Select a scheme and option
View the benefits, health management programmes and chronic conditions covered by your patient’s medical scheme and option.
| Benefit summaries | |
|---|---|
| Hospitalisation benefits |
Unlimited at preferred provider hospitals. Please call 0860 104 012 or email [email protected] to request pre-authorisation. |
| Day-to-day benefits |
Click the link below read more about day-to-day benefits for the Diversity Plan. |
| Chronic medication benefits |
The Chronic Medication Benefit includes cover for medicine listed on the Sisonke Health Medical Scheme Chronic Medication Formulary for treatment of a specified list of chronic conditions in accordance with the Scheme Plan. Members are encouraged to make use of Designated Service Provder (DSP) Pharmacies to avoid out-of-pocket expenses Please call 041 395 4482 or email [email protected] to register for chronic medication. Chronic medication benefit application form (pdf) Designated Service Provider (DSP) Pharmacies |
| Healthcare programmes Members need to register on health management programmes to gain access to the benefits outlined below. | |
|---|---|
| Maternity programme |
Subject to registration on the Maternity Programme. Please call 0860 104 012 to register a member on the programme. |
| Chronic medication programme |
Subject to registration on the Chronic Management Programme, internal treatment protocols, medicine formulary and PMBs. For registration on the programme, Please call 041 395 4482. or email the Chronic Medication Application form to [email protected] |
| Chronic condition lists | |
|---|---|
| Prescribed minimum benefits (PMB) | |