2019 - HOME | SAMWUMED

MEMBER GUIDE2019

• Increases in Overall Annual Limit for hospitilisation to R750,000 on Option A and R1,500,000 on Option B.

• Removal of State hospitals from network of DSP for all in-hospital procedures.

• Yet still one of the lowest contribution you will pay in the entire sector.• No contribution increase for salary bands R0 - R5,900 on Option A

and salary bands R0 - R5,400 on Option B.• Non-PMB Chronic covered on both Options.• Improved oncology benefits – members on both Options get to

enjoy the non-PMB oncology benefit.• General radiology on Option A for also covers non-PMB

conditions.• Improved Preventative Care Benefits for 2019.

MISSION STATEMENT

We commit ourselves to service excellence by providing the most affordable, member friendly, accessible and accountable scheme and administration.

VISION

BENEFITS AND CONTRIBUTION IMPROVEMENTS

• To be the leading medical scheme in the local government sector.• To provide a holistic and progressive primary health service

nationally.• To provide guaranteed affordability by offering appropriate benefits

and access to the best medical services.• To create healthy and satisfied members through education

and efficient administration in a member friendly environment.• Commitment to the principle of non-profit and to remain sustainable.• To be one of the most desired organisations to work for

in South Africa.• To promote clean, healthy and sustainable environment.

SAMWUMED | MEMBER GUIDE 2019

DISCLAIMER:This Member Guide is prepared and distributed for purposes of providing you with essential information to help you select the best benefit option for you and your family. It is not a full guide to the Scheme Rules and Benefits and does not supersede the Scheme Rules. All contributions and benefit options presented in the Member Guide are subject to the approval by the Council for Medical Schemes. Kindly familiarise yourself with your chosen benefit option and note where pre-authorisations, motivations and or letters of referral are required to access benefits.


The Scheme’s foremost priority, which is quality service to its members and all related parties, remains unchanged.

People are at the heart of all we do. For this reason, we strive to provide our members with positive experiences that go beyond simply facilitating healthcare transactions.

Our success is based on high reserve levels way above the requirements of the Regulator, a strong focus on service excellence which together, ensure that our members and their families have access tothe right medical cover when they need it.

In this way, we see ourselves not just as a medical aid scheme, but as an advocate of our members’ interests and their right to a healthy life.

CONTENTS

GLOSSARY OF TERMS USED IN THIS GUIDE 1REASONS WHY WE ARE THE BEST MEDICAL AID FOR YOU 3BENEFITS CAN BE GROUPED INTO TWO CATEGORIES 4PREVENTATIVE CARE BENEFITS AND EARLY DETECTION 5ENTITLEMENT TO BENEFITS 6CHANGING OF BENEFITS, LIMITS (INCLUDING OVERALL ANNUAL LIMITS), AND MEMBERSHIP CATEGORIES

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PRESCRIBED MINIMUM BENEFITS (“PMB”) 8GENERAL BENEFITS AND LIMITS 8Prescribed Minimum Benefits 8Limitation and Restriction of Benefits 82019 BENEFITS AND CONTRIBUTIONS 11Option A 12Option B 17MATERNITY BENEFITS 22ADDITIONAL VALUE 23SAMWUMED Primary Healthcare Benefit Programme 23Chronic Medicine Benefits 23Hospital Care 23MONTHLY CONTRIBUTIONS 24Definitions 26WHAT DOCUMENTS DO I NEED TO BECOME A MEMBER? 27MEMBERSHIP MANAGEMENT 28SAMWUMED’s Premiums and Membership Department is responsible for all aspects of membership and the collection of contributions

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Movement between Schemes during the year is not allowed 28Registering dependants 29Child dependants 29Birth of a child 29Adult Dependants 29EXCLUSIONS 30


CONTENTS


QUICK GUIDE: INFORMATION ON ACCESSING YOUR BENEFITS EFFICIENTLY 30Getting authorisation for your hospital stay 30Why is pre-authorisation necessary? 30When do you need to contact us for pre-authorisation? 31How do I pre-authorise? 31What if I'm diagnosed with Cancer? 31What happens in an emergency? 31What is a PMB? 32Access and care 32Checking available benefits 33Obtaining pre-authorisation from the call centre 33Benefits that require motivation and/or referral letters 33What is covered under the medication benefit? 33How to register and obtain medication for a chronic condition 33HIV MANAGEMENT PROGRAMME 34How and when to use the SAMWUMED Primary Healthcare Programme Benefit 34How to replace lost membership cards 35Submission and payment of accounts 35How our claims processing works 36HOW TO CHOOSE YOUR MEDICAL SCHEME FOR 2019 37Advice on choosing a medical scheme or benefit option 37Advice for current medical scheme members 37WHAT IS A MEDICAL SCHEME? 38But what does this mean? 38How the Act protects members of medical schemes 38WHAT IS AN ADMINISTRATOR? 38What are administrators? 38What do administrators do exactly? 38Self-administered medical schemes 39MEDICAL SCHEMES VS MEDICAL INSURANCE? 39

CONTENTS


WHAT SHOULD YOU ASK YOUR DOCTOR OR SERVICE PROVIDER BEFORE TREATMENT?

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What is involuntary use of a non-DSP? 41How does treatment at DSPs work? 41THE COMPLAINTS PROCESS 42Who can complain to the Registrar’s Office? 42Who can you complain about? 42Time limits for dealing with complaints 42The Registrar’s Ruling and appeal to Council 43The Section 50 Appeal’s process 43How to avoid complaints 43HOSPITAL NETWORKS 44Eastern Cape 44Free State 44Gauteng 44Kwa-Zulu Natal (*Note: Melomed Richards Bay is an exclusive Scheme DSP) 45Limpopo 46Mpumalanga 46North West 46Northern Cape 46Western Cape (*Note: The Scheme has an exclusive contract with the Melomed group of hospitals in Cape Town and surroundings, up to a 40 km radius).

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PHARMACY NETWORKS 46Eastern Cape 46Free State 48Gauteng 49Kwa-Zulu Natal 55Limpopo 58Mpumalanga 59North West 59Western Cape 61FAQ'S: FREQUENTLY ASKED QUESTIONS 65TALK TO SAMWUMED TODAY 66

GLOSSARY OF TERMS USED IN THIS GUIDE:• BENEFIT LIMIT:

The maximum amount that the member or dependant is entitled to for a specific benefit category, taking into account the Scheme Rules and Scheme Tariff paid for goods, services or appliances.

• CO-PAYMENT:The part of the account that a member pays in situations where the benefit does not cover the relevant health service, or when the provider charges fees that are higher than the Scheme Tariff.

• DEPENDANT:A spouse or partner, child or parent who is dependent on the member for care and support.

• PBPA: Per Beneficiary Per Annum

• DESIGNATED SERVICE PROVIDER (DSP):The service provider that the Scheme has chosen to provide certain medical care for PMBs.

• EXCLUSIONS:Any treatment, medications, appliances or similar that are not covered in terms of the Rules of the Scheme.

• FORMULARY: A list of medicines.

• ICD-10 CODE:The International Classification of Diseases (ICD) – 10. A system that organises diseases and the complications connected to these diseases according to specific categories.

• MEDICAL SCHEMES ACT: The law that governs all medical schemes in South Africa.

• OVERALL ANNUAL LIMIT (OAL): The limit that every member and their dependants cannot exceed during each benefit year.

• PRE-AUTHORISATION:The prior approval of scheduled surgeries and procedures. Whenever hospitalisation is required (ER, triage, that already exists at the time a member or their dependant joins the Scheme (scans and casualty ward) this must be confirmed with the Scheme and Managed Care. Please also not that there are certain day-to-day benefits that require pre-authorisation.

• PRE-EXISTING MEDICAL CONDITION: A medical condition or illness.

• PRESCRIBED MINIMUM BENEFITS (PMBs): A list of conditions, specified in the Medical Schemes Act 131 of 1998, for which all members are entitled to treatment.

SAMWUMED | MEMBER GUIDE 2019 1

• PRESCRIBED CYCLES:The number of times a member is allowed to access certain benefits during a specific benefit year(s).

• PREFERRED PROVIDER:A provider that the Scheme has negotiated favourable rates with and that can be used as an alternative to a DSP in the event of an emergency. A Preferred Provider may also be used if a DSP is not within reasonable travelling distance or does not offer the treatment or services required.

• PRO-RATED BENEFITS:Benefits allocated to a member based on the number of contributions they have paid. This applies to members who join after March of the benefit year.

• SCHEME TARIFF:The rate according to which the Scheme pays for claims.

• SUB-LIMIT:Forms part of a broader benefit category.

• WAITING PERIOD:A period during which members will not be covered even though they are paying contributions.


• 1 MONTH WAITING PERIODWe have reduced the general waiting period from 3 months to 1 for new members.Dependants who join after the main member will be subject to a 3 month waitingperiod.

• LOWEST CONTRIBUTION INCREASES IN THE INDUSTRY Our contribution increases are about the lowest in the industry. Whilst we have reviewed the Overall Annual and Hospital Limits – our analysis indicates that this may only adversely affect approximately 3% of members. The average claim spend of an average family remains at approximately R30 000.00 – so in simple terms a million rands worth of benefit is not generally going to be consumed by the average family – except being used to woo and impress members. The only incentive this creates is for opportunistic service providers. In the event that a member does require high level care for PMB conditions – THERE ARE NO LIMITS.

• ACCESS TO PRIVATE HOSPITALS* Our hospital contracts and networks have been reviewed to include more choice for our members and PMB level of care in private hospitals, subject to terms and conditions.

• WE ARE ABLE TO PROVIDE PERSONALISED SERVICES We have our own marketing infrastructure – this means that we are able to provide personalised services on an exclusive and consistent basis. We have our own offices and are rolling out more offices around the country.

• NO LATE JOINER FEES You do not pay late joiner fees when you join us.

REASONS WHY WE ARE THE BEST MEDICAL AID FOR YOU


BENEFITS CAN BE GROUPED INTO

• DAY-TO-DAY BENEFITS that you can access outside of hospital such as doctor and specialist consultations and visits, dental procedures, medication and optical care. Each benefit category is subject to limits as specified in the Scheme Rules. These benefits allow you and your family to access a wide range of healthcare services.

• SECONDARY OR TERTIARY CARE includes hospitalisation and the treatment of Prescribed Minimum Benefit (PMB) conditions. The hospitalisation benefit makes provision for in-hospital admission and/or transfers to rehabilitation and step-down facilities.

BENEFITS CAN BE GROUPED INTO TWO CATEGORIES:


• Addison's disease• Asthma• Bipolar Mood Disorder• Bronchiectasis• Cardiac failure• Cardiomyopathy• Chronic obstructive pulmonary disease• Chronic renal disease • Coronary artery disease

• Crohn's disease • Diabetes insipidus• Diabetes mellitus types 1 & 2• Dysrhythmias • Epilepsy• Glaucoma • Haemophilia• HIV/Aids• Hyperlipidaemia

• Hypertension• Hypothyroidism• Multiple sclerosis• Parkinson's disease• Rheumatoid arthritis• Schizophrenia• Systemic lupus erythematosus• Ulcerative colitis

SPECIFIES MEDICATION AND TREATMENT FOR THE 26 CHRONIC CONDITIONS THAT ARE COVERED UNDER THE PMBs:

IF YOU HAVE ANY QUESTIONS PLEASE CONTACT OUR CONTACT CENTRE ON 0860 104 117

THE CHRONIC DISEASE LIST (CDL)

WE BELIEVE EVERYONE

IS ENTITLED TO QUALITY

HEALTHCARE

AGE SCREENING TEST CONDITIONS 2019Adults Blood Pressure Up to one screening Pbpa

Adults Type II diabetesAdults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg or BMI in the overweight or obese ranges

Up to one screening Pbpa

25 to 64 years Total Blood Cholesterol

• Males between 25-64 years of age• Females between 45-64 years of age• Persons with a family history of familial hypercholesterolemia, heart attacks and cholesterol problems

Up to one screening Pbpa

11 To 24 years

25 To 64 years

over 65 years old

Papanicolaou (Pap) test

• Sexually active female beneficiaries from age 18• Chlamydia screen is recommended as part of this process• Teach clinical breast examination to >18 Up to one screening

Pbpa within a 2 year cycleChlamydia screening This should be done concomitantly with Pap Smear.

Child bearing age Folic acid Up to 1 per month for the first 3 months of pregnancyUp to 1 per month for the first 3 months of pregnancy

50 Years and older

Faecal occult blood test Up to one screening Pbpa Up to one screening Pbpa

Over the age of45 until the age of 70 Mammogram

• Breast Cancer • Every 3 years - females over the age of 45 until the age 70• If sister or mother had/ has breast cancer start annually at 40 years of age• Every 1-2 years - Females between 65-69 years of age• If normal previously: do every 2 years, if clinical examination normal and self-examination is done

Up to one screening Pb every three years until the age of 70

Women older than 60 years and men older than 70 years

Bone density Test Screening from 60 years for patients who are at risk of developing osteoporosis Up to one Pbpa

45 years to 70 years

Screening for prostate cancer Up to one Pbpa

All Ages HIV One test per member per annum

25 years to 65 years Cervical cancer

• Initiate screening at age 25 or at diagnosis of HIV positivity• End screening at age 65 or after hysterectomy• End screening only after previous negative tests, never end if HIV positive• HPV tests to be repeated every 5 years if HIV negative or unknown and annually if HIV positive• Cytology tests to be repeated every 3 years if HIV negative or unknown or annually if HIV positive

Repeat every 5 years if HIV negative, every 3 years if HIV positive

Less than 1 month old TSH screening Congenital hyperthyroidism

Once-off for hyperthyroidism in new-borns

2 to 64 years,over 65 years old

Pneumococcal vaccine

Up to one vaccination per beneficiary over 65 and beneficiaries aged 2-64 who are at risk of serious pneumococcal disease per lifetime.

One vaccination per beneficiary per lifetime

* Pbpa = Per beneficiary per annum

PREVENTATIVE CARE BENEFITS AND EARLY DETECTION

Apart from ensuring our members do not find themselves in hospital, the SAMWUMED Preventative Healthcare and early detection benefit provides members with an opportunity to take ownership of their own health. This programme will ensure together we could better manage quality health outcomes which would ultimately result in lower medical aid premiums. Our amazing Preventative Healthcare Programmes includes the following screenings:


• The Scheme Tariff for will be the SAMWUMED monetary tariffs applicable in 2019 increased by CPI as published by the SARB, unless an alternative tariff has been negotiated with specific providers, which will not be less than the fee charged by the State.

• Beneficiaries are entitled to benefits as shown in this Annexure B, subject to the monetary limits and implementation restrictions set out herein, to the exclusions referred to in Annexure C of the Rules, to the general limitation and restriction of benefits set out in Annexure D of the Rules and to the procedural and other requirements set out in the Main Rules.

ENTITLEMENT TO BENEFITS

• The column headed “SAMWUMED Option benefits available” shows the extent to which the relevant benefit is limited annually or sub-limited in monetary value or other terms. When that limit is reached no further benefits are available in the category.

• The column headed “Benefits” shows how the cost of a valid claim shall be determined for the purpose of reimbursing the member or the supplier and the share of such cost that the Scheme will bear. The balance of the share of costs to make up 100% thereof shall be the member’s responsibility, except for Prescribed Minimum Benefits.

• The overall annual benefit limits are as follows:

OPTION LIMIT AMOUNTS Option A R 750,000 per family per annum Option B R 1 500,000 per family per annum

• Membership categories:

Member only = M0 Member plus 1 dependant = M1 Member plus 2 dependants = M2 Member plus 3 or more dependants = M3+

CHANGING OF BENEFITS, LIMITS (INCLUDING OVERALL ANNUAL LIMITS), AND MEMBERSHIP CATEGORIES


• General conditions for the selection/change of a Preferred Family Practitioner (PFP)

• The Scheme shall pay for benefits in respect of out-of-hospital consultations by Family Practitioners subject to the conditions set out in the Scheme Rules.

• Each member, on behalf of himself or herself and his or her registered dependants, shall select a PFP by completing the Selection Form as required by the Scheme.

• It is permissible for dependants to select different PFP’s, subject to the following provi-sions:

• Adult dependants (e.g. spouses) may select a PFP of their choice;• For child dependants under the age of 16 years, a PFP will be selected by the parent

registered as the principal member of the Scheme;• Child dependants over the age of 16 years may select their own PFP, with the con-

sent of the parent registered as the principal member of the Scheme;• A PFP may be changed at the principal member’s discretion once every six (6)

months by completing a “Selection/Change of Preferred Family Practitioner” form. These forms are available from the Employer’s Human Resources Department;

• Where a PFP is part of a group practice of Family Practitioners, members may visit any doctor in the group practice provided that the claim is submitted on a group practice number;

• When a member/beneficiary is referred by a Family Practitioner to a specialist, the consultation for the specialist will be covered in accordance with the Scheme Rules;

• In the event of emergencies, the rule relating to PFP’s will apply.

• A member/beneficiary will be required to obtain a referral number from his PFP for a specialist consultation. The following exceptions are applicable:

• 1 (one) Urologist consultation/ visit for male beneficiaries• 1 (one) gynaecological consultation/ visit for female beneficiaries• Children under the age of 2 (two) years, for paediatric visits / consultations• Alternative healthcare practitioners • Dental practitioners, technologists and therapists• Maternity benefits - Ante natal visits and consultations• Oncologists, haematologists and credentialed medical practitioners during pre,

active and/ or post active treatment periods• Ophthalmologist• Optometrists• Pathologists• Psychiatrists, psychometrists, psychologists and registered counsellors• Radiologists

The preferred family practitioner (PFP) negotiations are still in progress


Prescribed Minimum Benefits as shown in Annexure A of the General Regulations, made in terms of the Medical Schemes Act 131 of 1998, override all benefits and limits indicated in this Annexure.

The Prescribed Minimum Benefits are available in conjunction with the Scheme’s contracted managed health care programmes, which include the application of treatment protocols, medicine formularies, pre-authorisation and case management. These measures have been implemented to ensure appropriate and effective delivery of Prescribed Minimum Benefits. See Annexure D - paragraph 7 for a full explanation.

PRESCRIBED MINIMUM BENEFIT (“PMB”) RULES EXTRACT

PRESCRIBED MINIMUM BENEFITS

• The Scheme will pay in full, without co-payment or use of deductibles, the diagnosis, treatment and care costs of the prescribed minimum benefits as per Regulation 8 of the Act, in compliance to agreed tariffs. The Scheme will employ appropriate interventions aimed at improving the efficiency and effectiveness of healthcare provision, including such techniques as requirements for pre-authorisation, the application of treatment protocols, and the use of formularies. (Regulation 8(3)).

• Where a managed health care protocol or a formulary drug preferred by the Scheme, but excluding the PMB algorithm as defined in the Regulation has been ineffective or would cause harm to a beneficiary, the Scheme will fund the cost of the appropriate substitution treatment without a penalty to the beneficiary as required by Regulation 15H and 15I of the Act.

LIMITATION AND RESTRICTION OF BENEFITS

• In cases of an illness of a protracted nature, the Scheme shall have the right to insist upon a member or dependant of a member consulting any particular specialist, the Scheme may nom-inate in consultation with the attending provider.

• The Scheme may require a second opinion in respect of proposed health care service(s) which may result in a claim for benefits and for that purpose the relevant beneficiary shall consult a dental or medical provider nominated by the Scheme and at the cost of the Scheme. In the event that the second opinion proposes different health care service(s) to the first, the Scheme may in its discretion require that the second opinion proposals be followed, unless in terms of the managed health care programme.

• In cases where a specialist is consulted without the recommendation of a Family Practitioner, the benefit allowed by the Scheme may, at its discretion, be limited to the amount that would have been paid to the Family Practitioner for the same service.

• Unless otherwise decided by the Scheme, benefits in respect of medicines obtained on a prescription are limited to one month’s supply (or to the nearest unbroken pack) for every such prescription or repeat thereof.

• If the Scheme or its managed health care programme contracted service supplier has funding guidelines or protocols in respect of covered services and supplies, beneficiaries will only qualify for benefits in respect of those services and supplies with reference to the available funding guidelines and protocols with due regard to the provision of Regulation 15(H) and 15(I).

GENERAL BENEFITS AND LIMITS


• If the Scheme does not have funding guidelines or protocols in respect of benefits for services and supplies referred to in Annexure B, beneficiaries will only qualify for benefits in respect of those services and supplies if the Scheme or its managed health care programme contracted service supplier acknowledges them as medically necessary, and then subject to such conditions as the Scheme or its managed health care programme contracted service supplier may impose.

