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 | |
|---|---|
| In-hospital benefits |
Subject to pre-authorisation is not a guarantee of payment. Scheme rules, formulary, internal protocols and PMB's will be applied where applicable. For hospital pre-authorisation call 0861 843 236 or email [email protected]. |
| Out-of-hospital benefits |
Click the link below to read more about out-of-hospital benefits for Universal Plan. |
| Chronic medication benefits |
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] |
| Maternity benefits |
Click the link below to read more about the Thebe Bambino Programme maternity benefits. |
| Healthcare programmes Members need to register on health management programmes to gain access to the benefits outlined below. | |
|---|---|
| Maternity programme |
Maternity benefits are subject to registration on the Thebe Bambino Programme. |
| Chronic medication programme |
Benefit for chronic medication are subject to the registration on the Chronic Management Programme. To register a member call 041 385 4482. or email the Chronic Medication Application form to [email protected] |
| Chronic condition lists | |
|---|---|
| Prescribed minimum benefits (PMB) | |