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Select a scheme and option

View the benefits, health management programmes and chronic conditions covered by your patient’s medical scheme and option.

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Benefit summaries
Hospitalisation benefits

Subject to pre-authorisation and managed care protocols.

For hospital pre-authorisation please call 041 395 4481 or, email [email protected].
For specialist pre-authorisation please call 041 395 4481 or, email [email protected].

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Day-to-day benefits

Read more about day-to-day benefits for Alpha Option by clicking the link below.

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Chronic medication benefits

The chronic medication benefit may be subject to applied limits, levies, and Formulary / Reference pricing or exclusions.

Members are encouraged to make use of Designated Service Provider (DSP) Pharmacies and formulary medicine, where applicable to avoid out-of-pocket expense.

To register for chronic medication call 041 395 4482 or, email completed chronic medication application form to [email protected].

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Healthcare programmes Members need to register on health management programmes to gain access to the benefits outlined below.
HIV/AIDS

Read more about the HIV/AIDS programme by clicking the link below.

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Maternity programme

Subject to registration on Medimed maternity programme.

Chronic condition lists
Prescribed minimum benefits (PMB)

Medimed - chronic disease listopen_in_new

Resources for you and your patient

Momentum Carecross GP Guide

Health4Me network GP patient education pad

English, Afrikaans, Sesotho, isiZulu

Health4Me network GP IVR flow diagram