“Medically necessary” refers to health services or supplies that meet all the following requirements:

• they are required to restore normal function of an affected limb, organ, or system; • no alternative exists that has a better outcome, is more cost-effective, or has a lower risk; • they are accepted by the relevant service provider as optimal and necessary for the specific

condition, and at an appropriate level to render safe and adequate care; • they are not rendered or provided for the convenience of the relevant beneficiary or service

provider;• outcome studies are available and acceptable to the Scheme in respect of such services

or supplies.• they are not rendered or provided because of personal choice or preference of the relevant

beneficiary or service provider, while other medically appropriate, more cost-effective alternatives exist.

• The Scheme reserves the right not to pay for any new medical technology or, investigational procedures, interventions, new drugs or medicine as applied in clinical medicine, including new indications for existing medicines or technologies, unless the following clinical data relating to the above have been presented to and accepted by the Medical Advisory Committee and such data demonstrating their:

• therapeutic role in clinical medicine;• cost-efficiency and affordability;• value relative to existing services or supplies;• role in drug therapy as established by the Schemes’ managed health care programme

contracted service supplier.

• In the event that:

• the treatment of an extended chronic sickness condition becomes necessary; • a disease or a condition (including pregnancy) requires specialised or intensive treatment; • the treatment of any disease or condition becomes of a protracted nature or requires

extended medicine and such treatment is given in or by a non-designated service provider or a preferred provider, the case may be evaluated in terms of the relevant managed health care programme and, having regard to the aforementioned diseases or conditions in question, the Scheme may require or advise:

• the transfer as arranged by the Scheme of that beneficiary to a public hospital or other designated service provider where appropriate care is available, with due regard to Regulation 8(3)(c);

• the application of a limited drug formulary; • both such transfer and restricted drug formulary;• in order to conserve or maximise efficient utilisation of available benefits.


• In the event that a decision has been, the following conditions shall apply:

• in respect of Prescribed Minimum Benefits, no benefit limit shall apply provided treatment is given in or by a public hospital or designated service provider. If for any reason the beneficiary involuntarily receives treatment in or by a non-designated service provider, no co-payment applies;

• in respect of non-Prescribed Minimum Benefit conditions, if the Scheme or its managed health care programme contracted service supplier should determine that any annual benefit limits, as set out in Annexure B, and available to the beneficiary receiving such treatment, are likely to be exceeded in the course of the year, the beneficiary may be advised to move to a public hospital or designated service provider or to accept a limited drug formulary, or both, in order to conserve available benefits.

In such designated service provider or public facility any costs incurred over and above the limit stipulated in Annexure B (excluding Prescribed Minimum Benefit conditions), shall be the member’s responsibility. The member may elect on behalf of himself or his beneficiary, to remain in the private hospital, or remain on the full drug formulary available, or both, in which event the Scheme shall pay up to the benefit limit stipulated in Annexure B, whereafter the member shall be responsible for payment, direct to the private hospital, for any further treatment in such hospital, or for payment direct to the supplier for further medicine.

• The Scheme (or its managed health care programme contracted service supplier on behalf of the Scheme) may from time to time contract with or credential specific provider groups (networks) or centres of excellence as determined by the Scheme in order to ensure cost effective and appropriate care. The Scheme reserves the right not to fund or partially fund services acquired outside of these networks, provided reasonable steps are taken by the Scheme to ensure access to the network, subject to Prescribed Minimum Benefits.

• The Scheme reserves the right not to pay for procedures performed by non-recognised provid-ers (where applicable).

• Certain procedures may be associated with a significant learning curve and/or are not taught routinely at local universities and/or require special training and experience, including that aimed at maintenance of expertise, and/or need access to certain infrastructure for quality outcomes, where such procedures have been identified by the Scheme’s managed health care programme contracted service supplier. Recognised providers are those who have been acknowledged by meeting minimum training and practice criteria for the safe and effective performance of such procedures. Recognition occurs as a result of a formal application process by interested providers and adjudication of relevant information against competency guidelines by the managed health care programme contracted service supplier and/or appointed credentialing body. Criteria for formal recognition are informed by clinical evidence, clinical guidelines and/or expert opinion.



BENEFITS & CONTRIBUTIONS

WE HAVE TWO BENEFIT PLANS, OPTION A AND OPTION B,HAVE BEEN CAREFULLY DESIGNED TO PROVIDE FOR YOUR HEALTHCARE NEEDS.

AOPTION BENEFITS


ALTERNATIVE HEALTH CARE

PODIATRISTHOMEOPATH NATUROPATH CHIROPRACTOR

INCLUDED with GP consultations and visits.

Practitioners to be registered with the Health Professions Council of SA or Allied Health Professionals Council of South Africa.

R 2,650

R 3,750

R 4,750

AMBULANCE SERVICES

ROAD AND AIR Designated Service Provider only.

UNLIMITED FOR EMERGENCY ASSISTANCE ONLY - case managed, and protocols apply.

25% Co-Payment rule for voluntary use of a Non-DSP.

Scheme Members to be held liable for the full cost oftransportation for non-medically justifiable cases.

APPLIANCES MEDICAL ANDSURGICAL

Subject to the submission of a clinical motivation with correct Tariff codes and costing for pre-authorisation by the Scheme.

The Scheme (or contracted managed care company on behalf of the Scheme) may from time to time contract with or pilot with or credential specific provider groups (networks) or centres of excellence or supplier groups as determined by the Scheme in order to ensure cost effective and appropriate care.

Beneficiaries are entitled to benefits from contracted networks appointed as the Scheme’s DSP for PMB benefits and other benefits.

DENTISTRY BASIC BASIC DENTISTRY INCLUDES fillings, root canal treatments, scaling & polishing, extractions, fissure sealants, dentures and repairs Subject to prescribed cycles

R 3,300

R 3,940

R 5,470

R 6,600 FULL DENTURES A 3 YEAR benefit cycle applies.

A 2 YEAR benefit cycle applies.

PFPA = R2,100

The Scheme reserves the right not to fund or partially fund services acquired outside of these networks, provided reasonable steps are taken by the Scheme to ensure access to the network, subject to Prescribed Minimum Benefits.


Limits and cycles as per the Scheme’s list of approved appliances apply

PARTIAL DENTURES

GP CONSULTATIONS,

VISITS AND PROCEDURES

DOCTOR’S ROOMS OR HOME

R 3,150

R 4,200

R 5,250

R 6,300

BENEFICIARY LIMITR 3,150 PER ANNUM

EMERGENCY TREATMENT AND PROCEDURES

THIS SUB-LIMIT IS INCLUDED WITH THE GP Consultations, Visits and Procedures limit.

INFERTILITY ONLY PMB CONDITIONS

SUB-LIMITR 1,180 PER FAMILYPER YEAR

EXCLUDED:Cosmetic Dentistry, Veneers and Implants.

Use of DSP


MEDICATION PRESCRIBED, DISPENSED OR ACUTE

R 1,700

R 2,900

R 4,000

R 5,300

SUB-LIMITR 2,900 PER BENEFICIARY, PER YEAR

PRIMARY HEALTHCARE BENEFIT PROGRAMME

Condition specific benefits, sub limits and treatment plans apply.

CHRONIC MEDICATION Subject to Chronic Disease List (CDL) and Chronic Formulary and protocols apply.

PAT: OVER-THE-COUNTER MEDICINE

INCLUDED with prescribed, dispensed or acute medication limit.

25% CO-PAYMENTvoluntarily utilisation of an out-of-network pharmacy

25% CO-PAYMENTusing out-of-formulary medication

Limited to listed conditions and number of incidents per beneficiary per year as outlined below: Stomach pain, heartburn, indigestion (including reflux), 2 | Acute gastroenteritis: - vomiting and diarrhoea, 2 | Upper and lower respiratory tract infections, 3 | Oral and topical candidiasis: - thrush/fungal or yeast infections, 2 | Helminthic infestation: - worms, 2 | Headache, 4 | Bacterial conjunctivitis: - eye infection, 2 | Urinary tract infection (acute uncomplicated cystitis), 1 | Urticarial: skin rashes, insect bites and stings, 2 | Treatment of wounds and/or infections of the skin/subcutaneous tissues (excl. post- operative wound care), 1

Remind your pharmacist to include the appropriate ICD-10 diagnostic codes with all claims for this Programme.

25% CO-PAYMENTfor Chronic medication not on the Chronic Formulary

25% CO-PAYMENTfor voluntarily utilisation of an out-of-network pharmacy

25% CO-PAYMENTfor using out-of-formulary medication.


MENTAL HEALTH

SUBSTANCE DEPENDENCY

CONSULTATIONS/VISITS AND PROCEDURES

Clinical motivation required for authorisation of continued consultations AFTER FIRST 10 INITIAL ASSESSMENTS.

HOSPITALISATION SUBSTANCE DEPENDENCYReferral from an Employee Assistance Programme (EAP) or GP required

MENTAL HEALTH CONDITIONSReferral from specialist required

UP TOR 660PER FAMILY, PER YEAR

SUB-LIMITR 140 PER DAY

Subject to Medicine Formularies and Exclusion Lists.

PMB conditions and protocols apply.

Subject to Scheme Network

Limited to PMB Conditions only


Chronic Medication for Depression, Gout, and GORD added to the chronic formulary

Scheme Rules and Protocols apply

INCLUDED with In-Patient benefit.


AOPTION BENEFITS

OPTICAL FRAMES/LENSES R 6,300 PER FAMILYSubject to prescribed cycles.

Exclusions apply, including but not limited to repairs.

OPHTHALMOLOGIST VISITsubject to referral from Optometrist or GP

FRAMES LENSES A 2 YEAR benefit cycle applies.


FRAMES FRAMESR 810 LIMIT PER BENEFICIARY


PATHOLOGY OUT-OF-HOSPITAL INCLUDED with Specialist Benefit.

IN-HOSPITAL R 4,300 PER FAMILYPER YEAR

INCLUDED with In-Patient benefit

PHYSIOTHERAPY OUT-OF-HOSPITAL

IN-HOSPITAL Clinical motivation required for authorisation of continued consultations after first two visits.

INCLUDED with Specialist Benefit.

Limited to PMB Conditions only

R 1,950 PER FAMILYPER YEAR

INCLUDED with Specialist Benefit.

LENSESWHITE LENSES: 100% of the lower cost or Optical Assistant Tariff.

PHOTOCHROMIC LENSES: 100% of the lower cost or Optical Assistant Tariff up to a maximum of R 370 per pair Subject to a prescription of +0.50/-0.50 and above.

FIXED OR GRADIENT TINTS UP TO 35%100% of the lower cost or Optical Association Tariff.

EYE TESTS Subject to family limitLIMITEDONE CONSULTATION PER BENEFICIARYPER ANNUM

Clinical motivation required for authorisation of continued consultations after first two visits.


PROSTHESES INTERNAL

The Scheme reserves the right to purchase the appliance on behalf of the member and the purchase may be billed against the member’s benefit.

EXTERNAL (INCLUDING ARTIFICIAL EYES AND LIMBS)

R 25,600PER FAMILY, PER YEARIncluded with In-Patient benefit.

25% co-paymentsAPPLY FOR VOLUNTARY USE OF NON-DSP NETWORKS.

Subject to the submission of a clinical motivation and costings for pre-authorisation by the Scheme.

R 13,150 PER FAMILY, PER YEAR



RADIOLOGYRADIOGRAPHY

GENERAL(IN AND OUT-OF-HOSPITAL)

R 8,500 INCLUDED WITH IN-PATIENT BENEFIT

SPECIALISED (IN AND OUT-OF-HOSPITAL)


REMEDIAL THERAPY

OCCUPATIONAL, SPEECHTHERAPY, AUDIOLOGY & DIETICIANS

Subject to GP Referral. Applicable for Out-of-hospital treatment.

SUBJECT TOR 2,110PER FAMILY, PER YEAR

INCLUDED with Specialist benefit for In- or Out-of-hospital treatment.

SPECIALIST CONSULTATIONS,

VISITS AND PROCEDURES

OUT-OF-HOSPITAL R 3,800

R 5,700

R 7,600

R 9,500

IN-HOSPITAL

BENEFICIARY LIMITR 4,600 PER YEAR

Subject to GP Referral


PER FAMILY,PER YEAR


AOPTION BENEFITS

HOSPITALISATION IN-PATIENT

“Take Home” medication limited to 7 days’ supply

MATERNITY CAESAREAN SECTIONR 24,400 PER BENEFICIARY, PER YEAR

NORMAL DELIVERY

ABORTIONTHREATENEDR 5,900 PER BENEFICIARY, PER YEAR

OVERALL ANNUAL LIMIT - R 750,000 PER FAMILY, PER YEAR.

R 750,000PER FAMILY,PER YEAR

ABORTIONINCOMPLETER 16,550 PER BENEFICIARY, PER YEAR

ABORTIONINEVITABLER 16,600PER BENEFICIARY, PER YEAR

ABORTIONVOLUNTARYR 4,650 PER BENEFICIARY, PER YEAR

BLOOD TRANSFUSIONSERVICES


ALTERNATIVES TOHOSPITALISATION

Private nursing, Frail care, Hospice, Step-down facility


ORGAN TRANSPLANT Scheme Rules and treatment plans apply

OUT-OF-HOSPITALMedication to be obtained from Scheme Networks.

IN-HOSPITALIncluded with In-Patient Benefit. Subject to Scheme Networks.

Pre-Authorisation required

ONCOLOGY

OUT-OF-HOSPITALNon-PMB subject to R 200,000 Subject to Overall Annual Limit and Scheme Networks.

IN-HOSPITALSubject to Overall Annual Limit and Scheme Networks. Included with In-Patient benefit and subject to Scheme Networks.

Subject to Pre-Authorisation

RENAL DIALYSIS PMB ONLYINCLUDED with In-Patient benefit

Subject to Scheme Networks.



Subject to pre-authorisation at a DSP (Scheme Network hospitals).




BOPTION BENEFITS

ALTERNATIVE HEALTH CARE

PODIATRIST HOMEOPATH NATUROPATH CHIROPRACTOR

INCLUDED with GP andSpecialist consultations and visits limit.

Practitioners to be registered with the Health Professions Council of SA or Allied Health Professionals Council of South Africa.

AMBULANCE SERVICES

ROAD AND AIR Preferred Service Provider only: Netcare 911

UNLIMITED FOR EMERGENCY ASSISTANCE ONLY - case managed, and protocols apply.

25% Co-Payment rule for voluntary use of a Non-DSP.

Scheme Members to be held liable for the full cost oftransportation for non-medically justifiable cases.

APPLIANCES MEDICAL AND SURGICAL

Subject to the submission of a clinical motivation with correct Tariff codes and costing for pre-authorisation by the Scheme.

The Scheme (or contracted managed care company on behalf of the Scheme) may from time to time contract with or pilot with or credential specific provider groups (networks) or centres of excellence or supplier groups as determined by the Scheme in order to ensure cost effective and appropriate care.

Beneficiaries are entitled to benefits from contracted networks appointed as the Scheme’s DSP for PMB benefits and other benefits.

DENTISTRY BASIC R 7,050

R 8,100

R 9,400

R 10,600 FULL DENTURES

GP AND SPECIALIST

CONSULTATIONS AND VISITS

ROOMS OR HOME R 3,700

R 6,000

R 8,150

R 10,150

BENEFICIARY LIMITR 6,000 PER YEAR

ROOMS OR HOME



PFPA = R3,200


Limits and cycles as per the Scheme’s list of approved appliances apply

PARTIAL DENTURES



Subject to Scheme networks.

Subject to Scheme networks.

ADVANCED DENTISTRY

Clinical motivation required for pre- authorisation from Scheme.

Orthodontics, crown and bridge work or any procedure that requires anaesthetics. Hospitalisation costs for removal of wisdom teeth or treatment for children under the age of 7 paid from the hospitalisation benefit. Dental procedure costs paid from dentistry benefit

EXCLUSIONS Cosmetic dentistry such as veneers and implants is excluded

GP AND SPECIALIST

PROCEDURES AND TESTS

BASIC DENTISTRY INCLUDES Fillings, root canal treatments, scaling & polishing, extractions, fissure sealants, dentures and repairs Subject to prescribed cycles


INFERTILITY ONLY PMB CONDITIONS PMB Protocols Apply

MEDICATION PRESCRIBED, DISPENSED OR ACUTE

R 3,300

R 4,350

R 6,650

R 8,750


PRIMARY HEALTHCARE BENEFIT PROGRAMME

Condition specific benefits, sub limits and treatment plans apply.

CHRONIC MEDICATION Subject to Chronic Disease List (CDL) and Chronic Formulary and protocols apply.

PAT: OVER-THE-COUNTER MEDICINE


25% CO-PAYMENTfor using out-of-formulary medication

Limited to listed conditions and number of incidents per beneficiary per year as outlined below: Stomach pain, heartburn, indigestion (including reflux), 3 | Acute gastroenteritis: - vomiting and diarrhoea, 3 | Upper and lower respiratory tract infections, 4 | Oral and topical candidiasis: - thrush/fungal or yeast infections, 3 | Helminthic infestation: - worms, 2 | Headache, 6 | Bacterial conjunctivitis: - eye infection, 2 | Urinary tract infection (acute uncomplicated cystitis), 1 | Urticarial: skin rashes, insect bites and stings, 2 | Treatment of wounds and/or infections of the skin/subcutaneous tissues (excl. post- operative wound care), 2

Remind your pharmacist to include the appropriate ICD-10 diagnostic codes with all claims for this Programme.

25% CO-PAYMENTfor Chronic medication not on the Chronic Formulary


25% CO-PAYMENTfor using out-of-formulary medication


MENTAL HEALTH

SUBSTANCE DEPENDENCY

CONSULTATIONS/VISITS AND PROCEDURES.

HOSPITALISATION SUBSTANCE DEPENDENCYReferral from an Employee Assistance Programme (EAP) or GP required

MENTAL HEALTH CONDITIONSReferral from specialist required

LIMITEDR 1,400 PER FAMILY, PER YEAR

SUB-LIMITR 180 PER DAY

Clinical motivation required for authorisation of continued consultations AFTER FIRST 10 INITIAL ASSESSMENTS.

Subject to Medicine Formularies and Exclusion Lists. Included with prescribed, dispensed or acute medication limit.


Chronic Medication for Depression, Eczema, Gout, GORD, and Menopause added to the chronic formulary


Scheme Rules andPMB Protocols apply

Scheme Rules andPMB Protocols apply


BOPTION BENEFITS


OPTICAL FRAMES/LENSES/CONTACT LENSES

R 8,450 PER FAMILYSubject to prescribed cycles.

Exclusions apply, including but not limited to repairs.

OPHTHALMOLOGIST CONSULTATIONsubject to referral from Optometrist or GP



SPECTACLE LENSES AND CONTACT LENSES CANNOT BE OBTAINED SIMULTANEOUSLY

LENSES WHITE LENSES: 100% of the lower cost or Optical Assistant Tariff.

PHOTOCHROMIC LENSES: 100% of the lower cost or Scheme Tariff up to a maximum of R 370 per pair Subject to a prescription of +0.50/-0.50 and above.

FIXED OR GRADIENT TINTS: 100% of the lower cost or Optical Association Tariff.

PATHOLOGY IN-AND-OUT-OF-HOSPITAL

PHYSIOTHERAPY IN-AND-OUT-OF-HOSPITAL

FRAMES FRAMESR 1,050 LIMIT PER BENEFICIARY

EYE TESTS Subject to family limitONE EYE TEST PER BENEFICIARY, PER ANNUMAT OPTICAL ASSISTANT’S TARIFF




Clinical motivation required for authorisation of continued consultations after first two visits.


CONTACT LENSES Contact lenses with a prescription reading of -0.75 or +1.00 and above: 100% of the lower of costs or Optical Assistant Tariff up to a maximum of R 2,350 per beneficiary

FRAMES LENSES A 2 YEAR benefit cycle applies

CONTACT LENSES A 2 YEAR benefit cycle applies


BOPTION BENEFITS

PROSTHESES INTERNAL


EXTERNAL (INCLUDING ARTIFICIAL EYES AND LIMBS)

RADIOLOGYRADIOGRAPHY

GENERAL (IN AND OUT-OF-HOSPITAL)

R 13,100PER BENEFICIARY, PER YEAR MRI/CAT or similar Scans limited

SPECIALISED (IN AND OUT-OF-HOSPITAL)

REMEDIAL THERAPY OCCUPATIONAL, SPEECH

THERAPY, AUDIOLOGY & DIETICIANS

Subject to GP Referral.Only applicable for Out-of-hospital treatment.

R 26,100 PER FAMILY, PER YEARIncluded with In-Patient benefit.


R 15,350 PER FAMILY, PER YEARIncluded with In-Patient benefit.


R 8,700PER FAMILY, PER YEAR

SUB-LIMITR 4,350PER FAMILY, PER YEAR

In-and-Out of Hospital


Subject to pre-authorisation from the Scheme

HOSPITALISATION IN-PATIENT Subject to pre-authorisation and registration with Clinical Disease Management Programme for asthma, cardiovascular disease, diabetes, and cancer, where applicable.Scheme Networks for joint replacements, cardiac and abdominal surgery.

