dsp for chronic pmb medicine Dimension Prime network range DSP
October 2014 dsp for chronic pmb medicine DSP 2015 Dimension Prime network range Members of the Dimension Prime Network range of benefit options must obtain their chronic PMB medicine from a designated service provider. This will ensure they do not have to pay the 60% co-payment payable when they obtain their medicine anywhere else. These DSPs are as follows: Oncology medicine HIV/Aids medicine Tel: 011 251 9480 (option 3) Tel: 086 0906 090 Other Chronic PMB medicine Tel: 0100 017 970 Oncology Arrange for the delivery of your oncology medicine by contacting Optipharm: 011 251 9480 (option 3) [email protected] 086 675 3021 Due to the sensitive process of administering oncology medicine, yours will be delivered to your treating oncologist’s practice. Prevent co-payments on oncology medicine by – • Visiting an oncologist who is a member of the Independent Clinical Oncology Network (ICON) – if not, a 10% co-payment will apply; • Following the ICON treatment protocol – if not, a co-payment will apply; and • Obtaining prescribed medicine (including chemotherapy) from Optipharm – if not, a 60% co-payment will apply. Hiv/Aids Register on Medihelp’s HIV/Aids programme by contacting Optipharm: 086 0906 090 [email protected] 086 0100 678 | www.medihelp.co.za Chronic PMB medicine Visiting your assigned Faranani doctor Always obtain your chronic PMB medicine from your designated Faranani doctor to prevent paying a 60% co-payment out of your own pocket. 1 Visit your GP or specialist Renewing your prescription after six months Renew your prescription after six months by visiting your assigned Faranani doctor. Or, if you visit your own doctor, remember that you will have to take your prescription to your assigned Faranani doctor to start the process again. Get authorisation Medihelp evaluates the application and approves benefits according to PMB protocols and criteria. Phone Faranani on 0100 017 970 to: • Cancel your prescription and obtain your medicine from a pharmacy or dispensing doctor (with the 60% co-payment). • Change prescribed medicine after Medihelp has approved it. Is the medicine on the formulary? Visit the secured websites to obtain the chronic PMB medicine formulary of the Dimension Prime network range. No No Faranani doctor close to you? Obtain your medicine from any network pharmacy (the 60% co-payment will still apply), or upgrade to a Dimension Prime non-network alternative. 4 Contact Faranani at 0100 017 970 to find the Faranani doctor closest to you. Where are the Faranani doctors situated? NB 3 Your assigned Faranani doctor • Your Faranani doctor will SMS you to collect your medicine. • Your statement will show that Clicks Direct Medicines delivered the medicine. 7 2 Yes Obtaining next month’s prescription • Make an appointment with your assigned Faranani doctor. • Take your prescription with you. • The doctor will make sure all medicines are on the formulary, or replace non-formulary medicine with formulary medicine. • S/he will order the medicine, which will be ready to collect in about seven to ten days. Obtain your medicine by following this process: If you are diagnosed with a PMB condition, your doctor will complete a chronic/PMB application form. Return the application form to: [email protected] 012 334 2466 6 uppe marketing A11443 5 60% co-payment Faranani is a nationwide network. Because Faranani assigns members to their closest Faranani doctor, only advisers have access to the complete list. Limpopo 5 Northwest 4 Gauteng 22 Free State 4 Northern Cape 2 Mpumalanga 1 KwaZuluNatal 8 Eastern Cape 3 You will have a 60% co-payment if your medicine is not listed on the chronic medicine formulary. Non-formulary medicine will not be available from your Faranani doctor and should be obtained from any pharmacy in the Medihelp Preferred Pharmacy network. Western Cape 4 DSP Medihelp is an authorised financial services provider. Administered by Strata Healthcare Management (Pty) Ltd (Reg No 2003/008154/07)
© Copyright 2024