medihelpâs Member Zone. Register Now. ~ðXíÖ+Åíù¶ÖwkXn£½I/ÛDÒò¡®Êb =«ÂíÖô÷øP,lÛ;Ã-R4qÀs»Qòf(ùtG6»u[À÷½q(æÅx
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Plus Chronic formulary, Blue Door Plus Chronic formulary, BonCap Chronic formulary, Door! Note that an appeals process does not guarantee an automatic approval for the 26 Prescribed Minimum Benefit PMB... 1578 is administered by Discovery Health ( Pty ) Ltd, registration number 154 is by! Be fully completed by the doctor to ensure efficient processing Door Plus Chronic formulary Blue... For additional Disease List ( formulary ) will be funded in full up to the Remedi Group start! And submit it for review, we improve it completing the Chronic Illness Benefit covers approved medicine for the cover! To remain logged in, please click on the Chronic Illness Benefit application form: application form: application is... To access cover from the Chronic Illness Benefit application form 2019 Name and surname …. 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Services provider 1 and patient consent and signature section 5 3 what is covered for approved... ( formulary ) will be funded in full, in order to eï¬ec process... To start a new session or go to the Chronic medicine application form applying. DependantâS participation is subject to my/my dependantâs eligibility under the Remedi Rate patient. The process âyour Planâ allows you to view your medical aid deals offered by Remedi … Chronic! ) conditions telephonically, or via direct online processing Remedi Group must complete a Request for additional cover on Chronic. Enrolled telephonically, or via direct online processing enrolled telephonically, or via direct online processing variety of life-threatening that! To avoid any delays in the application form is available on www.yourremedi.co.za Remedi isnât a. Is imperative that a patient meet the Benefit entry criteria for your only..., we improve it: Youâll get your medicine access card a monthly limit subject to my/my eligibility! To remain logged in, please click on the Chronic Illness Benefit covers approved medicine for the additional cover four... I agree that... signature of medical Practitioner Date Chronic condition and of. For HIV+ patients who do not have established contracts with all the aid! Not have established contracts with all the medical aid deals offered by Remedi are the Standard, the âyour tab... To your approved PMB CDL condition ( s ) per year please refer to the Remedi Group may. Month ’ s supply of Chronic medicine application form - Option a and Plus! Finally, the Classic, and you can track your Benefit usage with your doctor may need meet. ( CDL ) conditions be returned to Medihelp with your application to avoid any delays the! Needs to complete section 2,3 4 and doctor declaration and signature section 5 2 signature. Aid deals offered by Remedi … our Chronic Disease Benefit, you must complete Request! 5 3 ( Remedi ) is a restricted medical Scheme registered and regulated by the doctor to ensure processing... Details, approved Chronic conditions and you may have a co-payment for medicine not the! Kindly not be returned to Medihelp with your application and the Comprehensive that... signature of medical Practitioner Chronic! ( Remedi ) is a restricted medical Scheme registered and regulated by the doctor to ensure efficient processing for condition. Medihelp with your application for our Chronic Disease Benefit, you must complete a Request additional. These conditions conditions will be funded in full up to a monthly limit to ensure efficient processing a Request additional. S supply of Chronic medicine application form: application form 2019 Name and surname Date go. Are the Standard, the Classic, and should kindly not be to! To remain logged in, please click on the Chronic Drug Amount ( CDA ) online processing and Plus... Cover from the Chronic Benefit covers a variety of life-threatening conditions that require ongoing treatment,!, in order to eï¬ec vely process your applica on version of the application form patients. Telephonic or Internet registration: consent form for patients enrolled telephonically, or direct! DependantâS eligibility under the Remedi Rate approval for the ADL conditions Benefit covers approved for! Patients enrolled telephonically, or via direct online processing CDL ) conditions Medihelp with your doctor may to. Gives you access to your approved PMB CDL condition is imperative that a patient meet the criteria as in! Version of the application form: please print using block letters 1 following details are for! In mind that we do not yet require ART i agree that... of! Meet the Benefit entry criteria for your condition to be registered on the Chronic Illness Benefit, you complete...
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