“Take Home” medication up to 7 days’ supply

R 1,500,000PER FAMILY,PER YEAR


Scheme Rules and PMB Protocols apply




MATERNITYCAESAREAN SECTIONR 26,100PER BENEFICIARY, PER YEAR

NORMAL DELIVERY

ABORTIONTHREATENEDR 6,400 PER BENEFICIARY, PER YEAR

ALTERNATIVES TOHOSPITALISATION

Private nursing, Frail Care,Hospice, Step down Facilities

BLOOD TRANSFUSIONSERVICES

RENAL DIALYSIS

ORGAN TRANSPLANT Scheme Rules and treatment plans apply

OUT-OF-HOSPITALSubject to Overall Annual Limit and Scheme Networks.

IN-HOSPITALIncluded with In-Patient benefit.Subject to Scheme Networks.

ONCOLOGY

OVERALL ANNUAL LIMIT - R 1,500,000 PER FAMILY, PER YEAR.

ABORTIONINCOMPLETER 17,750PER BENEFICIARY, PER YEAR

ABORTIONINEVITABLER 17,750PER BENEFICIARY,PER YEAR

ABORTIONVOLUNTARYR 4,950PER BENEFICIARY, PER YEAR



Subject to Scheme Networks.


Pre-Authorisation required

OUT-OF-HOSPITALNON-PMB SUBJECT TO R300,000Subject to Overall Annual Limit and Scheme Networks.

IN-HOSPITALIncluded with In-Patient benefit and subject to Scheme Networks

Subject to pre-authorisation and registration with Disease Management Programme.

HOSPITALISATION

Scheme Rules and PMB Protocols apply

Expecting moms can access the SAMWUMED Maternity Programme to help take better care of themselves and their unborn baby by taking advantage of a wide range of maternity preventative care and early detection benefits.

Folic Acid At least first trimester of pregnancy Up to first 3 months of pregnancy.

Ultrasounds 100% of Scheme rate, limited to two ultrasounds Pbpa for maternity. Up to two screening Pbpa.

Ante NatalConsultations

8 Ante-natal consultations per maternity event Up to 8 Ante-natal consultations per maternity.

Vitamins Iron Supplements Up to first 3 months of pregnancy.

HIV Screening Screen of 1 test per maternity event within 1st trimester Up to one Pbpa.

Pap Smear(6 weeks Post-Partum)

Limited to one Pbpa within 6 weeks post-partum. Up to one Pbpa.

MATERNITYBENEFITS


SIMPLY DIAL 0860 33 33 87 TO REGISTER

SAMWUMED PRIMARY HEALTHCARE BENEFIT PROGRAMME

This unique benefit offers SAMWUMED members peace of mind should a member deplete his/her annual medicine benefit. In partnership with our pharmacy network, SAMWUMED has created a formulary (a specific list of most cost effective medicines) available over the counter for the 10 most common ailments:

Subject to Scheme tariffs, members can access these from an approved pharmacist without paying extra money.

• Stomach pain, heartburn, indigestion (including reflux), 2• Acute gastroenteritis: vomiting and diarrhoea, 2• Upper and lower respiratory tract infections, 3• Oral and topical candidiasis: thrush/fungal or yeast infections, 2• Helminthic infestation: worms, 2• Headache, 4• Bacterial conjunctivitis: eye infection, 2• Urinary tract infection (acute uncomplicated cystitis), 1• Urticarial: skin rashes, insect bites and stings, 2• Treatment of wounds and/or infections of the skin/subcutaneous tissues (excl. post- operative wound care), 1

ADDITIONAL VALUE

CHRONIC MEDICINE BENEFITS

A chronic condition is a persistent or otherwise long-lasting illness that may be longer than three months or lifelong. SAMWUMED will cover for the diagnosis, treatment and care of 26 chronic conditions.

SAMWUMED works with Medscheme to give members the best advice on the use of their chronic medication, as well as ensure that their chronic benefits are correctly allocated.

You treating doctor will need to call our Managed Care Provider, Medscheme on 0860 33 33 87 to register for your Chronic Medication.

HOSPITAL CARE

When you need hospital treatment or an operation, SAMWUMED will cover you for approved medical expenses when you are in hospital. The comprehensive hospital benefit cover ensures you are taken care of should you or your loved ones land up in a hospital.

We have partnered with Medscheme as our Hospital and Oncology Benefit Management Service Provider to manage your hospital care.

For all hospital pre-authorisations members can call 0860 33 33 87.

Unless an emergency, members will need to contact Medscheme no less than 72 hours before the procedure to get authorisation for their admission to

hospital on 0860 33 33 87


OUR CONTRIBUTION TABLE FOROPTION A

Table below represents 100% contribution. EMPLOYEES ONLY PAY UP TO 40%.

A] Contributions are paid monthly in arrears.

CONTRIBUTION INCREASE0%100% Contribution 40% Contribution

INCOME BAND PRINCIPAL ADULT CHILD PRINCIPAL ADULT CHILD

R0 - R3 700 R995 R995 R350 R398 R398 R140

R3 701 - R4 800 R1 176 R1 176 R412 R470 R470 R165

R4 801 - R5 900 R1 265 R1 265 R444 R506 R506 R178

CONTRIBUTION INCREASEONLY 7%


100% Contribution 40% Contribution


R5 901 - R7 500 R1 530 R1 530 R537 R612 R612 R215

R7 501 - R9 100 R1 640 R1 640 R577 R656 R656 R231

R9 101+ R1 757 R1 757 R620 R703 R703 R248



R5 401 - R6 400 R2 054 R2 054 R720 R822 R822 R288

R6 401 - R7 501 R2 094 R2 094 R735 R838 R838 R294

R7 501 - R10 700 R2 137 R2 137 R751 R855 R855 R300

R10 701 - R13 900 R2 252 R2 252 R765 R901 R901 R306

R13 900+ R2 371 R2 371 R781 R948 R948 R312

Table below represents 100% contribution. EMPLOYEES ONLY PAY UP TO 40%.

B] Contributions are paid monthly in arrears.

OUR 2019CONTRIBUTION TABLE FOROPTION B




R0 - R5 400 R1 694 R1 694 R594 R678 R678 R238

CONTRIBUTION INCREASEONLY 8.3%

CONTRIBUTION INCREASE0%

HOW TO CALCULATE YOUR CONTRIBUTION AS PER YOUR EMPLOYMENT CONTRACT

Establish your income before deductions to establish your Income Band

1 Sum the values in the respective columns for the Principal member and beneficiaries

2 Multiply the total by your contribution percentage as per your Employment Contract

3

R2371 x (40% OR 0.4) = R948

MONTHLYCONTRIBUTIONS

DEFINITIONS OF THE COLUMNS OF THE CONTRIBUTION TABLES

• Salary column: This reflects the monthly salary before tax or other deductions.

• Principal column: This column shows how much the main member, who is a local government employee registered with SAMWUMED, has to pay.

• Adult column: This column shows how much you have to pay for your adult dependants.

• Child column: This column shows how much you have to pay for a child dependant. SAWUMED covers children up to the age of 21, unless the child is mentally or physically disabled or is below 25 years of age and is a student registered at a recognised educational institution and proof thereof is provided.


Your medical aid contribution is generally paid for from two sources: your employer’s subsidy and your monthly salary. Your employer deducts contributions from your salary each month and pays it over to the Scheme. Contributions are calculated according to income and family size and are paid monthly in arrears.

The Scheme does not have access to your salary.

The Scheme will advise you in cases where incorrect contributions are received or if your employer has not paid the correct amount to the Scheme. If you join after 31 March, you will be subject to pro-rated benefits.

January - March 100% of benefit April - June 75% of benefit July - September 50% of benefit October - December 25% of benefit

WHAT DOCUMENTS DO I NEED TO BECOME A MEMBER?

IT’S SIMPLE TO BECOME A MEMBER OF SAMWUMED

Request and complete an APPLICATION FORM from our Sales & Servicing and Broker Consultants or via your HR office.

Submit your application with photo copies of SOUTH AFRICAN IDENTITY.

You will receive an EMAIL AND SMS from SAMWUMED to confirm receipt of your application.

You will receive your SAMWUMED WELCOME PACK which includes your Membership Quick Guide and Membership Card.

STEP

1STEP

2STEP

3STEP

4

WHAT DOCUMENTS DO I NEED TO BECOME A MEMBER?

SOUTH AFRICAN ID Book/Card, Birth Certificates.

A SWORN AFFIDAVITproving financialdependency for children over the age of 21.

LEGAL DOCUMENTSof adopted/foster children, PREVIOUS MEMBERSHIP.CERTIFICATE

Confirmation of BANKING DETAILS and SALARY SLIP

No matter which benefit option you take, SAMWUMED Medical Aid offers cover in full and as stipulated by Scheme Rules, for the diagnosis, treatment and care of an extensive range of medical conditions.

GO AHEAD AND CHOOSE THE MOST SUITABLE OPTION FOR

YOUR FAMILY’S NEEDS


SAMWUMED’S PREMIUMS AND MEMBERSHIP DEPARTMENT IS RESPONSIBLE FOR ALL ASPECTS OF MEMBERSHIP AND THE COLLECTION OF CONTRIBUTIONS.

All local government employees have the opportunity to change their medical aid options during the Freedom of Association period (also known as the “window period”) from October until the end of November each year. Members who wish to make this change must notify the Scheme in writing by submitting an Option change form via their Human Resource Department by no later than 15 Decemberof the same year. All benefit option changes must be confirmed by January each year.

Section 7 of the South African Local Government Bargain Council’s Main Collective Agreement states that “medical scheme members may make an election regarding movement from one ac-credited medical scheme to another accredited medical scheme on an annual basis before 01 January”.

MOVEMENT BETWEEN SCHEMES DURING THE YEAR IS NOT ALLOWED.

Membership application and dependant registration forms make provision for the disclosure of pre-existing health conditions. Failure to provide the appropriate information to the Scheme could lead to the termination of your or your dependant’s membership. Single principal members are issued with one membership card and families receive two cards. The Scheme does not charge members for replacement of lost or stolen cards.

It is important that the Scheme has the correct identity numbers for members and dependants. Without it, you might not be able to use your benefits. Please contact the Scheme to ensure that we have your correct telephone numbers, address, and details of your dependants.

If your information changes during the year, it is important to let the Scheme know by contacting 0860 104 117.

MEMBERSHIP MANAGEMENT

ALL INFORMATION THAT YOU DISCLOSE TO THE SCHEME IS CONSIDERED CONFIDENTIAL.

You should be mindful not to disclose information such as your membership number or hand over tax or membership certificates/cards to any third party.


REGISTERING DEPENDANTS

• We have reduced the general waiting period from 3 months to 1 for new members. Dependants who join after the main member will be subject to a 3 month waiting period.

• To register a dependant, a Dependant Registration form must be completed and submitted to the Scheme via your Human Resource Department along with the required documentation such as copies of birth certificates when registering children; affidavits and marriage certificates for spouses and partners; proof of study and/or affidavits proving dependency for dependants over the age of 21.

• The Dependant Registration form makes provision for the disclosure of pre-existing conditions that prospective dependants might have. Depending on the severity of the condition(s), certain waiting periods may be considered by the Scheme before dependants can claim benefits.

• Failure to disclose these pre-existing conditions could limit or exclude a dependant from claiming benefits, according to provision 11.5 of the Scheme Rules, which states that “The Board may, in its absolute discretion, exclude from benefits or terminate the membership of a member or dependant whom the Board finds guilty of abusing the benefits and privileges of the Scheme by presenting false claims or making a material misrepresentation or non-disclosure of factual information or who, in the opinion of the Board, is guilty of misconduct that would either compromise the achievement of the aims and objects of the Scheme or bring the Scheme into disrepute. In such event, he or she may be required by the Board to refund to the Scheme any sum which, but for his or her abuse of the benefits or privileges of the Scheme, would not have been disbursed on his or her behalf.”

CHILD DEPENDANTS

A child dependant is someone up to the age of 21 but not older than 25 years. Student dependants must be attending a recognised educational institution and be without a regular income. To register a child dependant, a birth certificate, identity document, or affidavit (where the child’s surname is not the same as the main member’s) is required. Proof of study or medical report must be submitted for child dependants who are students or mentally/physically disabled.

Grandchildren can be registered, provided that the member is responsible for their care and financial support. An affidavit from parents and member confirming dependency is required and this is subject to an annual review.

BIRTH OF A CHILD

Members must notify the Scheme within 30 days of the birth of a child to qualify for immediate benefits. The birth certificate must be submitted along with the Dependant Registration form. A three-month waiting period will be imposed if the registration is not completed within this time.

ADULT DEPENDANTS

Adult dependants are 21 years and older and can be a spouse or partner. Spouses who are registered within 30 days of marriage will qualify for benefits immediately. A marriage certificate or affidavit must be submitted with the registration form.

A three-month waiting period will be imposed if the registration is not completed within this time.

Dependants over the age of 21, who are not spouses or partners, but are dependent on the main member for care and financial support, can be registered as adult dependants. An affidavit proving this dependency is required. Refer to scheme rules for definition.


If you have any questions regarding membership, please contact our Premiums Department by dialling 0860 104 117 and pressing 2 when prompted or email [email protected].

Exclusions: Any treatment, medications, appliances or similar that are not covered in terms of the Rules of the Scheme is regarded as an exclusion.

Refer to Annexure C of Scheme Rules.

EXCLUSIONSWHAT DOES THE SCHEME NOT PAY FOR?

GETTING AUTHORISATION FOR YOUR HOSPITAL STAY

A Managed Care partner has been contracted by the Scheme to ensure that you and your dependants get cost efficient, quality care in hospital. Managed Care offers you useful advice and their team of doctors and nurses will make sure that you are admitted at the appropriate facility at the correct fee. You must contact Managed Care for pre-authorisation on 0860 33 33 87, at least five (5) working days before a planned procedure or on the first working day after an emergency hospital admission to obtain an authorisation number for your treatment.

Authorisation requests for major surgery should be submitted at least thirty (30) days in advance to allow the Scheme to obtain a second opinion to ensure that you or your dependant receive appropriate treatment.

It is important to note that pre-authorisation is compulsory for hospitalisation and failure to comply could result in a commensurate penalty.

WHY IS PRE-AUTHORISATION NECESSARY?

Pre-authorisation for hospital admissions and certain out-of-hospital care is a key component in managing your access to affordable, appropriate, safe and quality health care. Medscheme’s pre-authorisation requests are adjudicated against clinical and funding guidelines as well as set criteria in recognising healthcare providers who are able to perform certain procedures. Once you are pre-approved, the healthcare provider and hospital account will then be paid according to your selected benefit option and available benefits.

QUICK GUIDE: INFORMATION ON ACCESSING YOUR BENEFITS EFFICIENTLY



WHEN DO YOU NEED TO CONTACT US FOR PRE-AUTHORISATION?

• Any procedure or treatment that clinically requires admission to hospital.• Specialised radiology in- and out-of-hospital (MRI and CT Scans).• Oncology Treatment.• Renal Dialysis.• Clinically appropriate home nursing, admission to a step-down facility and rehabilitation.• Maternity admissions and confinements.

HOW DO I PRE-AUTHORISE?

Call 0860 33 33 87 (preferably 72 hours before the procedure is performed) and provide the following information: • Membership number• Beneficiary details• Patient’s date of birth• Planned date of treatment or admission to hospital• Name and practice number of the hospital/facility• Name and practice number of the doctor who is treating the patient in hospital• Relevant diagnosis and/or procedure codes• If treatment will be in or out of hospital

WHAT IF I’M DIAGNOSED WITH CANCER?

• Register with the SAMWUMED Oncology Management Programme by calling 0860 33 33 87 or send an e-mail to [email protected].

• A SAMWUMED Oncology case manager will provide support and guidance that will continue throughout your treatment.

• As soon as you and your team of doctors agree on a treatment plan, ask your doctor to forward it to the SAMWUMED Oncology Management Programme. An Oncology case manager will review the plan, discuss it with your doctor and advise on the outcome of your application.

• You will then receive an authorisation letter for the authorised treatment. If there are certain items that are not covered, you will need to discuss this with your doctor.

• Please ensure that your doctor informs the SAMWUMED Oncology Management Programme of any change in your treatment, as your authorisation will have to be re-assessed and updated accordingly to ensure that your claim(s) are not rejected or paid from the incorrect benefit.

WHAT HAPPENS IN AN EMERGENCY?

Don’t worry. In the case of an emergency situation you or a family member may pre-authorise the admission on the first working day after being admitted.

WHAT IS A PMB?

Prescribed Minimum Benefits (PMB) is a set of defined benefits that ensure you have access to certain minimum health services, regardless of the benefit option you have selected. In accordance with the Medical Scheme’s Act, medical schemes have to cover the costs related to these conditions which include:

• Any emergency medical admission• A limited set of 270 pre-defined medical conditions• Twenty-six (26) chronic medical conditions

Your doctor will guide you in determining whether your condition falls into one of the PMB conditions. It is vital that you obtain a pre-authorisation for any PMB condition as your scheme may require you to be referred to a designated service provider so that all associated costs are in line with SAMWUMED’s Scheme Rules.

WHAT IS CASE MANAGEMENT AND CARE CO-ORDINATION?

While you are in hospital, our case managers will ensure that the appropriate length of stay and level of care is provided at all times and that appropriate discharge planning takes place.

Medscheme also focuses on care co-ordination to improve the quality of care that you receive while in hospital, and to improve your health status after you are discharged. The benefit of this is that, with your consent, we will share information about your condition, well-being and health within the different managed health care departments as well as with your nominated doctor.

Co-ordinating your care is done through various interventions from pre-admission to eight weeks after you are discharged so that you receive the best health care; reduce your chances of re-admission and encourage you to take responsibility for your own health.

Through care co-ordination you will receive a pre-admission hospital checklist (depending on your type of admission) that will assist you in preparing for hospitalisation and post discharge recovery. You will also be referred to various managed care services and appropriate healthcare providers as and when required.

ACCESS AND CARE

• SAMWUMED has removed State as a Designated Service Provider (DSP) for the treatment of Prescribed Minimum Benefit (PMB) conditions in hospital to ensure our member get value for their money.

• The Scheme still has negotiated favourable rates with various private hospital groups clas-sifying these as Preferred Providers (PPs). This excludes services rendered by attending specialists at these PPs. While the Scheme has secured agreements with certain providers, members might still be faced with possible out-of-pocket expenses based on tariffs above the Scheme’s rate. However negotiations with these networks will continue throughout the year for the benefit of our members.

• SAMWUMED pays for all healthcare services according to the Scheme Tariff, except in cases where involuntary utilisation of a non-DSP took place*.

• In cases of an emergency, you can access the hospital nearest to you if you are not within rea-sonable travelling distance from one of the Scheme’s Designated Service Providers (Melomed or Mediclinic) or a Preferred Provider (PP).

• Depending on where you are in the country, you can access hospital care kindly contact the Managed Care call centre for available facilities.



CHECKING AVAILABLE BENEFITS

You can check your available benefits by logging onto the Scheme’s website at www.samwumed.org

OBTAINING PRE-AUTHORISATION FROM THE CALL CENTRE

The Call Centre can assist you with the pre-authorisation for procedures and tests done in doctors’ or any other equipped procedure rooms, advanced dentistry such as orthodontics, crown and bridgework and appliances, for example: wheelchairs, walking frames or neck braces related to hospital admissions.

BENEFITS THAT REQUIRE MOTIVATION AND/OR REFERRAL LETTERS

• Clinical motivation and cost estimates will be requested from your treating doctor or specialist before appliances are approved. Approved appliances would be subject to Scheme’s list.

• Clinical motivation is required for all advanced dentistry procedures.• To access the mental health or substance dependency benefit, clinical motivation will be

required after the first two visits for continued sessions.• Physiotherapy – clinical motivation required after two visits.• Prostheses – clinical motivation and costing.• Specialised radiology and radiography.

WHAT IS COVERED UNDER THE MEDICATION BENEFIT?

The medication benefit provides cover for acute/ prescribed; over-the-counter and chronic medication and the Primary Healthcare Programme. Chronic medication cover includes the diagnosis, medical management and medication of conditions on the Chronic Disease List (CDL) as provided under PMB legislation. The Scheme has contracted a medicine risk management department to provide a service to members and their registered dependants who need treatment for their chronic conditions which include the following:

• Making sure that your chronic benefits are allocated accordingly.• Access to expert advisors who will assess medication/ treatment.• Useful advice and information regarding various chronic conditions.

