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 benefis |
Limited to one Network Hospital. Please call 0860 104 012 or email [email protected] to request pre-authorisation. |
| Day-to-day benefits |
Click the link below to read more about day-to-day for the Pride Plan. |
| Chronic medication benefis |
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 Provider (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. | |
|---|---|
| Disease and wellbeing management |
Subject to registration on Sisonke Health's disease management programme. Please call 0860 104 012 to register on the disease management programme. |
| Maternity programme |
Subject to registration on the Maternity Programme. Please call 0860 104 012 to register on the Maternity 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) | |