HOW TO REGISTER AND OBTAIN MEDICATION FOR A CHRONIC CONDITION:

A chronic condition is a persistent or otherwise long-lasting illness that may be longer than three months or lifelong. SAMWUMED will cover for the diagnosis, treatment and care of 26 chronic conditions (PMBs), and five (5) and three (3) additional chronic (Non-PMB) conditions on Option A and Option B respectively such as:

• Option A: Depression, Gout, Gastro-oesophageal reflux disease (GORD)• Option B: Depression, Eczema, Gout, Gastro-oesophageal reflux disease (GORD) and

Menopause

SAMWUMED works with Medscheme to give members the best advice on the use of their chronic medication, as well as to ensure that their chronic benefits are correctly allocated.

YOUR TREATING DOCTOR WILL NEED TO CALL OUR MANAGED CARE PROVIDER, MEDSCHEME ON 0860 33 33 87 TO REGISTER YOUR CHRONIC MEDICATION.


YOUR TREATING DOCTOR WILL NEED TO FAX THE HIV APPLICATION FORM TO OUR HIV MANAGED CARE PROVIDER, AID FOR AIDS ON 0800 600 773 OR CALL 0800 227 700 TO REGISTER YOU ON THE HIV MANAGEMENT PROGRAMME.

MANAGEMENT PROGRAMME

HIVHIV is a chronic condition where treatment is available and must be taken for life. SAMWUMED will cover the treatment, pathology monitoring and doctor consultations in order to keep all HIV positive beneficiaries healthy.

SAMWUMED works with Aid for AIDS to give members the best advice on how to manage their HIV status and the use of their HIV medication, blood monitoring tests and other associated medication.

HOW AND WHEN TO USE THE SAMWUMED PRIMARY HEALTHCAREPROGRAMME BENEFIT

• You can only access the benefit after your acute, prescribed/ dispensed; and over-the-counter (PAT) medicine benefit has been depleted.

• The Scheme’s Pharmacy Benefit Partner with a wide range of pharmacy networks across the country.

• Ask your pharmacist for the specific list of medicines that have been allocated to the condition that you need care for and remind them to include the correct ICD-10 code on the account.

• If you are unsure about your medicine benefits, please contact the SAMWUMED Call Centre for advice 0860 104 117.

This benefit provides you with a safety net by granting access to essential medicine benefits to treat ten common ailments every family can experience including but not limited to:

1. Stomach pain, heartburn, indigestion (including reflux)2. Headache3. Acute gastroenteritis: vomiting and diarrhoea4. Bacterial conjunctivitis: eye infection5. Upper and lower respiratory tract infections6. Urinary tract infection (acute uncomplicated cystitis)7. Oral and topical candidiasis: thrush/fungal or yeast infections8. Urticarial: skin rashes, usually due to an allergic reaction; insect bites and

stings9. Helminthic infestation: tapeworm10. Wound care and infections of the skin/subcutaneous tissue (excluding

post-operative care.)


It is important to note that there are sub-limits for each incident and that a specific list of suitable and cost efficient medicines has been prepared by the Scheme so that you can obtain these from your pharmacist without paying extra. The details and guidelines for this benefit category is outlined in the benefit tables on pages 9 - 13 (Option A) and 17 - 21 (Option B).

HOW TO REPLACE LOST MEMBERSHIP CARDS

Your SAMWUMED membership card is one of the most important items in your wallet because it ensures that you have access to the relevant healthcare services, therefore always take care to keep it in a safe place.

Please contact the Premiums Department on 021 697 9000 to request your newly branded membership card, should your card be lost or stolen.

SUBMISSION AND PAYMENT OF ACCOUNTS

• SAMWUMED will only accept original accounts and receipts for adjudication.

• The Scheme will not accept photocopied or faxed information, although we do advise that members keep copies for their own records. Providers may submit claims electronically via a process known as Electronic Data Interface (EDI) or via the post.

• It is your responsibility to confirm if your service provider is submitting claims on your behalf (via post or EDI) or if you should submit the account directly to the Scheme. It is common practice for many service providers to request that members settle their accounts in cash and then claim back from the Scheme.

• In instances where you have paid cash, submit the original account and receipt with your member number as reference to the Scheme for reimbursement. Members must be sure that every account they or their provider submits for payment includes the ICD-10 codes for the treatment or products provided. These codes are required by the Scheme to allocate and process payments according to the correct benefit categories.

HOW OUR CLAIMS PROCESSING WORKS

Members have four (4) months to submit claims for adjudication and processing Claims older than four months will be rejected as Stale Claims. Once a claim has been processed, you will receive a statement that details the payments that were made to service providers. It will also indicate your remaining benefits. Statements are sent via post or email. Receiving your statement electronically is safe and convenient. Please provide the Scheme with your updated email address. Please make sure that all claims indicated are accurate and that your bank details are correct.

STEP 1Service Provider submits account to Switchhouse

Should you have any queries regarding claims, please contact our Benefits Management Department by dialling 0860 104 117.

STEP 2Switchhouse submits to Scheme

STEP 3Account processed via system

STEP 4If approved, claim awaits payment during claims run

STEP 5Account paid

STEP 6Claims Statement sent to member



It is important to choose the right medical scheme not only based on price but by doing research to ensure that the scheme meets your needs and those of your family.

It is also best to change your benefit option at the beginning of the year, if needed, in order to get full benefits.

ADVICE ON CHOOSING A MEDICAL SCHEME OR BENEFIT OPTION

Ensure that the scheme you are considering is duly registered in terms of the Medical Schemes Act 131 of 1998. The names, addresses and telephone numbers of all registered schemes are published on the website of the Council for Medical Schemes at www.medicalschemes.com.

Identify a few schemes and request information about their benefits, contributions, limitations and exclusions. Compare this information provided to see which one meets your needs.

Besides the healthcare benefits also find out what the schemes’ reserves (solvency ratio) are, and non-healthcare expenditure, such as administration costs, to ensure they are in good financial health.

Understand what prescribed minimum benefits (PMBs) are and under what circumstances the chosen scheme provides such cover for you. Here you can look at designated service providers and their proximity to you as well as other networks that provide benefits to members.

HOW TO CHOOSE YOUR MEDICAL SCHEME FOR 2019

ADVICE FOR CURRENT MEDICAL SCHEME MEMBERS

If you are already a member of a scheme, read all the material such as options to change plans. Ensure that you understand how the benefit options operate and select according to your healthcare needs and what you can afford. The registered rules of medical schemes fully disclose detailed information regarding the relevant benefits and contributions. It is essential that you obtain the rules of the scheme or a summary thereof to verify all relevant information to enable you to make an informed choice.

Some people choose to make use of an agent or broker (intermediary). Remember it is not compul-sory to use a broker, but if you do ensure that he/she has been accredited by the CMS and that your selection of a scheme is based on informed consent.


WHAT IS A MEDICAL SCHEME?Medical Schemes are not for profit organisations.

“[The] ‘business of a medical scheme’ means the business of undertaking liability in return for a premium or contribution:

a) to make provision for the obtaining of any relevant health service;b) to grant assistance in defraying expenditure incurred in connection with the rendering of

any relevant health service; andc) where applicable, to render a relevant health service, either by the medical scheme itself,

or by any supplier or group of suppliers of a relevant health service or by any person, in association with or in terms of an agreement with a medical scheme.”

BUT WHAT DOES THIS MEAN?

Point (a) in the definition means that medical schemes must provide healthcare benefits, including a prescribed package of minimum benefits for healthcare needs. The uncertainty attached to your health poses a number of risks for your medical scheme; the most obvious risk to you is the loss of health itself. This is why medical scheme members buy benefit packages based on their need for healthcare – and why medical schemes are structured in a way that makes them financially sustainable in the long run.

Point (b) in the definition means that monetary contributions are paid in exchange for healthcare benefits. Members of medical schemes have the obligation to pay a relevant contribution which entitles them to access a defined benefits package. Members are encouraged to read up on their rights and responsibilities when accessing benefits, specifically the prescribed minimum benefits or PMBs.

Point (c) in the definition means that medical schemes are allowed to contract with service providers for the provision of comprehensive benefits, including out-of-hospital benefits and PMBs.

HOW THE ACT PROTECTS MEMBERS OF MEDICAL SCHEMES

The definition of the business of a medical scheme, as in the Medical Schemes Act 131 of 1998, was always meant to guide medical schemes on the type of services required to be provided to members in order to operate as a registered medical scheme.

WHAT ARE ADMINISTRATORS?

Medical scheme administrators are privately owned companies with the skills, infrastructure, and capacity to render a full range of administration services to schemes in compliance with prevailing legislation. They are accredited by the Council for Medical Schemes (CMS) in terms of the Medical Schemes Act if they meet the certain criteria. Most medical schemes outsource many of their functions to administrators.

WHAT DO ADMINISTRATORS DO EXACTLY?

Administrators perform a variety of administration functions as per their written contracts and service level agreements with schemes. They utilise comprehensive and integrated information technology systems capable of performing all administration, financial, and management functions.

WHAT IS AN ADMINISTRATOR?


MEDICAL SCHEMES VS MEDICAL INSURANCE?Medical schemes are not for profit organisations which operate like trust funds.

Short and long-term insurers providing health insurance products are commercially driven for-profit companies. Medical schemes belong to their members, while health insurance companies are owned by shareholders.

Medical schemes espouse unique principles which can only be found in the Medical Schemes Act. These principles are (i) open enrolment, (ii) community rating, and (iii) a set of prescribed minimum benefits, commonly called PMBs.

Open enrolment means that anyone can join a medical scheme and that if you apply for membership, the scheme of your choice cannot turn you away.

Community rating means that all members of a medical scheme pay the same monthly contribution for the same benefits. PMBs ensure that members are fully protected against unforeseen and potentially catastrophic health events.

These principles do not apply to health insurance products.

Anyone can buy a short- or long-term health insurance policy, but the premium you pay will usually depend on the insurer’s assessment of your state of health. Older individuals, or individuals with pre-existing health conditions, will pay more for health insurance cover. At the extreme, health insurance companies may refuse to cover you if they consider that there is too high a risk that you are likely to claim.

Medical scheme administrators maintain member records. Their systems can drill down to detailed information on an individual member. It is the administrator who processes your application for membership and also suspends and terminates it. Administrators collect the monthly member contributions and manage their allocation and reconciling. They ensure that outstanding amounts are collected.

SELF-ADMINISTERED MEDICAL SCHEMES

Some medical schemes do not use administrators. A self-administered scheme undertakes all administration functions with its own resources decisions. Self-administered schemes do not need to be accredited, but they must comply with the same administration standards and are subject to the same on-site evaluation of compliance as third-party administrators.


WHAT SHOULD YOU ASK YOUR DOCTOR OR SERVICE PROVIDER BEFORE TREATMENT? • Is this a Prescribed Minimum Benefit?• Is this my medical scheme’s Designated Service Provider?• Do I need authorisation from my medical scheme?• Do you charge at my medical scheme’s tariff?• DURING: Is there a co-payment or levy?• AFTER: Is this medication on my medical scheme’s formulary list?

Prescribed Minimum Benefits (PMBs) are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide people with continuous care to improve their health and well-being and to make healthcare more affordable.

PMBs are a feature of the Medical Schemes Act, in terms of which medical schemes have to cover the costs related to the diagnosis, treatment and care of:

• any emergency medical condition;• a limited set of 270 medical conditions; and• 26 chronic conditions defined in the Chronic Diseases List (CDL).

Medical schemes must pay in full, without a co-payment or the use of deductibles, for the diagnosis, treatment and care costs of the Prescribed Minimum Benefit conditions. The medical scheme cannot use your medical savings account to pay for Prescribed Minimum Benefits.

Each option offered by a medical scheme must make provision for the Prescribed Minimum Benefits, including hospital plan options.

State healthcare facilities can be DSPs too but before they can be listed as such in the rules of your medical scheme, your scheme must make sure that you and its other beneficiaries can reach these facilities with reasonable ease and that the required treatment, medication, and care are both available and accessible.

A designated service provider or DSP is a healthcare provider (doctor, pharmacist, hospital etc.) who is appointed by your medical scheme to treat or care for prescribed minimum benefit (PMB) conditions of their members.


WHAT IS INVOLUNTARY USE OF A NON-DSP?

If circumstances force you to obtain a service from a non-DSP (i.e. involuntarily), and it’s a PMB condition, your scheme must pay for the costs of your treatment, diagnosis, and care in full. These are the reasons why you may need to obtain treatment from a non-DSP involuntarily:

• the required service or treatment is not readily available from your scheme’s DSP or it will be provided with unreasonable delay;

• an emergency occurs under circumstances or at a location that prevents you from obtaining PMB treatment from a DSP; or

• there is no DSP within reasonable proximity to your ordinary place of business or personal residence

HOW DOES TREATMENT AT DSPs WORK?

Your scheme can insist that you go to a DSP as soon as your PMB condition is diagnosed, in which case they cover the costs from the start. When your condition is identified as a PMB after diagnosis, your scheme must pay for the tests and treatment in full retrospectively. Treatment for a PMB condition at a DSP is covered in full by the medical scheme.

A co-payment is the amount of money or portion of the account that your scheme may request you to fund from your own pocket. This could be either a percentage of the fee or the difference between the tariff of your scheme’s chosen DSP and the amount charged by the provider (non-DSP) you went to. The co-payment amount must be specified in the scheme rules.

A medicine formulary is a list of medications that the scheme is willing to fund for the treatment of PMB conditions. Feel free to ask your scheme for the formulary list for your specific benefit option and discuss the available medicines with your doctor.

If you choose to use medicine not listed on the formulary, the scheme is allowed to charge you a co-payment. But there are specific circumstances where schemes cannot enforce a co-payment and must make provision for appropriate exceptions or substitutions, including where the formulary medicine has proven ineffective or would cause you harm or an adverse reaction.

The Regulations to the Medical Schemes Act provide for specific principles that medical schemes may use to manage the financial risk associated with PMBs.

These principles include designated service providers, managed care protocols and formularies.

THE COMPLAINTS PROCESSWHO CAN COMPLAIN TO THE REGISTRAR’S OFFICE?

• Any beneficiary or any person who is aggrieved with the conduct of a medical scheme can submit a complaint.

• It is however very important to note that a prospective complainant should always first seek to resolve complaints through the complaints mechanisms in place at the respective medical scheme before approaching the Council for assistance.

• You can contact your scheme by phone or writing to the Principal Officer of the scheme, giving her/him full details of your complaint.

• If you are not satisfied with the response from your Principal Officer, you can ask the matter to be referred to the Disputes Committee of your scheme.

• If you are not satisfied with the decision of the Disputes Committee, you can appeal against the decision within 3 months of the date of the decision to the Council. The appeal should be in the form of an affidavit directed to the Council.

• Complaints can be submitted by any reasonable means such as a letter, fax, e-mail or in person at our Offices from Mondays to Fridays during 08:00 – 17:00. The complaint form is available on www.medicalschemes.com.

Your complaints should be in writing, detailing the following:

Full names, membership number, benefit option, contact details and full details of the complaint with any documents or information that substantiates the complaint.

The Council for Medical Scheme’s Complaints Adjudication Unit also provides telephonic advice and personal consultations, when necessary.

WHO CAN YOU COMPLAIN ABOUT?

The Council for Medical Schemes governs the medical schemes industry and therefore your complaint should be related to your medical scheme.

If your complaint is related to any other aspect of the health industry, please visit the relevant websites:

• For complaints against Health Professionals (doctors) and allied health professional such as physiotherapists, occupational therapists etc. – www.hpcsa.co.za or call 012 338 9300

• For complaints against Private Hospitals – www.hasa.co.za or call 011 784 6828• For complaints against Nurses – www.sanc.co.za or call 012 420 1000• For complaints against Brokers – www.faisombud.co.za or call 012 762 5000• For complaints in respect of other health insurance products – www.osti.co.za (short term

insurance ombudsman) or call 012 762 5000 or www.ombud.co.za (long term insurance ombudsman) or call 021 657 5000

TIME LIMITS FOR DEALING WITH COMPLAINTS

• Our aim is to provide a transparent, equitable, accessible, expeditious as well as a reasonable and procedurally fair dispute resolution process.

• The Registrar’s Office will send a written acknowledgement of a complaint within 3 working days of its receipt, providing the name, reference number and contact details of the person who will be dealing with a complaint.

• In terms of Section 47 of the Medical Schemes Act 131 of 1998 a written complaint received in relation to any matter provided for in this Act will be referred to the medical scheme. The medical scheme is obliged to provide a written response to the Registrar’s Office within 30 days.



• The Registrar’s Office shall within 4 days of receiving the complaint from the administrator, analyse the complaint and refer a complaint to a medical scheme for comments.

• Upon receipt of the response from the medical scheme, the Registrar’s Office will analyse the response in order to make a decision or ruling. Decisions/rulings will be made within 120 working days of the date of referral of a complaint and communicated to the parties.

THE REGISTRAR’S RULING AND APPEAL TO COUNCIL

Section 48 of the Act makes provision for any party who is aggrieved with the decision of the Registrar to appeal such a decision.

This appeal is at no cost to either of the parties.

An appeal must be submitted within three months and should be in the form of an affidavit directed to the Council. The operation of the decision shall be suspended pending review of the matter by the Council’s Appeals Committee.

The secretariat of the Appeals Committee will inform all parties involved of the date and time of the hearing. This notice should be provided no less than 14 days before the date of the hearing.

The parties may appear before the Committee and tender evidence or submit written arguments or explanations in person or through a representative. The Appeals Committee may after the hearing confirm or vary the decision concerned or rescind it and give another decision they deem to be just.

THE SECTION 50 APPEAL’S PROCESS

Any party that is aggrieved with the decision of the Appeals Committee may appeal to the Appeal Board. The aggrieved party has 60 days within which to appeal the decision and must submit written arguments or explanation of the grounds of his or her appeal.

The Appeal Board shall determine the date, time and venue for the hearing and all parties will be notified in writing.

The Appeal Board shall be heard in public unless the chairperson decides otherwise.

The Appeal Board shall have the powers which the High Court has to summon witnesses, to cause an oath or affirmation to be administered by them, to examine them, and to call for the production of books, documents and objects.

The decisions of the Appeal Board are in writing and a copy thereof shall be furnished to parties. The prescribed fee of R2000.00 is payable for Section 50 Appeals.

How to avoid complaints

• Make sure you have read and understood your scheme rules.• Study your benefit guide and familiarise yourself with the benefit option you have chosen.• Read all correspondence from your scheme, e.g. newsletters and statements.• Make sure your contributions are paid in full and on time each month.• Remember: Avoid complaints by informing yourself!

The Council for Medical Schemes (CMS) protects and informs the public about their medical scheme rights and obligations, ensuring that complaints raised are handled appropriately and speedily.

HOSPITAL NETWORKS

EASTERN CAPE

FREE STATEHospital Group

Hospital Town/City

Life Pasteur Hospital- dedicated to acute rehab

Bloemfontein

Life Rosepark Clinic Bloemfontein

Mediclinic Mediclinic Bloemfontein Bloemfontein

Mediclinic Mediclinic Hoogland Bloemfontein

NHN Horizon Eye Care Centre (Bloemfontein Eye Centre)

Bloemfontein

NHN Jane Keyser Clinic Bloemfontein

NHN Riemland Clinic Bloemfontein

NHN St Helena Hospital Welkom

Netcare Netcare Kroon Hospital Bloemfontein

Netcare Netcare St Augustine's Hospital

Bloemfontein

Netcare Netcare Vaalpark Hospital Bloemfontein

Netcare Pelonomi Hospital Bloemfontein

Netcare Universitas Hospital Bloemfontein

Hospital Group Hospital Town/City

Life Beacon Bay Hospital Beacon Bay North

Life East London Private Hospital East London

Life Isivivana Private Hospital Port Elizabeth

Life Mercantile Hospital Port Elizabeth

Life Queenstown Private Hospital Queenstown

Life St Dominic's Hospital East London

Life St George's Hospital Port Elizabeth

Life St James Hospital East London

Life St Mary's Private Hospital Mthatha

NHN Crossmed Mthatha Private Hospital Mthatha

NHN East London Eye Hospital East London

Netcare Netcare Cuyler Hospital Port Elizabeth

Netcare Netcare Greenacres Hospital Port Elizabeth

Netcare Port Alfred Hospital Port Alfred

Netcare Settlers Private Hospital Eastern Cape

GAUTENGHospital Group Hospital Town/City

Life Bedford Gardens Hospital Johannesburg

Life Brenthurst Clinic Johannesburg

Life Carstenhof Clinic Johannesburg

Life Dalview Clinic Johannesburg

Life Eugene Marais Hospital Pretoria

Life Faerie Glen Hospital Pretoria

Life Genesis Clinic Johannesburg

Life Groenkloof (Old name: Little Company of Mary Pretoria

Life Riverfield Lodge Johannesburg

Life Robinson Private Hospital Johannesburg

Life Roseacres Clinic Johannesburg

Life Springs Parkland Clinic Johannesburg

Life Suikerbosrand Clinic Johannesburg

Life The Glynnwood Johannesburg

Life Wilgeheuwel Hospital Johannesburg

Mediclinic Mediclinic Gynaecological Pretoria

Mediclinic Mediclinic Heart Hospital Pretoria

Mediclinic Mediclinic Medforum Pretoria

Mediclinic Mediclinic Morningside Johannesburg

Mediclinic Mediclinic Muelmed Pretoria

Mediclinic Mediclinic Sandton Johannesburg

Mediclinic Mediclinic Vereeniging Johannesburg

Mediclinic Mediclinic Wits Donald Gordon Johannesburg

NHN Fochville Hospital Johannesburg

NHN Lenmed Daxina Medical Clinic Johannesburg

NHN Lenmed Health Ahmed Kathrada Private Hospital Johannesburg

NHN Lenmed Randfontein Private Hospital Johannesburg

NHN Lenmed Zamokuhle Private Hospital Johannesburg

NHN Louis Pasteur Private Hospital Pretoria

NHN Medfem Clinic Sandton

NHN Midvaal Private Hospital Johannesburg

NHN Optimed Eye and Laser Clinic Pretoria

NHN Pretoria Eye Institute Pretoria

NHN Sunshine Hospital Johannesburg

NHNThe Fountain Private Hospital aka Leslie Williams Private Hospital

Johannesburg


Disclaimer: The Hospital Networks are subject change. The changes may occur as a result of the ongoing network review process during the year.

GAUTENG (CONTINUED)


NHN Urolocare Hospital Pretoria

NHN Zuid-Afrikaans Hospitaal Pretoria

Netcare Lakeview Hospital Johannesburg

Netcare Netcare Akasia Hospital Pretoria

Netcare Netcare Bell Street Hospital Krugersdorp

Netcare Netcare Bougainville Private Hospital Pretoria

Netcare Netcare Clinton Hospital Johannesburg

Netcare Netcare Femina Hospital Pretoria

Netcare Netcare Garden City Hospital Johannesburg

Netcare Netcare Jakaranda Hospital Pretoria

Netcare Netcare Krugersdorp Hospital Johannesburg

Netcare Netcare Linksfield Hospital Johannesburg

Netcare Netcare Linkwood Hospital Johannesburg

Netcare Netcare Linmed Hospital Johannesburg

Netcare Netcare Milpark Hospital Johannesburg

Netcare Netcare Montana Hospital Pretoria

Netcare Netcare Moot Algemene Hospitaal Pretoria

Netcare Netcare Mulbarton Hospital Johannesburg

Netcare Netcare N17 Hospital Johannesburg

Netcare Netcare Olivedale Hospital Johannesburg

Netcare Netcare Optiklin Eye Hospital Johannesburg

Netcare Netcare Park Lane Clinic Johannesburg

Netcare Netcare Pinehaven Hospital Johannesburg

Netcare Netcare Pretoria East Hospital Pretoria

Netcare Netcare Rand Hospital Johannesburg

Netcare Netcare Rehabilitation Hospital Johannesburg

Netcare Netcare Rosebank Hospital Johannesburg

Netcare Netcare Sunninghill Hospital Johannesburg

Netcare Netcare Sunward Park Hospital Johannesburg

Netcare Netcare Union Hospital Johannesburg

Netcare Netcare Unitas Hospital Johannesburg

Netcare Netcare Waterfall City Hospital Johannesburg

KWA-ZULU NATAL (Note: Melomed Richards Bay is an exclusive Scheme DSP)


Life Chatsmed Garden Hospital Durban

Life Empangeni Garden Clinic Durban

LifeEntabeni Hospital- acute in-corporating Life St Josephs psychiatric unit

Durban

Life Life Hilton Private Hospital Pietermaritz-burg

Life Mount Edgecombe Hospital Phoenix

Life New Kensington Clin-ic-Rehab Durban

Life The Crompton Hospital Durban

Life Westville Hospital Durban

Mediclinic Mediclinic Newscastle Durban

Mediclinic Mediclinic Pietermaritzburg Pietermaritz-burg

Mediclinic Mediclinic Potschefstroom Durban

Mediclinic Mediclinic Victoria Durban

NHN Daymed Private Hospital Pietermaritz-burg

NHN Ethekwini Hospital and Heart Centre Durban

NHN Gateway Private Hospital Durban

NHN Hibiscus Private Hospital Port Shep-stone

NHN Hillcrest Private Hospital Durban

NHN Lenmed La Verna Durban

NHN Lenmed Shifa Hospital Durban

NHN Matatiele Private Hospital Durban

NHN Mooimed Hospital Potschef-stroom

NHN Nongoma Private Hospital Durban

Netcare Kokstad Hospital Durban

Netcare Netcare Alberlito Hospital Durban

Netcare Netcare Kingsway Hospital Durban

Netcare Netcare Margate Hospital Durban

Netcare Netcare Parklands Hospital Durban

Netcare Netcare St Anne's Hospital Pietermaritz-burg

Melomed Melomed Richards Bay

Netcare Netcare Umhlanga Hospital Umhlanga


LIMPOPO

Hospital Group

Hospital Town/City

Mediclinic Mediclinic Emfuleni Polokwane

Mediclinic Mediclinic Lephalale Polokwane

Mediclinic Mediclinic Limpopo Limpopo

Mediclinic Mediclinic Thabazimbi Limpopo

NHN Quality Care Private Hospital

Polokwane

NHN St Vincent's Hospital Polokwane

Netcare Netcare Pholoso Hospital Polokwane

MPUMALANGA

Hospital Group

Hospital Town/City

Life Comso Hospital Mpumalanga

Life a Midmed Hospital Middelburg

Life Piet Retief Hospital Nelspruit

Mediclinic Mediclinic Barberton Nelspruit

Mediclinic Mediclinic Ermelo Nelspruit

Mediclinic Mediclinic Highveld Nelspruit

Mediclinic Mediclinic Nelspruit Nelspruit

Mediclinic Mediclinic Secunda Nelspruit

Mediclinic Mediclinic Welkom Nelspruit

NHN Emalahleni Private Hospital (Pty) Ltd

Nelspruit

NHN Kiaat Private Hospital Nelspruit

NHN Lowveld Hospital Nelspruit

NHN Nelspruit Surgiclinic Hospital Nelspruit

NHN Zoutpansberg Private Hospital

Nelspruit

NORTH WEST


Life Anncron Clinic Klerksdorp

Life La Femme Clinic Rustenburg

Life Peglerae Hospital Rustenburg

Mediclinic Mediclinic Brits Brits

Mediclinic Mediclinic Legae Mabopane

NHN Rustenburg Medicare Rustenburg

NHN Sunningdale Hospital Klerksdorp

NHN Vryburg Private Hospital Vryburg

Netcare Netcare Ferncrest Hospital Rustenburg

NORTHERN CAPE


Mediclinic Mediclinic Kimberley (Gariep) Kimberley

Mediclinic Mediclinic Upington Upington

NHN Lenmed Kathu Northern Cape

NHN Royal Hospital and Heart Centre Kimberley

NHN Wilmed Park Private Hospital Klerksdorp

WESTERN CAPE (*Note: The Scheme has a DSP arrangement with the Mediclinic and Melomed group of hospitals in Cape Town and surroundings, up to a 40 km radius)

Hospital Group

Hospital Town/City

Life Bayview Private Hospital MosselBay

Life Knysna Private Hospital Knysna

Mediclinic Mediclinic Geneva George

Mediclinic Mediclinic George George

Mediclinic Mediclinic Klein Karoo Oudtshoorn

NHN Melomed Bellville Medical Centre

Cape Town

NHN Melomed Gatesville Medical Centre

Cape Town

NHN Melomed Mitchells Plain Medical Centre

Cape Town

NHN Melomed Tokai Cape Town

PHARMACY NETWORKS

EASTERN CAPE

Insititution Name Town/City

Clicks Pharmacy - Vincent Park East London

Clicks Pharmacy - Walker Drive Port Elizabeth

Clicks Pharmacy - Greenacres Port Elizabeth

John Forbes Pharmacy East London

Klinicare Lorraine Pharmacy Port Elizabeth

Klinicare Bluewater Bay Pharmacy Port Elizabeth

Clicks Pharmacy - Walmer Park Port Elizabeth

Clicks Pharmacy - Grahamstown Grahamstown

Clicks Pharmacy - Sunridge Village Port Elizabeth


Disclaimer: The Pharmacy Networks are subject change. The changes may occur as a result of the ongoing network review process during the year. Please refer to our website for an updated list of pharmacies.

EASTERN CAPE (CONTINUED)


Clicks Pharmacy - King William's Town King William`s Town

Clicks Pharmacy - Cleary Park Ibhayi

Greenways Family Pharmacy Port Elizabeth

Clicks Pharmacy - Beacon Bay East London

Medi-Rite Pharmacy - Port Elizabeth Port Elizabeth

P Ochse Pharmacy Cradock

Medi-Rite Pharmacy - Bethelsdorp Ibhayi

Vincent Family Pharmacy East London

Amathole Valley Pharmacy King William`s Town

Medi-Rite Pharmacy - Uitenhage Uitenhage

Clicks Pharmacy - Uitenhage Uitenhage

Amayeza Ethu Pharmacy Mdantsane

Medi-Rite Pharmacy - Moffat On Main Port Elizabeth

Clicks Pharmacy - Graaff Reinet Graaff-Reinet

Netcare Port Alfred Private Hospital Pharmacy Port Alfred

Clicks Pharmacy - Fountains Mall Jeffreys Bay

Clicks Pharmacy - Port Alfred Port Alfred

Baymed Pharmacy Jeffreys Bay

Clicks Pharmacy - Kabega Park Port Elizabeth

Policlinic Pharmacy - Jeffrey's Bay Jeffreys Bay

Clicks Pharmacy - Gonubie East London

Medi-Rite Pharmacy - Amalinda East London

Medi-Rite Pharmacy - King Williams Town King William`s Town

Netcare Settler's Pharmacy Grahamstown

Dis-Chem Hemingways Mall Pharmacy East London

Clicks Pharmacy - Hemmingways East London

Clicks Pharmacy - 6th Avenue Walmer Port Elizabeth

Klinicare Belmore Pharmacy Port Elizabeth

Protea Pharmacy - Sidwell Port Elizabeth

Provincial Westbourne Pharmacy Port Elizabeth

Clicks Pharmacy - Mthatha Plaza Mthatha

Medi-Rite Pharmacy - Kwanobuhle Kwa Nobuhle

Clicks Pharmacy - Penford Uitenhage

Dis-Chem Cape Road Pharmacy Port Elizabeth

Dis-Chem Walmer Park Pharmacy Port Elizabeth

Mbizana Pharmacy Bizana

Ooskaap Pharmacy Humansdorp

Clicks Pharmacy - Oxford Street East London


Klinicare Despatch Pharmacy Despatch

Medi-Rite Pharmacy - Vincent East London

Clicks Pharmacy - Moffet Retail Park Port Elizabeth

Klinicare Blooms Pharmacy Port Elizabeth

Klinicare Gelvandale Pharmacy (N N Pharmaceutical Pty Ltd) Port Elizabeth

Clicks Pharmacy - Humewood Port Elizabeth

Dis-Chem Jeffreys Bay Pharmacy Jeffreys Bay

Medi-Rite Pharmacy - Greenacres Port Elizabeth

Medi-Rite Pharmacy - Butterworth Butterworth

Medi-Rite Pharmacy - Queenstown Queenstown

Medi-Rite Pharmacy - New Brighton Port Elizabeth

Clicks Pharmacy - Nonesi Mall Queenstown

New Brighton Pharmacy Port Elizabeth

Clicks Pharmacy - Despatch Despatch

Clicks Pharmacy - New Brighton Port Elizabeth

Klinicare Kings Court Pharmacy Port Elizabeth

Clicks Pharmacy - Pier 14 Port Elizabeth

Mpilontle Pharmacy Lady Frere

Medi-Rite Pharmacy - Mthatha Mthatha

Clicks Pharmacy - B T Ngebs Mall Mthatha

Clicks Pharmacy - Baywest Port Elizabeth

Umendo Pharmacy Sterkspruit

Clicks Pharmacy - Mthatha Mthatha

Dis-Chem Baywest Mall Pharmacy Port Elizabeth

Clicks Pharmacy - Kamma Crossing Port Elizabeth

Clicks Pharmacy - Gillwell East London

Clicks Pharmacy - Mdantsane Mdantsane

Eldre Apteek Aliwal North

Clicks Pharmacy - East London (Netcare East London Dispensary) East London

Clicks Pharmacy - Westering Port Elizabeth

Watersons Pharmacy Cradock

Berea Pharmacy East London

Bonnie Doon Pharmacy East London

Greenfields Pharmacy East London

Linton Grange Pharmacy Port Elizabeth

The Medicine Chest Port Elizabeth

Rink Street Pharmacy Port Elizabeth

Troppers Pharmacy Port Elizabeth

Klinicare Mosel Pharmacy Uitenhage




Arcade Pharmacy - Humansdorp Humansdorp

Hendricks Pharmacy King William`s Town

Clicks Pharmacy - Summerstrand Port Elizabeth

Klinipharm Pharmacy Port Elizabeth

Schuin Villa Apteek & Medisyne Depot Port Elizabeth

Korsten Pharmacy Port Elizabeth

Klinicare Pharmacy - Uitenhage Uitenhage

Netcare Greenacres Hospital Dispensary Port Elizabeth

Klinimed Pharmacy Port Elizabeth

Clicks Pharmacy - Buffelsfontein Road (Netcare Walmer Dispensary) Port Elizabeth

Clicks Pharmacy - Westering Port Elizabeth



Netcare Cuyler Pharmacy Uitenhage

Harrison's Pharmacy King William`s Town

Dorans Pharmacy Aliwal North

Klinicare Mill Park Pharmacy Port Elizabeth

Klinicare Oval Pharmacy Port Elizabeth

Mountweg Pharmacy Port Elizabeth


FREE STATE


Clicks Pharmacy - Bayswater Bloemfontein

Clicks Pharmacy - Fleurdal Bloemfontein

Clicks Pharmacy - Fichardtpark Bloemfontein

Central Park Pharmacy Bloemfontein

Clicks Pharmacy - Loch Logan Bloemfontein

Vrystaat Pharmacy Bloemfontein

Netcare Universitas Pharmacy Bloemfontein

Medi-Rite Pharmacy - Bloemfontein Bloemfontein

Bothaville Pharmacy Bothaville

Medi-Rite Pharmacy - Westdene Bloemfontein

Kroonstad Pharmacy Kroonstad

Clicks Pharmacy - Dynarc Walk Bloemfontein

Medi-Chem Westdene Pharmacy Bloemfontein

Medi-Chem Pharmacy - Universitas Bloemfontein

Medi-Chem Rosepark Pharmacy Bloemfontein

FREE STATE (CONTINUED)


Clicks Pharmacy - Bloemfontein C B D Bloemfontein

Clicks Pharmacy - Mimosa Mall Bloemfontein

Clicks Pharmacy - Welkom Welkom

Clicks Pharmacy - Bethlehem Bethlehem

Edenburg Pharmacy Edenburg

Wesselsbron Apteek Wesselsbron

Netcare Pelonomi Private Hospital Pharmacy Bloemfontein

Mangaung Pharmacy Mangaung

Dis-Chem Bloemfontein Pharmacy Bloemfontein

Clicks Pharmacy - Sasolburg Sasolburg

Medirex Pharmacy Bloemfontein

Medi-Rite Pharmacy - Welkom Welkom

Masupatsela Pharmacy Welkom

Medi-Rite Pharmacy - Heidedal Bloemfontein

Heidedal Pharmacy Bloemfontein

Medi-Rite Pharmacy - Sentraal Bloemfontein

Langenhovenpark Pharmacy Bloemfontein

Dis-Chem Loch Logan Pharmacy Bloemfontein

Clicks Pharmacy - Kroonstad (Cross Street) Kroonstad

Clicks Pharmacy - Kroonstad (Cnr Van Zyl & North Street) Kroonstad

Medi-Rite Pharmacy - Kroonstad Kroonstad

Jurg Van Der Westhuizen Pharmacy Frankfort

Clicks Pharmacy - Goldfields Mall Welkom

Clicks Pharmacy - Harrismith Harrismith

Medi-Rite Pharmacy - Goldfields Welkom

Clicks Pharmacy - Dihlabeng Bethlehem

U Pharmacy - Riebeeckstad Welkom

Clicks Pharmacy - Ficksburg Ficksburg

Redicare Pharmacy Bloemfontein

Dis-Chem Langenhovenpark Pharmacy Bloemfontein

Clicks Pharmacy - Woodland Hills Bloemfontein

Rockville Alpha Pharmacy Mangaung

Clicks Pharmacy - Boitumelo Junction Welkom

Clicks Pharmacy - Botshabelo Botshabelo

The Towers Pharmacy Bloemfontein

Lengau Alpha Pharmacy Bloemfontein

Clicks Pharmacy - Heidedal Bloemfontein

Bloemfontein Pharmacy Bloemfontein


FREE STATE (CONTINUED)


E R Meyer Pharmacy Odendaalsrus

Avenue Pharmacy Virginia

Oranje Pharmacy Virginia

Virginia Pharmacy Virginia

Harrismith Apteek En Medisyne Depot Harrismith

Flamingo Pharmacy Welkom

Senekal Pharmacy Senekal

Netcare Parys Pharmacy Parys

Riverside Pharmacy - Sasolburg Sasolburg

Medi Bloem Pharmacy Bloemfontein

Netcare Kroon Hospital Pharmacy Kroonstad

Pharmacross Pharmacy - Bloemfontein Bloemfontein

C Kroon Apteek Viljoenskroon

Spitskop Pharmacy Bloemfontein

Wilge Apteek Frankfort

Netcare Vaalpark Hospital Pharmacy Sasolburg

The Village Pharmacy Marquard

Botshabelo Pharmacy Botshabelo

GAUTENG


Netcare Mulbarton Hospital Pharmacy Johannesburg

Sunward Park Hospital Pharmacy Boksburg

Netcare Akasia Hospital Pharmacy Akasia

Pharma Valu - Queenswood Pretoria

Clicks Pharmacy - Ontdekkers Park Rood-epoort (Netcare Roodepoort Dispensary) Roodepoort

Dis-Chem Roodepoort Pharmacy Roodepoort

Clicks Pharmacy - Montana Crossing Pretoria

Doornpoort Pharmacy & Medicine Depot Pretoria

Arrie Nel Pharmacy & Medisyne Depot Pretoria

Netcare Bougainville Private Hospital Pharmacy Pretoria

Dis-Chem Centurion Pharmacy Centurion

Clicks Pharmacy - Village View Germiston

Clicks Pharmacy - Rosebank Johannesburg

Clicks Pharmacy - Menlyn Retail Park Pretoria

Clicks Pharmacy - Midrand Midrand

Dis-Chem Northgate Pharmacy Randburg

Dis-Chem Parkmeadows Pharmacy Johannesburg

GAUTENG (CONTINUED)


Clicks Pharmacy - Eastgate (Bruma) Germiston

Empilweni Pharmacy Soweto

Clicks Pharmacy - Campus Square Johannesburg

Clicks Pharmacy - Town Square Roodepoort

Clicks Pharmacy - Clearwater Mall Roodepoort

Eldoraigne Village Pharmacy Centurion

Netcare Clinton Pharmacy Alberton

Wilgers Apteek Pretoria

Dis-Chem Olympus Pharmacy Pretoria

Dis-Chem Lynnwood Road Pharmacy Pretoria

Dis-Chem Benmore Gardens Pharmacy Sandton

Dahya's Pharmacy Randburg

Clicks Pharmacy - Saxby (Netcare Saxby Pharmacy) Centurion

Netcare Olivedale Pharmacy Randburg

Clicks Pharmacy - Fourways Gardens Sandton

Duxmed Pharmacy Lenasia South

Dis-Chem Cresta Pharmacy Randburg

Ferngate Pharmacy Randburg

Pick N Pay Pharmacy - Faerie Glen Pretoria

Park Central Pharmacy Johannesburg

Rant-En-Dal Pharmacy Krugersdorp

Clicks Pharmacy - Cresta Centre Randburg

Pick N Pay Pharmacy - Bedworth Vereeniging

Dis-Chem Montana North Pharmacy Pretoria

Clicks Pharmacy - Northgate Randburg

Sacks Pharmacy Krugersdorp

Farrar Care Pharmacy Benoni

Blairgowrie Pharmacy Randburg

Medi-Rite Pharmacy - Kempton Park Kempton Park

Medi-Rite Pharmacy - Roodepoort Roodepoort

Pick N Pay Pharmacy - Boksburg Boksburg

Menlo Park Pharmacy Pretoria

Medi-Rite Pharmacy - Centurion Centurion

Medi-Rite Pharmacy - Menlyn Pretoria

Medi-Rite Pharmacy - Vanderbijlpark Vanderbijlpark

Pick N Pay Pharmacy - Norwood Johannesburg

Dis-Chem Norwood Gardens Pharmacy Johannesburg

Clicks Pharmacy - Silverwater Crossing Pretoria

Medi-Rite Pharmacy - Eastgate Germiston


GAUTENG (CONTINUED)


Medi-Rite Pharmacy - Edenvale Edenvale

Medi-Rite Pharmacy - Sandton Sandton

Dis-Chem Boksburg North Pharmacy Boksburg

Clicks Pharmacy - Featherbrook Roodepoort

Medi-Rite Pharmacy - Fourways Sandton

Clicks Pharmacy - Edenmeadow Edenvale

Clicks Pharmacy - Springs Springs

Clicks Pharmacy - Killarney Mall Johannesburg

Medi-Rite Pharmacy - Montana Pretoria

Clicks Pharmacy - Sandton City Sandton

Clicks Pharmacy - Mall@reds Centurion

Clicks Pharmacy - Festival Mall Kempton Park

Brooklyn Pharmacy Pretoria

Clicks Pharmacy - Alberton Alberton

Clicks Pharmacy - Carnival Mall Brakpan

Pick N Pay Pharmacy - Steeledale Johannesburg South

Clicks Pharmacy - Lakeside Mall Benoni

Clicks Pharmacy - Lonehill Sandton

Clicks Pharmacy - Sanridge Square Midrand

Clicks Pharmacy - Brooklyn Mall Pretoria

Medi-Rite Pharmacy - Westgate Roodepoort

Medi-Rite Pharmacy - Marks Park Vereeniging

Clicks Pharmacy - Midway Mews Midrand

Wonderpark Pharmacy Akasia

Clicks Pharmacy - Jacaranda Centre Pretoria

Olivewood Pharmacy Pretoria

Barclay Square Pharmacy Pretoria

Clicks Pharmacy - Trade Route Mall Lenasia South

Dis-Chem Carlswald (Midrand) Pharmacy Midrand

Dis-Chem Greenstone Mall Pharmacy Lethabong

Dis-Chem Strubens Valley Pharmacy Roodepoort

Clicks Pharmacy - Wonderpark Akasia

Medi-Rite Pharmacy - Ontdekkers Roodepoort

Gallo Manor Pharmacy Sandton

Dis-Chem Vaal Mall Pharmacy Vanderbijlpark

Clicks Pharmacy - Eco Boulevard Centurion

Medi-Rite Pharmacy - Balfour Park Johannesburg

Clicks Pharmacy - Silverlakes Pretoria

Clicks Pharmacy - Riverside Boulevard Vanderbijlpark

GAUTENG (CONTINUED)


Clicks Pharmacy - Vaal Mall Vanderbijlpark

Clicks Pharmacy - Lambton Germiston

Clicks Pharmacy - Jabulani Mall Soweto

Medi-Rite Pharmacy - Mayville Pretoria

Medi-Rite Pharmacy - Parklands Boksburg

Clicks Pharmacy - Menlyn Pretoria

Clicks Pharmacy - Columbine Square Johannesburg South

Pick N Pay Pharmacy - Centurion Centurion

Pick N Pay Pharmacy - Montana Pretoria

Joburg City Pharmacy Johannesburg

Clicks Pharmacy - Southdowns Centurion

Clicks Pharmacy - Bellairs Randburg

Clicks Pharmacy - East Rand Mall Boksburg

Clicks Pharmacy - Greenstone Mall Lethabong

Kungwini Pharmacy Bronkhorst-spruit

Pick N Pay Pharmacy - Greenstone Lethabong

Clicks Pharmacy - Cedar Road Sandton

Dis-Chem Hazeldean Pharmacy Pretoria

Dis-Chem Athol Oaklands Pharmacy Johannesburg

Dis-Chem Farramere Pharmacy Benoni

Clicks Pharmacy - Maponya Mall Pimville

Medi-Rite Pharmacy - Arcon Park Vereeniging

Medi-Rite Pharmacy - Quagga Pretoria

Pick N Pay Pharmacy - Soweto Soweto

Clicks Pharmacy - Fourways Mall Sandton

Clicks Pharmacy - Key West Krugersdorp

Clicks Pharmacy - the Glen Johannesburg South

Medi-Rite Pharmacy - Glenvista Johannesburg South

Clicks Pharmacy - Southgate Johannesburg South

Dis-Chem Woodmead Pharmacy Sandton

Clicks Pharmacy - Bedford Centre Germiston

Pick 'n Pay Pharmacy - Woodmead Sandton

Clicks Pharmacy - Kolonade Pretoria

Clicks Pharmacy - Meyerton Meyerton

Medi-Rite Pharmacy - Gezina Pretoria

Clicks Pharmacy - Hatfield Plaza Pretoria

Clicks Pharmacy - Randfontein Randfontein


GAUTENG (CONTINUED)


Clicks Pharmacy - Carletonville Carletonville

Clicks Pharmacy - Fedsure Forum Pretoria

Clicks Pharmacy - Hyde Park Sandton

Clicks Pharmacy - Carlton Centre Johannesburg

Clicks Pharmacy - Norkem Mall Kempton Park

Clicks Pharmacy - Northvaal Arcade Pretoria

Dis-Chem Wonderboom Pharmacy Pretoria

Clicks Pharmacy - Rivonia Sandton

Dis-Chem Raslouw Pharmacy Centurion

Clicks Pharmacy - the Zone Johannesburg

Medi-Rite Pharmacy - Lenasia Lenasia

Medi-Rite Pharmacy - Moreleta Park Pretoria

Clicks Pharmacy - Quagga Centre Pretoria

Clicks Pharmacy - Brackenhurst Alberton

Clicks Pharmacy - Sunninghill Sandton

Medi-Rite Pharmacy - Raslouw Centurion

Clicks Pharmacy - Sunnypark Pretoria

Clicks Pharmacy - Atlasville Boksburg

Clicks Pharmacy - Gezina Pretoria

Clicks Pharmacy - Brightwater Commons Randburg

Clicks Pharmacy - Glenvista Johannesburg South

Greenways Lambton Pharmacy Germiston

Clicks Pharmacy - Percegold Pretoria

Clicks Pharmacy - Bryanston Sandton

Clicks Pharmacy - Woodbridge Mall Kempton Park

Medi-Rite Pharmacy - Atteridgeville Pretoria

Clicks Pharmacy - Rand City Mall (2nd Avenue) Alberton

Clicks Pharmacy - Randburg Randburg

Clicks Pharmacy - Southdale Johannesburg South

Clicks Pharmacy - Parkrand Boksburg

Clicks Pharmacy - River Square Vereeniging

Clicks Pharmacy - Broadacres Sandton

Medi-Rite Pharmacy - Palm Springs Springs

Medi-Rite Pharmacy - Jabulani Soweto

Medi-Rite Pharmacy - Greenstone Lethabong

Clicks Pharmacy - Wonderboom Pretoria

Van Heerden Pharmacy - Parkview Pretoria

Dis-Chem the Glen Pharmacy Johannesburg South

GAUTENG (CONTINUED)


Clicks Pharmacy - Bronkhorstspruit Bronkhorst-spruit

Clicks Pharmacy - Fourways Crossing Sandton

Clicks Pharmacy - Northmead Square Benoni

Medi-Rite Pharmacy - Jan Smuts Kempton Park

Clicks Pharmacy - the Angelo - Nigel Nigel

Clicks Pharmacy - Lynridge Mall Pretoria

Medi-Rite Pharmacy - Randburg Randburg

Medi-Rite Pharmacy - Grey Owl Olifantsfontein

Medi-Rite Pharmacy - Horizon View Roodepoort

Medi-Rite Pharmacy - Bartlett Boksburg

Irene Pharmacy Centurion

Clicks Pharmacy - the Village@moreleta Pretoria

Clicks Pharmacy - Northpark Pretoria

Clicks Pharmacy - Lyttleton Centurion

Clicks Pharmacy - the Grove Pretoria

Clicks Pharmacy - Comaro View Johannesburg South

Clicks Pharmacy - Olivedale Randburg

Clicks Pharmacy - Valley Centre Randburg

Dis-Chem Krugersdorp Pharmacy Krugersdorp

Dis-Chem Brooklyn Mall Pharmacy Pretoria

Clicks Pharmacy - Losberg Fochville

Medi-Rite Pharmacy - Braam Fisher Randburg

Dis-Chem Woodlands Boulevard Pharmacy Pretoria

Clicks Pharmacy - Waverley Pretoria

Pick N Pay Pharmacy - Hurlingham Sandton

Dis-Chem Clearwater Mall Pharmacy Roodepoort

Khanyisa Sosh Pharmacy Soshanguve

Clicks Pharmacy - Selcourt Towers Springs

Medi-Rite Pharmacy - Daspoort Pretoria

Medi-Rite Pharmacy - Dobsonville Soweto

Waterkloof Corner Pharmacy Pretoria

Medi-Rite Pharmacy - Chris Hani Crossing Vosloorus

Medi-Rite Pharmacy - Brakpan Brakpan

Medi-Rite Pharmacy - Benoni Lake Benoni

Dis-Chem Verdi Pharmacy Randburg

Clicks Pharmacy - Heathway Square Randburg

Clicks Pharmacy - Lemon Tree Alberton

Clicks Pharmacy - Appletons Village Randburg


GAUTENG (CONTINUED)


Clicks Pharmacy - Chris Hani Crossing Vosloorus

Clicks Pharmacy - Tembisa Tembisa

Clicks Pharmacy - Village @ Horizon - Roodepoort Roodepoort

Clicks Pharmacy - Honey Ridge Randburg

Firstcare Courier Pharmacy Krugersdorp

Clicks Pharmacy - Eldo Square Centurion

Clicks Pharmacy - Melrose Arch Johannesburg

Clicks Pharmacy - Farrarmere Benoni

Dis-Chem Three Rivers Pharmacy Vereeniging

Dis-Chem Victory Park Pharmacy Randburg

Dis-Chem Carnival Mall Pharmacy Brakpan

Medi-Rite Pharmacy - Golden Walk Germiston

Dis-Chem Direct Oncology Pharmacy Midrand

Clicks Pharmacy - Jubilee Mall Hammansk-raal

Clicks Pharmacy - Centurion Lifestyle Centre Centurion

Dis-Chem Glenfair Pharmacy Pretoria

Netcare Waterfall City Hospital Pharmacy Midrand

Medi-Rite Pharmacy - Carnival City Brakpan

Oakdene Pharmacy Johannesburg South

Medi-Rite Pharmacy - Southgate Johannesburg South

Medi-Rite Pharmacy - Northcliff Corner Randburg

Dis-Chem Nicolway Pharmacy Sandton

Medi-Rite Pharmacy - Three Rivers Vereeniging

Clicks Pharmacy - Birchleigh North Kempton Park

Clicks Pharmacy - Elspark Germiston

Clicks Pharmacy - Meyersdal Alberton

Medi-Rite Pharmacy - Silver Lakes Pretoria

Medi-Rite Pharmacy - Protea Glen Mall Soweto

Clicks Pharmacy - Flora Centre Roodepoort

Pick N Pay Pharmacy - the Falls Roodepoort

Clicks Pharmacy - Protea Gardens Soweto

Pick N Pay Pharmacy - Brentwood Park Benoni

Clicks Pharmacy - Tsakane Brakpan

Clicks Pharmacy - Cavendish Glen Kempton Park

Dis-Chem Westgate Pharmacy Roodepoort

Clicks Pharmacy - Crowthorne Midrand

Pick N Pay Pharmacy - Lonehill Sandton

GAUTENG (CONTINUED)


Van Heerden Pharmacy - Herfsblaar Pretoria

Medi-Rite Pharmacy - Randfontein Randfontein

Clicks Pharmacy - Diepkloof Square Diepkloof

Albemarle Pharmacy Germiston

Clicks Pharmacy - Protea Glen Soweto

Dis-Chem Festival Mall Pharmacy Kempton Park

Medi-Rite Pharmacy - Riverview Krugersdorp

Clicks Pharmacy - Cradlestone Mall Krugersdorp

Dis-Chem Cradlestone Pharmacy Roodepoort

Dis-Chem Rosebank Pharmacy Johannesburg

Dis-Chem Wonderpark Pharmacy Akasia

Clicks Pharmacy - Mamelodi Crossing Pretoria

Clicks Pharmacy - Norwood Mall Johannesburg

Clicks Pharmacy - Parkview Pretoria

Clicks Pharmacy - Cosmo City Randburg

Clicks Pharmacy - Mabopane Mabopane

Pick N Pay Pharmacy - Randfontein (Helikonpark Pharmacy) Randfontein

Clicks Pharmacy - Forest Hill Centurion

Clicks Pharmacy - Balfour Park Johannesburg

Clicks Pharmacy - Soshanguve Crossing Soshanguve

Clicks Pharmacy - Eyethu Orange Farm Orange Farm

Lennymed Pharmacy Westonaria

Medi-Rite Pharmacy - Pretoria North Pretoria

Dis-Chem Park Station Pharmacy Johannesburg

Dis-Chem Southgate Mall Pharmacy Johannesburg South

Dis-Chem Heidelberg Mall Pharmacy Heidelberg - GP

Dis-Chem Glen Acres Pharmacy Kempton Park

Pharmacy @ Spar - Willow Way Pretoria

Dis-Chem Vanderbijlpark Pharmacy Vanderbijlpark

Clicks Pharmacy - Heidelberg Mall Heidelberg - GP

Clicks Pharmacy - Newtown Junction Johannesburg

Dis-Chem Jean Avenue Pharmacy Centurion

Dis-Chem Bedford Square Pharmacy Germiston

Clicks Pharmacy - Mark Park Vereeniging

Clicks Pharmacy - Dainfern Square Sandton

U Pharmacy - Nevada Alberton

Dis-Chem Direct Courier Pharmacy Midrand

Dis-Chem Killarney Mall Pharmacy Johannesburg


GAUTENG (CONTINUED)


Dis-Chem Dainfern Square Pharmacy Sandton

Clicks Pharmacy - Sancardia Pretoria

Dis-Chem Mall of the South Pharmacy Johannesburg South

Clicks Pharmacy - Mall of the South Johannesburg South

Dis-Chem Sunninghill Pharmacy Sandton

Pick N Pay Pharmacy - Glen Balad Kempton Park

Pharmacy @ Spar - Evaton Sebokeng

Clicks Pharmacy - Golden Walk Germiston

U Pharmacy - Vorna Valley Midrand

Clicks Pharmacy - Waterfall Corner Midrand

Clicks Pharmacy - Blue Hills Midrand

Stix Morewa Memorial Hospital Pharmacy Johannesburg

U Pharmacy - Waverley Pretoria

Clicks Pharmacy - Wingtip Pretoria

Clicks Pharmacy - Northmead Mall Benoni

Dis-Chem Direct Oncology Pharmacy Midrand

Clicks Pharmacy - Olympus Village Pretoria

Dis-Chem Mall of Africa Pharmacy Midrand

Medi-Rite Pharmacy - Mall of Africa Midrand

Clicks Pharmacy - Mall of Africa Midrand

Clicks Pharmacy - Carletonville Mall Carletonville

Clicks Pharmacy - Oakfields Benoni

Clicks Pharmacy - Thabong Sebokeng

Clicks Direct Medicines Randburg

Clicks Pharmacy - Equestria Pretoria

Dis-Chem Newmarket Mall Pharmacy Alberton

Northriding Pharmacy Randburg

Dis-Chem Menlyn Park Pharmacy Pretoria

Clicks Pharmacy - Sinoville Pretoria

Dis-Chem Maponya Mall Pharmacy Soweto

Dis-Chem Greenvalley Pharmacy Lethabong

Winternest Pharmacy Akasia

Kelly Road Pharmacy Randburg

Pharmacy @ Spar - Clubview (Ashmed Pharmacy) Centurion

Dorite Pharmacy @ Spar - Jean Avenue Centurion

Clicks Pharmacy - Daveyton Mall Benoni

Clicks Pharmacy - Menlyn Maine Pretoria

Atlyn Pharmacy Pretoria

GAUTENG (CONTINUED)


Medicare Pharmacy - Grosvenor Sandton

Linksfield Park Clinic Pharmacy Johannesburg

Clicks Pharmacy - Rynfield Square Benoni

Clicks Pharmacy - Springs Mall Springs

Dawn Park Pharmacy Boksburg

Dis-Chem Springs Mall Pharmacy Springs

Clicks Pharmacy - Alex Mall Alexandra

Docmed Pharmacy Vanderbijlpark

Dis-Chem Rynfield Terrace Pharmacy Benoni

Clicks Pharmacy - Irene Village Mall Centurion

Dis-Chem Randfontein Pharmacy Randfontein

Dis-Chem Jubilee Mall Pharmacy Hammansk-raal

Kilburn Pharmacy Roodepoort

Clicks Pharmacy - Kyalami Corner Midrand

Clicks Pharmacy - Middestad Pretoria Pretoria

Clicks Pharmacy - Katlehong Katlehong

Clicks Pharmacy - Ontdekkers Park Rood-epoort (Netcare Roodepoort Dispensary) Roodepoort

Clicks Pharmacy - the Berg (Netcare Schoongezicht Pharmacy) Randburg

Clicks Pharmacy - Carlswald Midrand

Clicks Pharmacy - Constantia (Netcare Constantia Pharmacy) Pretoria

Clicks Pharmacy - Nimrod Park (Netcare Monument Dispensary) Kempton Park

Clicks Pharmacy - Kembirch (Netcare Kembirch Dispensary) Kempton Park

Clicks Pharmacy - Pretoria North (Netcare Pretoria North Dispensary) Pretoria

Clicks Pharmacy - Saxby (Netcare Saxby Pharmacy) Centurion

Clicks Pharmacy - Silverton Pretoria Street (Netcare Silverton Dispensary) Pretoria

Dis-Chem Valley View Pharmacy Krugersdorp

The Local Choice Pharmacy - Village Centre Pretoria

The Local Choice Pharmacy - Village Centre Pretoria

Dis-Chem Soshanguve Pharmacy Soshanguve

Dis-Chem Meadowdale Mall Pharmacy Germiston

Clicks Pharmacy - Germiston Germiston

Clicks Pharmacy - Benoni Benoni

Nelson Mandela Children's Hospital - Pharmacy Johannesburg


GAUTENG (CONTINUED)


Clicks Pharmacy - Pretoria West (Netcare Pretoria West Dispensary) Pretoria

Clicks Pharmacy - Vereeniging (Netcare Vereeniging Pharmacy) Vereeniging

Clicks Pharmacy - Edenvale Edenvale

Clicks Pharmacy - Boksburg (Netcare Boksburg Dispensary) Boksburg

Clicks Pharmacy - Sophia Town (Netcare Sophiatown Pharmacy) Johannesburg

Clicks Pharmacy - Rabie Street Randburg

Clicks Pharmacy - Krugersdorp Krugersdorp

Clicks Pharmacy - Dalpark Brakpan

Clicks Pharmacy - Selection Park Springs

Dis-Chem Melville Pharmacy Johannesburg

Dis-Chem Morningside Pharmacy Sandton

Dis-Chem Mall @ 55 Pharmacy Centurion

Dis-Chem Gandhi Square Pharmacy Johannesburg

Benns Pharmacy Brakpan

Ackermans Apteek Germiston

Heidelberg Apteek Heidelberg - GP

El Corro Link Pharmacy Randburg

Dis-Chem Mondeor Pharmacy Johannesburg South

Rosebank Clinic Pharmacy Johannesburg

Milpark Hospital Dispensary Johannesburg

Rox Pharmacy Johannesburg

Adlams Pharmacy - Carletonville Carletonville

Vanderwalt Pharmacy Meyerton

Nigel Apteek Nigel

Eastwood Park Pharmacy Pretoria

Kramer's Pharmacy Pretoria

Randgate Pharmacy Randfontein

Alpha Petersfield Pharmacy Springs

Strubenvale Pharmacy Springs

Netcare Rand Clinic Dispensary Johannesburg

Cullinan Pharmacy Cullinan

Netcare Park Lane Pharmacy Johannesburg

Clicks Pharmacy - Doringkloof Centurion

Tileba Apteek Akasia

Harmelia Apteek Germiston

Bronberrik Pharmacy Centurion

Netcare Union Pharmacy Alberton

GAUTENG (CONTINUED)


Medi-Park Apteek Kempton Park

Ferryvale Pharmacy Nigel

De Wiekusweg Apteek Kempton Park

Moreletapark Apteek Pretoria

Jacqueline Pharmacy Alberton

Dis-Chem Randridge Medicine Centre Pharmacy Randburg

Mega Apteek & Medisyne Depot Vereeniging

Station Pharmacy - Mayfair Johannesburg

Adlams Pharmacy Oberholzer Carletonville

Netcare Krugersdorp Hospital Pharmacy Krugersdorp

Netcare Unitas Hospital Pharmacy Centurion

Clicks Pharmacy - Woodlands Boulevard Pretoria

Netcare Jakaranda Hospital Pharmacy Pretoria

Serene Apteek Pretoria

Panorama Pharmacy Centurion

Pharma Valu - Die Hoek Pretoria

Netcare Garden City Hospital Pharmacy Johannesburg

Baker Street Pharmacy Edenvale

Kagiso Pharmacy Krugersdorp

Dr S K Matseke Memorial Hospital Pharmacy Diepkloof

Dis-Chem the Mall Pharmacy Sandton

Bronkhorstspruit Hospital Dispensary Bronkhorst-spruit

Clicks Pharmacy - Centurion Centre (Hyper-Pharm Centurion) Centurion

Henda Pharmacy Pretoria

Van Heerden Apteek & Medisyne Depot - Hamilton Pretoria

Netcare Sunninghill Pharmacy Sandton

Netcare Linmed Pharmacy Benoni

Colony Pharmacy Randburg

Netcare Linksfield Park Retail Pharmacy Johannesburg

Netcare Bell St Pharmacy Krugersdorp

Clicks Pharmacy - Boksburg (Netcare Boksburg Dispensary) Boksburg

Clicks Pharmacy - Edenvale Edenvale

Clicks Pharmacy - Kembirch (Netcare Kembirch Dispensary) Kempton Park

Clicks Pharmacy - Gezina (Netcare Gezina Dispensary) Pretoria

Clicks Pharmacy - Gezina (Netcare Gezina Dispensary) Pretoria


GAUTENG (CONTINUED)


Clicks Pharmacy - Rabie Street Randburg

Clicks Pharmacy - Silverton Pretoria Street (Netcare Silverton Dispensary) Pretoria

Arrie Nel Montana Pharmacy Pretoria

Clicks Pharmacy - the Berg (Netcare Schoongezicht Pharmacy) Randburg

Clinix Botshelong - Empilweni Private Hospital Pharmacy Vosloorus

Clicks Pharmacy - Watermeyer Pretoria

Clicks Pharmacy - Pretoria North (Netcare Pretoria North Dispensary) Pretoria

Clicks Pharmacy - Vereeniging (Netcare Vereeniging Pharmacy) Vereeniging

Van Heerden Lynriff Apteek Pretoria

Clicks Pharmacy - Selection Park Springs

Clinix Tshepo-Themba Private Hospital Pharmacy Soweto

Clicks Pharmacy - Germiston Germiston

Clicks Pharmacy - Krugersdorp Krugersdorp

Clicks Pharmacy - Constantia (Netcare Constantia Pharmacy) Pretoria

Hanrimed Medisyne Depot Brakpan

Van Heerden Glen Village Pharmacy Pretoria

Netcare Femina Hospital Pharmacy Pretoria

Clicks Pharmacy - Pretoria West (Netcare Pretoria West Dispensary) Pretoria

Clicks Pharmacy - Sophia Town (Netcare Sophiatown Pharmacy) Johannesburg

Clicks Pharmacy - Benoni Benoni

Clicks Pharmacy - Nimrod Park (Netcare Monument Dispensary) Kempton Park

Netcare Pretoria East Hospital Pharmacy Pretoria

Veganview Dispensary Edenvale

Lily Pharmacy Germiston

Clicks Pharmacy - Atterbury Pretoria

Clinix Naledi-Nkanyezi Private Hospital Pharmacy Sebokeng

Dis-Chem Bracken Gardens Pharmacy Alberton

Eldo Park Pharmacy - Wierda Park Centurion

Oak Avenue Pharmacy (Oaklaan-Germis-ton Apteek) Boksburg

Muntu Medicine Depot Boksburg

Clicks Pharmacy - Noordheuwel Krugersdorp

Netcare Montana Private Hospital Pharmacy Pretoria

Pharmacentre - Kyalami Midrand

GAUTENG (CONTINUED)


Dis-Chem East Rand Pharmacy Boksburg

Netcare N17 Pharmacy Springs

Clicks Pharmacy - Mayville Pretoria

Clicks Pharmacy - Westgate (Ontdekkers Road) Roodepoort

Clicks Pharmacy - Cornwall View Pretoria

Dis-Chem Rynfield Terrace Pharmacy Benoni

Falls Apteek En Medisyne Depot Benoni

Netcare Moot General Hospital Pharmacy Pretoria

S Buys Park Pharmacy Carletonville

KWA-ZULU NATAL


Newlands City Pharmacy & Medicine Depot

Newlands West

Hayfields Pharmacy Pietermaritz-burg

Clicks Pharmacy - La Lucia La Lucia

Durdoc Clinic Pharmacy Durban

Hasmed Pharmacy Phoenix

Netcare Margate Hospital Pharmacy Margate

Glenwood Village Pharmacy Berea

Medi-Rite Pharmacy - Chatsworth Chatsworth

Clicks Pharmacy - Liberty Midlands Mall Pietermaritz-burg

Clicks Pharmacy - Gateway Umhlanga

Medi-Rite Pharmacy - Gateway Umhlanga

Medi-Rite Pharmacy - Pavilion Westville

Clicks Pharmacy - Shelly Beach Margate

Clicks Pharmacy - Pavilion Westville

Clicks Pharmacy - Pinetown Pinetown

Shepmed Pharmacy Pinetown

Clicks Pharmacy - Richards Bay Richards Bay

Dis-Chem Glen Lucia Pharmacy La Lucia

Medi-Rite Pharmacy - Richards Bay Richards Bay

Pick N Pay Pharmacy - Durban North Durban North

Just Health Pharmacy Durban

Clicks Pharmacy - Kensington Square Durban North

Springmed Pharmacy Durban

Clicks Pharmacy - Westville Mall Durban

Clicks Pharmacy - Hayfields Pietermaritz-burg


KWA-ZULU NATAL (CONTINUED)


Clicks Pharmacy - Amajuba Mall Newcastle

Netcare Alberlito Hospital - Pharmacy Dolphin Coast

Dis-Chem Hillcrest Pharmacy Hillcrest

Medi-Rite Pharmacy - Shallcross Queensburgh

Clicks Pharmacy - Ballito Lifestyle Dolphin Coast

Medi-Rite Pharmacy - Shelley Beach Port Shep-stone

Dis-Chem Westville Pharmacy Westville

D-Med Pharmacy Durban

Umhlanga Medical Centre Pharmacy Umhlanga

Clicks Pharmacy - Montclair Durban South

Clicks Pharmacy - Scottburgh Scottburgh/Umzinto North

Clicks Pharmacy - Empangeni Empangeni

Clicks Pharmacy - Windermere Berea

Endumeni Pharmacy Dundee

Medi-Rite Pharmacy - Boardwalk Richards Bay

Clicks Pharmacy - the Bluff Bluff

Clicks Pharmacy - Game City Durban

Medi-Rite Pharmacy - Bluff Bluff

Pick N Pay Hypermarket Pharmacy - South Coast

Amanzimtoti

Medi-Rite Pharmacy - Newcastle Newcastle

Milmed Pharmacy Durban

Clicks Pharmacy - Chatsworth Chatsworth

Clicks Pharmacy - Westguard Durban

Clicks Pharmacy - the Workshop Durban

Clicks Pharmacy - South Coast Mall Margate

Cosmed Pharmacy Margate

Clicks Pharmacy - the Galleria Aman-zimtoti

Amanzimtoti

Dis-Chem Amanzimtoti Pharmacy Amanzimtoti

Medi-Rite Pharmacy - Galleria Amanzimtoti

Medi-Rite Pharmacy - Margate Margate

Clicks Pharmacy - Kokstad Kokstad

Medi-Rite Pharmacy - Bridge City Iqadi

Dis-Chem Ballito Junction Regional Mall Pharmacy

Dolphin Coast

Clicks Pharmacy - Pietermaritzburg Pietermaritz-burg

Clicks Pharmacy - Victoria Pietermaritz-burg

The Dundee Trading Pharmacy Dundee



People's Choice Pharmacy Kokstad

Dis-Chem Richards Bay Pharmacy Richards Bay

Clicks Pharmacy - Southway Mall Durban South

Clicks Pharmacy - Ladysmith Ladysmith

Link Hills Pharmacy Waterfall

Clicks Pharmacy - Musgrave Berea

Clicks Pharmacy - Queensburgh Durban

Eastbury Pharmacy Phoenix

Clicks Pharmacy - Margate Margate

Medi-Rite Pharmacy - Edendale Mall Pietermaritz-burg

Clicks Pharmacy - Westville Village Westville

Clicks Pharmacy - Umhlali Dolphin Coast

Dis-Chem Liberty Midlands Mall Phar-macy

Pietermaritz-burg

Clicks Pharmacy - Cascades Pietermaritz-burg

Clicks Pharmacy - Westwood Westville

Clicks Pharmacy - Reservoir Hills Durban

Clicks Pharmacy - Meer En See Richards Bay

Medi-Rite Pharmacy - Cascades Pietermaritz-burg

Medi-Rite Pharmacy - Castle Rock Newcastle

Clicks Pharmacy - Newcastle Mall Newcastle

Waterloo Pharmacy Blackburn

Clicks Pharmacy - Lillies Quarter Hillcrest

Clicks Pharmacy - Edendale Pietermaritz-burg

Clicks Pharmacy - Scottsville Mall Pietermaritz-burg

Clicks Pharmacy - Bridge City KwaMashu

Pick N Pay Pharmacy - Pavillion Westville

Clicks Pharmacy - the Crescent - Um-hlanga

Umhlanga

Clicks Pharmacy - Howick Howick

Clicks Pharmacy - Stanger KwaDukuza

Dis-Chem Overport Pharmacy Durban

Umtshezi Pharmacy Estcourt

Clicks Pharmacy - Vryheid Vryheid

T L C Umdloti Pharmacy Umdloti

Newkwa Pharmacy Newlands West

Dis-Chem the Pavilion Pharmacy Westville




Clicks Pharmacy - Kloof Kloof

Clicks Pharmacy - Amazimtoti (Seadoone Mall)

Amanzimtoti

Clicks Pharmacy - Phoenix Plaza Phoenix

Dis-Chem Watercrest Mall Pharmacy Waterfall

Isandlwana Pharmacy Vryheid

Clicks Pharmacy - Brookside Mall Pietermaritz-burg

Medi-Rite Pharmacy - Brookside Mall Pietermaritz-burg

Clicks Pharmacy - Pongola Pongola

Clicks Pharmacy - Kwamnyandu Umlazi

Clicks Pharmacy - Watercrest Mall Waterfall

Clicks Pharmacy - Dundee Dundee

Clicks Pharmacy - Ulundi Ulundi

Caremed Pharmacy Pietermaritz-burg

Crystal Pharmacy - Kokstad Kokstad

Pharmacy @ Spar - Port Edward Port Edward

Durban North Pharmacy Umhlanga

Dis-Chem the Bluff Pharmacy Bluff

Pharmacy @ Spar - Bridge City KwaMashu

Clicks Pharmacy - Smith Street Durban

Clicks Pharmacy - Mtubatuba Mtubatuba

Dis-Chem Pinecrest Pharmacy Pinetown

Clicks Pharmacy - Kingsburgh Amanzimtoti

Hilton Health Pharmacy Hilton

Main Pharmacy - Hill Street Pinetown

Mpop-Med Pharmacy Umhlabuyalin-gana Rural

Pharmacy @ Spar - Winkle Kingsburgh

Clicks Pharmacy - Umlazi Mega City Umlazi

Ekuphileni Pharmacy Newcastle

Medi-Rite Pharmacy - Mangusi Hluhluwe

Ahmed Al-Kadi Private Hospital Pharmacy Durban

Nature's Health Pharmacy Chatsworth

Clicks Pharmacy - Ballito Junction Regional Mall

Dolphin Coast

Dis-Chem Southcoast Mall Pharmacy Margate

Clicks Pharmacy - Berea Centre Berea

Clicks Pharmacy - Conabor Street Durban

Clicks Pharmacy - Hillcrest Corner Hillcrest



Clicks Pharmacy - Hayfields Mall Pietermaritz-burg

Skinmed Pharmacy Durban

Clicks Pharmacy - the Bluff Lighthouse Road

Bluff

Clicks Pharmacy - Meller Road Pinetown

Mdlovane Pharmacy Greytown

Dis-Chem Cornubia Pharmacy Mount Edge-combe

Clicks Pharmacy - Cornubia Mount Edge-combe

Dis-Chem Newcastle Pharmacy Newcastle

Medi-Rite Pharmacy - Cornubia Mount Edge-combe

Ladysmith Pharmacy Ladysmith

Pharmacy @ Spar Ramsgate Margate

Aquarius Pharmacy Port Shep-stone

Medicare Pharmacy - Verulam Verulam

Randeree's Pharmacy Durban

Maxwell Centre Pharmacy Durban

Linmed Pharmacy Tongaat

Delta Pharmacy Pietermaritz-burg

Netcare Kingsway Hospital Pharmacy Amanzimtoti

Scott Street Day & Nite Pharmacy Scottburgh/Umzinto North

Naveen's Pharmacy Newcastle

Remedia Pharmacy Vryheid

Netcare Parklands Hospital Pharmacy Durban

Whitehouse Mall Pharmacy Port Shep-stone

Netcare St Augustine's Hospital - Dis-pensary

Berea

Parkgate Pharmacy & Medicine Depot Phoenix

Motalas Pharmacy Durban

Stanger Pharmacy KwaDukuza

Netcare St Anne's Hospital Pharmacy Pietermaritz-burg

Stonebridge Pharmacy & Medicine Depot Phoenix

Medpharm Pharmacy Pietermaritz-burg

Pointmed Pharmacy Durban

Clicks Pharmacy - the Bluff Lighthouse Road

Bluff




Clicks Pharmacy - Conabor Street Durban

Clicks Pharmacy - Hayfields Mall Pietermaritz-burg

Clicks Pharmacy - Meller Road Pinetown

The Bay Hospital - Pharmacy Richards Bay

Murray Square Pharmacy & Medicine Depot

Pinetown

Netcare Umhlanga Hospital - Pharmacy Umhlanga

Rinaldo Pharmacy Durban North

Medfield Pharmacy Durban

LIMPOPO


Clicks Pharmacy - Polokwane 2 Polokwane

Mokopane Pharmacy - Potgietersrus Mokopane

Van Heerden Pharmacy - Tzaneen Tzaneen

Thulamela Pharmacy Thohoyandou

Van Heerden Pharmacy - Thabazimbi Thabazimbi

Peacemed Pharmacy Tzaneen

Clicks Pharmacy - Polokwane C B D Polokwane

Clicks Pharmacy - Cycad Polokwane

Medi-Rite Pharmacy - Polokwane Polokwane

Masingita Pharmacy Giyani

Clicks Pharmacy - Tzaneen Tzaneen

Clicks Pharmacy - Phalaborwa Phalaborwa

Van Heerden Pharmacy - Nylstroom 2 Modimolle

Clicks Pharmacy - Savannah Centre Polokwane

Ladanna Pharmacy Polokwane

Clicks Pharmacy - Thornhill Polokwane

T J Healthcare Pharmacy Thohoyandou

Dis-Chem Savannah Mall Pharmacy Polokwane

Dis-Chem Platinum Park Pharmacy Polokwane

Clicks Pharmacy - Mall of the North Polokwane

Medi-Rite Pharmacy - Mall of the North Polokwane

Dis-Chem Mall of the North Pharmacy Polokwane

Pick N Pay Pharmacy - Mall of the North Polokwane

Clicks Pharmacy - Ellisras Lephalale

Clicks Pharmacy - Louis Trichardt Louis Trichardt

Nyeleti Pharmacy Greater Tza-neen Rural

Clicks Pharmacy - Tubatse Crossing Burgersfort

LIMPOPO (CONTINUED)


Clicks Pharmacy - Modi Mall Modimolle

Clicks Pharmacy - Mall@lebo (Lebowak-gomo)

Lepele-Nkum-pi Rural

Pharmacy @ Spar City Centre Polokwane

Clicks Pharmacy - Thaba Mall Thabazimbi

Clinix Phalaborwa Private Hospital Pharmacy Phalaborwa

Clicks Pharmacy - Lephalale Mall Lephalale

Tzaneen Pharmacy Tzaneen

Modjadji Pharmacy - Duiwelskloof Modjadjiskloof

Bophelomed Pharmacy Lepele-Nkum-pi Rural

Tsusanang Pharmacy Burgersfort

Clicks Pharmacy - Mokopane Mokopane

Ripfumelo Pharmacy Greater Tza-neen Rural

Parks-Med Pharmacy Polokwane

Mutakalo Pharmacy Thohoyandou

Lombard Pharmacy Tzaneen

Sebola Pharmacy Bela-Bela

Clicks Pharmacy - Musina Mall Musina

Clicks Pharmacy - Groblersdal Groblersdal

Hospitality Pharmacy Louis Trichardt

Clicks Pharmacy - Thavhani Mall Thohoyandou

Mogolaneng Pharmacy Polokwane

Weldon's Apteek Louis Trichardt

Potgietersrus Pharmacy Mokopane

Muldok Pharmacy Mokopane

Watts Apteek Mokopane

Van Heerden Apteek & Medisyne Depot Head Office (Warmbaths) Bela-Bela

Van Heerden Pharmacy - Nylstroom Modimolle

Groblersdal Pharmacy Groblersdal

Sanbonani Pharmacy Groblersdal

Medline Pharmacy Bela-Bela

The Local Choice Pharmacy - Polokwane Polokwane

Cure-O-Pharm Pharmacy Polokwane


MPUMALANGA


Clicks Pharmacy - Highland Mews Witbank Ext 16

Clicks Pharmacy - Saveways Witbank

Van Heerden Pharmacy - Sonpark - Nelspruit

Sonheuwel

Van Heerden Pharmacy - Nelspruit Sonheuwel

Medico Medisyne Depot Secunda

Medi-Rite Pharmacy - Nelspruit Nelspruit

Clicks Pharmacy - Midwater Centre Aerorand

Protea Medi-Wise Pharmacy Secunda

Greylingstad Pharmacy Balfour

Clicks Pharmacy - Standerton Standerton

Clicks Pharmacy - Highveld Mall Witbank

Clicks Pharmacy - Riverside Mall Nelspruit

Clicks Pharmacy - Middelburg Middelburg

Van Heerden Pharmacy - Sabie Sabie

Cosmos Pharmacy Bethal

Laeveld Pharmacy White River

Clicks Pharmacy - Hazyview Hazyview

Medi-Rite Pharmacy - Ermelo Ermelo

Medi-Rite Pharmacy - Bell Street Nelspruit

Dis-Chem Nelspruit Pharmacy Nelspruit

Medi-Rite Pharmacy - Klipfontein Klipfontein

Clicks Pharmacy - Delmas Delmas

Mopani Pharmacy - Ilanga Mall Nelspruit

Dis-Chem Witbank Pharmacy Witbank

Russells Pharmacy Nelspruit

Rixile Pharmacy Bushbuckridge

Clicks Pharmacy - Ermelo Ermelo

Clicks Pharmacy - Ilanga Mall Nelspruit

Medi-Rite Pharmacy - Lydenburg Lydenburg

Zamantungwa Pharmacy - Amersfoort Amersfoort

Pick N Pay Pharmacy - Middelburg Middelburg

Clicks Pharmacy - Middelburg Mall Middelburg

Medi-Rite Pharmacy - Middelburg Mall Middelburg

Clicks Pharmacy - Ben Fleur Witbank

Mopani Pharmacy - White River White River

Vigilcare Pharmacy - Mhluzi Mhluzi Ext 4

Dis-Chem Secunda Pharmacy Secunda

Clicks Pharmacy - Secunda Regional Mall Secunda

U Pharmacy - Kriel Kriel

MPUMALANGA (CONTINUED)


Dis-Chem Middelburg Mall Pharmacy Middelburg

Mpumelelo Pharmacy Witbank

U Pharmacy - Emalahleni Witbank

U Pharmacy - Transvalia Secunda

Clicks Pharmacy - Barberton Barberton

Clicks Pharmacy - Mall @ Emba Embalenhle

Medi-Rite Pharmacy - Secunda Secunda

Clicks Pharmacy - K G Mall Emalahleni

Clicks Pharmacy - Malelane Ingwe Centre Malelane

Clicks Pharmacy - Mall @ Mfula Piet Retief

Clicks Pharmacy - Nelspruit (Netcare Nelspruit Pharmacy)

Nelspruit

Clicks Pharmacy - Tonga Mall Tonga

Clicks Pharmacy - Phola Park Kwamhlanga

M G Eksteen Apteek Barberton

Van Biljon Apteek Belfast

Kark Apteek Bethal

Leading Pharmacy Delmas

Melrow Pharmacy Ermelo

Bhyat Pharmacy Ermelo

Evander Pharmacy Evander

Eastdene Pharmacy Middelburg

Hazyview Apteek Hazyview

Komati Pharmacy Komatipoort

Tasbet Park Apteek Emalahleni

Clicks Pharmacy - Nelspruit (Netcare Nelspruit Pharmacy)

Nelspruit

Rivermall Pharmacy Nelspruit

NORTH WEST


Blackmode Pharmacy Rustenburg

Clicks Pharmacy - Mafikeng Mmabatho

Clicks Pharmacy - Wilkoppies Klerksdorp

Clicks Pharmacy - Potchefstroom Potchefstroom

Clicks Plus Pharmacy - Waterfall Mall Rustenburg

Klerksdorp Pharmacy Klerksdorp

Ifafi Pharmacy Hartbeespoort

Clicks Pharmacy - Klerksdorp Klerksdorp

Krishna Medi Pharmacy Brits

Taljaard Aptekers Coligny


NORTH WEST (CONTINUED)


Giggs Pharmacy Rustenburg

Wilge-Park Pharmacy Potchefstroom

Schoemansville Pharmacy Hartbeespoort

Kampus Apteek Potchefstroom

Tuscany Pharmacy Rustenburg

Medi-Rite Pharmacy - Klerksdorp Klerksdorp

Molemo Pharmacy Mmabatho

Dis-Chem Rustenburg Pharmacy Rustenburg

Clicks Pharmacy - Thabo Mbeki Rustenburg

Biblio Plaza Pharmacy Rustenburg

Ridder Street Pharmacy Rustenburg

Clicks Pharmacy - Brits Brits

Clicks Pharmacy - Mooi River Potchefstroom

Mesemed Pharmacy Ventersdorp

Medi-Rite Pharmacy - Mooirivier Potchefstroom

Clicks Pharmacy - Rustenburg Rustenburg

Medi-Rite Pharmacy - Hartebeespoort Hartbeespoort

Clicks Pharmacy - Vryburg Vryburg

Clicks Pharmacy - Hartebeespoortdam Hartbeespoort

Clicks Pharmacy - Zeerust Zeerust

Clicks Pharmacy - Mafikeng Crossing Mmabatho

Mooinooi Apteek Mooinooi

Dis-Chem Potchefstroom Pharmacy Potchefstroom

Wollies Pharmacy Wolmarans-stad

Medi-Rite Pharmacy - Waterberg Rustenburg

Clicks Pharmacy - Brits Mall Brits

Brits Mall Pharmacy Brits

Medi-Rite Pharmacy - Brits Mall Brits

Dis-Chem Klerksdorp Pharmacy Klerksdorp

Ibiza Pharmacy Rustenburg

Nu Horizon Pharmacy Cc Rustenburg

Clicks Pharmacy - Lichtenburg Lichtenburg

Medi-Rite Pharmacy - Taung Taung

Dis-Chem Hartbeespoort Pharmacy Hartbeespoort

Medi-Rite Pharmacy - Platinum Junction Rustenburg

Minty's Pharmacy Klerksdorp

Clicks Pharmacy - Lichtenburg Mall Lichtenburg

Clicks Pharmacy - Moruleng Mall Rustenburg

Clinix Itokolle-Victoria Private Hospital Dispensary

Mmabatho



Clicks Pharmacy - Matlosana Mall Klerksdorp

Molemo Good Health Pharmacy Mmabatho

Valumed Sun City Pharmacy Rustenburg

Clicks Pharmacy - Boitekong Rustenburg

Clicks Pharmacy - Thabo Mbeki Rustenburg

Clicks Pharmacy - Lombard Street Potchefstroom

Bloemhof Apteek Bloemhof

Saambou Pharmacy Klerksdorp

Springbok Apteek - Klerksdorp Klerksdorp

Atomic Pharmacy Orkney

Orkney Pharmacy Orkney

Mooi River Pharmacy Potchefstroom

Nissen's Pharmacy Rustenburg

Deka Apteek Stilfontein

Andre Pharmacy Rustenburg

Chris Gibson Pharmacy Rustenburg

Waldorf Pharmacy & Medicine Depot Klerksdorp

Nel 3 Pharmacy Brits

Van Rensburg Pharmacy & Med Depot Brits

Vryburg Apteek Vryburg

Hartbeesfontein Pharmacy Hartbeesfon-tein

Clicks Pharmacy - Lombard Street Potchefstroom

Wilmed Park Pharmacy Klerksdorp

Netcare Ferncrest Hospital Pharmacy Tlhabane

Pharmacy @ Spar - Lautzlaan Klerksdorp

Nel 2 Apteek Brits

Oryx Pharmacy Upington

Zest Pharmacy Kimberley

Clicks Pharmacy - Kimberley Kimberley

Clicks Pharmacy - Diamond Pavillion Kimberley

Kathu Pharmacy Kathu

Medi-Rite Pharmacy - Kimberley Kimberley

Medi-Rite Pharmacy - Diamond Pavilion Kimberley

Clicks Pharmacy - Upington Upington

Clicks Pharmacy - North Cape Mall Kimberley

Clicks Pharmacy - Kathu Kathu

Clicks Pharmacy - Springbok Springbok

Medi-Rite Pharmacy - Upington Upington

Dis-Chem Kimberley Pharmacy Kimberley

Palmae Pharmacy Kuruman




Palmae Pharmacy Kuruman

Clicks Pharmacy - Hartswater Hartswater

Clicks Pharmacy - Kalahari Mall Upington

Ons Apteek Aggeneys

Clicks Pharmacy - Kuruman Mall Kuruman

Medi-Rite Pharmacy - Kuruman Kuruman

Clicks Pharmacy- Kameeldoorn Kathu

Clicks Pharmacy - Stone Street (Netcare Kimberley Pharmacy)

Kimberley

Richmond Pharmacy Kimberley

Assembley Pharmacy Kimberley

Port Nolloth Pharmacy Port Nolloth

Clicks Pharmacy - Stone Street (Netcare Kimberley Pharmacy)

Kimberley

WESTERN CAPE


Medi-Rite Pharmacy - Somerset West Somerset

Symphony Pharmacy Cape Town

Clicks Pharmacy - Glengariff Cape Town

King George Pharmacy George

Clicks Pharmacy (Table View) Netcare Table view Pharmacy Cape Town

Clicks Pharmacy - Stellenbosch (Eikestad Mall) Stellenbosch

Caledon Pharmacy Caledon

Mini-Kem Pharmacy Goodwood Cape Town

Clicks Pharmacy - Edgemead Cape Town

Netcare Kuils River Hospital - Pharmacy Cape Town

Parow Family Pharmacy Cape Town

Clicks Pharmacy - Parklands Intercare Cape Town

Clicks Pharmacy - Melkbos Cape Town

Esack's Pharmacy Cape Town

Medi-Rite Pharmacy - Parow Cape Town

Dis-Chem Somerset Mall Pharmacy Cape Town

Nu-Crane Pharmacy - Mitchell's Plain Cape Town

Medi-Rite Pharmacy - N1 City Cape Town

Riverside Pharmacy - George George

Fairbairn Pharmacy Worcester

Clicks Pharmacy - Blue Route Cape Town

Clicks Pharmacy - Canal Walk Cape Town

Clicks Pharmacy - Golden Acre Cape Town

WESTERN CAPE (CONTINUED)


Medi-Rite Pharmacy - Atlantis Cape Town

Medi-Rite Pharmacy - Cape Gate Cape Town

Clicks Pharmacy - V & A Waterfront Cape Town

Clicks Pharmacy - Intercare Tyger Valley Cape Town

Medi-Rite Pharmacy - Table View Cape Town

Pick n Pay Pharmacy-Ottery Cape Town

Clicks Pharmacy - Cape Gate Cape Town

Clicks Pharmacy - Tygervalley Cape Town

Clicks Pharmacy - Somerset Mall Cape Town

Clicks Pharmacy - Kenilworth Centre Cape Town

Medi-Rite Pharmacy - Blue Route (Tokai) Cape Town

Dis-Chem Paarl Mall Pharmacy Paarl

Dis-Chem Tygervalley - Willowbridge Pharmacy Cape Town

Dis-Chem Claremont Pharmacy Cape Town

Clicks Pharmacy - Garden Route Mall George

Clicks Pharmacy - Promenade Cape Town

Clicks Pharmacy - N1 City Cape Town

Essential Health Pharmacy - Arcade Cape Town

Clicks Pharmacy - Paarl Mall Cape Town

Clicks Pharmacy - Mountain Mill Worcester

Clicks Pharmacy - Parow Centre Parow East Cape Town

Clicks Pharmacy - Langeberg Mall Mossel Bay

Clicks Pharmacy - Vangate Mall Cape Town

Clicks Pharmacy - Knysna Knysna

Pick N Pay Pharmacy - Brackenfell Cape Town

Medi-Rite Pharmacy - Sea Point Cape Town

Waterstone Pharmacy Cape Town

Clicks Pharmacy - Rondebosch Cape Town

Netcare Blaauwberg Pharmacy Cape Town

Clicks Pharmacy - Hermanus Hermanus

Pick N Pay Pharmacy - Plattekloof Cape Town

Clicks Pharmacy - Westcoast Village Cape Town

Essential Health Pharmacy - Protea Heights Cape Town

Clicks Pharmacy - Ceres Ceres

Pick N Pay Pharmacy - Table View Cape Town

Medi-Rite Pharmacy - Paarl Paarl

Medi-Rite Pharmacy - Mountain Mill Cape Town

Medi-Rite Pharmacy - Khayelitsha Cape Town

Clicks Pharmacy - Waterstone Village Cape Town




Clicks Pharmacy - Southgate Cape Town

Medi-Rite Pharmacy - Weltevreden Mitchell's Plain Cape Town

Clicks Pharmacy - Cobble Walk Cape Town

Clicks Pharmacy - Oudtshoorn Oudtshoorn

Clicks Pharmacy - Paarl Paarl

Pick N Pay Pharmacy - Claremont Cape Town

Medi-Rite Pharmacy - Eerste Rivier Cape Town

Medi-Rite Pharmacy - Kenilworth Cape Town

Essential Health Pharmacy - Kuils River Cape Town

Clicks Pharmacy - Langebaan Langebaan

Clicks Pharmacy - Zevenwacht Cape Town

Clicks Pharmacy - Soneike Cape Town

Clicks Pharmacy - Burg Street Cape Town

Medi-Rite Pharmacy - Bothasig Cape Town

Akmed Pharmacy Cape Town

Medi-Rite Pharmacy - Witteklip Vredenburg

Franschhoek Pharmacy Franschoek

Gansbaai Pharmacy Gansibaai

Clicks Pharmacy - Graanendal Cape Town

Clicks Pharmacy - Robertson Robertson

Clicks Pharmacy - Constantia Cape Town

Clicks Pharmacy-Malmesbury Malmesbury

Medi-Rite Pharmacy - Blue Downs Cape Town

Clicks Pharmacy - Weskus Mall Vredenburg

Clicks Pharmacy - Fairbridge Mall Cape Town

Clicks Pharmacy - Sable Square Cape Town

Clicks Pharmacy - Adelphi Centre Cape Town

Medi-Rite Pharmacy - Middestad Cape Town

Medi-Rite Pharmacy - Gugulethu Cape Town

Clicks Pharmacy - Pinelands (Howard Centre) Cape Town

Clicks Pharmacy - Central Square Pinelands Mossel Bay

Medi-Rite Pharmacy - Heiderand Cape Town

Medi-Rite Pharmacy - De Grendel Cape Town

Medi-Rite Pharmacy - Vineyard Cape Town

Medi-Rite Pharmacy - Bishop Lavis Cape Town

Clicks Pharmacy - Hout Bay Wellington

Clicks Pharmacy - Wellington Cape Town

Clicks Pharmacy - Gardens Centre Bredasdorp

Medi-Rite Pharmacy - Bredasdorp George



Dis-Chem George Pharmacy Cape Town

Golden Acre Pharmacy Cape Town

Clicks Pharmacy - Durbanville Cape Town

Clicks Pharmacy - Bellville (Teddington St) George

Clicks Pharmacy - George C.B.D. Beaufort West

Clicks Pharmacy - Beaufort West Paarl

Medi-Rite Pharmacy - Berg River Cape Town

Clicks Pharmacy - Cavendish Connect Cape Town

Clicks Pharmacy - Gugulethu Square Hermanus

Medi-Rite Pharmacy - Hermanus Citrusdal

Citrusdal Pharmacy Stellenbosch

Clicks Pharmacy - Stellenbosch Square Cape Town

Pick N Pay Pharmacy - Somerset Mall Cape Town

Dis-Chem Bayside Pharmacy Cape Town

Clicks Pharmacy - Regent Road Langebaan

Langebaan Pharmacy Mossel Bay

Clicks Pharmacy - Mossel Bay Mall Cape Town

Medi-Rite Pharmacy - Vasco Cape Town

Clicks Pharmacy - Westgate Mall (Mitch-ells Plain) Mossel Bay

Kwanonqaba Pharmacy Cape Town

Medi-Rite Pharmacy - Durbanville Cape Town

Pick N Pay Pharmacy - Promenade Cape Town

Chemcare Pharmacy Plettenberg Bay

Clicks Pharmacy - Plettenberg Bay Cape Town

Medi-Rite Pharmacy - Philippi Cape Town

Clicks Pharmacy - Ashers Cape Town

Clicks Pharmacy - Adderley Street George

Pick N Pay Pharmacy - George Cape Town

Medi-Rite Pharmacy - Lansdowne Corner Cape Town

Atlantis Pharmacy Stellenbosch

Stellenbosch Square Pharmacy Cape Town

Clicks Pharmacy - Capricorn Square Cape Town

Dis-Chem Blue Route Pharmacy Cape Town

Medi-Rite Pharmacy - Mh Parklands Franschhoek

Clicks Pharmacy - Franschoek Cape Town

Clicks Pharmacy - Flamingo Square Swellendam

Clicks Pharmacy - Swellendam Stellenbosch

Eikestad Mall Pharmacy Cape Town

Medi-Rite Pharmacy - Broadway Bredasdorp




Essential Health Pharmacy - Bredasdorp Cape Town

Medi-Rite Plus Pharmacy - Big Bay George

Clicks Pharmacy - George 2 (Pick N Pay) Mossel Bay

Mossel Bay Pharmacy Cape Town

Medi-Rite Pharmacy - Parow Park Cape Town

Clicks Pharmacy - Cinnamon Square Cape Town

Clicks Pharmacy - the Paddocks Cape Town

Dis-Chem Sea Point Pharmacy Caledon

Clicks Pharmacy - Caledon Cape Town

Clicks Pharmacy - Glengarry Cape Town

Clicks Pharmacy - Welgemoed Cape Town

Melopharm Pharmacy Cape Town

Clicks Pharmacy - Pinehurst Cape Town

Clicks Pharmacy - Lansdowne Vredendal

Clicks Pharmacy - Vredendal Worcester

Dis-Chem Worcester Pharmacy Cape Town

Essential Health Pharmacy - Claremont Cape Town

Clicks Pharmacy - Vergelegen Cape Town

Clicks Pharmacy - Strand Square Cape Town

Dis-Chem Zevenwacht Mall Pharmacy Cape Town

Dis-Chem Central Park Pharmacy Cape Town

Pharma-Kem Pharmacy - Strand Cape Town

Webb and Savoy Pharmacy Cape Town

Dis-Chem Noordhoek Pharmacy Cape Town

Dis-Chem Panorama Oncology Pharmacy George

Medi-Rite Pharmacy - Eden Meander Cape Town

Chemcare Pharmacy - Church Way Cape Town

Clicks Pharmacy - Atlantis Cape Town

Dis-Chem Cape Gate Pharmacy Cape Town

Medi-Rite Pharmacy - Helderberg Mall Paarl

Clicks Pharmacy - Laborie Paarl Cape Town

Melopharm Tokai Pharmacy Cape Town

Rivetts Pharmacy Cape Town

Clicks Pharmacy - 2 Long Street Mossel Bay

Dis-Chem Mosselbaai Mall Pharmacy Cape Town

Pharmacy @ Spar - Uitzicht Cape Town

Medi-Rite Pharmacy - Langa Cape Town

Dis-Chem Liberty Promenade Pharmacy Cape Town

Clicks Pharmacy - the Sanctuary Wellington

Clicks Pharmacy - Welgelee Plein Bredasdorp



Clicks Pharmacy - Bredasdorp Cape Town

Clicks Pharmacy - Prospur Cape Town

Clicks Pharmacy - Clock Tower Cape Town

Plax Chemist Cape Town

Clicks Pharmacy - Rosmead Avenue (Netcare Kenilworth Pharmacy) Cape Town

Clicks Pharmacy - Table View (Netcare Table View Pharmacy) Cape Town

Clicks Pharmacy - Tokai (Netcare Tokai Dispensary) Cape Town

Clicks Pharmacy - Kipling Street (Netcare Langeberg Pharmacy) Worcester

Clicks Pharmacy - Worcester Hermanus

Clicks Pharmacy - Whale Coast Cape Town

Pick N Pay Pharmacy - Table Bay Cape Town

Clicks Pharmacy - Erica Square Cape Town

Clicks Pharmacy - Table Bay Mall Cape Town

Dis-Chem Table Bay Mall Pharmacy Sandbaai

Dis-Chem Hermanus Pharmacy Cape Town

Culemborg Pharmacy Cape Town

Vitacare Unikem Pharmacy - Rylands Cape Town

Sunset Pharmacy Cape Town

Wynberg Pharmacy George

Protea Pharmacy George

Ress & Van Zyl Pharmacy Cape Town

Monument Pharmacy Robertson

Robertsons Pharmacy Wellington

Bergrivier Pharmacy Worcester

Homes Pharmacy Worcester

QuΘnets Pharmacy Cape Town

Essential Health Pharmacy - Brackenfell Vredenburg

Weskem Apteek Clanwilliam

Sederkem Pharmacy Worcester

Durban Street Pharmacy - Worcester Malmesbury

Geard Apteek Cape Town

Essential Health Pharmacy - Helderzicht Paarl

Drakenstein Apteek Sedgefield

Sedgefield Pharmacy Porterville

Porterville Alpha Pharmacy Cape Town

Nu-Kem Pharmacy Cape Town

Medicare Pharmacy - Retreat Cape Town

Kem-Park Pharmacy Robertson




Wynland Pharmacy Cape Town

Netcare Christiaan Barnard Memorial Pharmacy

Plettenberg Bay

Plett Medicine Depot Cape Town

Eikendal Pharmacy George

Medical Centre Pharmacy Cape Town

Cylnor Pharmacy Worcester

Narotam Pharmacy Cape Town

Broad Road Pharmacy Cape Town

Steenberg Pharmacy Cape Town

Hypermed Pharmacy Cape Town

Wavecrest Pharmacy Cape Town

Westgate Pharmacy Onrus

Onrus Pharmacy Cape Town

Khayelitsha Pharmacy Cape Town

Netcare N1 City Hospital Dispensary Cape Town

Mediplein Pharmacy Incorporated Stellenbosch

Die Boord Apteek Cape Town

Bel - Kem Pharmacy Cape Town

Cape Town Station Pharmacy Cape Town

Southern Suburbs Pharmacy Mossel Bay

Pharmacy @ Spar - Mosskem Cape Town

Athlone Pharmacy Cape Town

Lite-Kem Pharmacy Cape Town

Clicks Pharmacy - Parow (Netcare Parow Dispensary) Cape Town

Clicks Pharmacy - Parow (Netcare Parow Dispensary) Cape Town

Clicks Pharmacy - Rosmead Avenue (Netcare Kenilworth Pharmacy) Cape Town

Vitacare Pharmacy - Rondebosch Still Bay

Fynbos Pharmacy Cape Town

Clicks Pharmacy - Tokai (Netcare Tokai Dispensary) Cape Town

Ariefa's Pharmacy Cape Town

Clicks Pharmacy - Kipling Street (Netcare Langeberg Pharmacy) Cape Town

Koeberg Pharmacy Cape Town

Essential Health Pharmacy - Strand Paarl

Gys Smit Pharmacy Cape Town

Kemtique Pharmacy Cape Town

David Bloom Pharmacy Cape Town

Chavda's Pharmacy Cape Town



Rondebosch East Pharmacy Cape Town

Clicks Pharmacy - Bayside Centre Cape Town

Medi-Rite Pharmacy - Brackenfell Stellenbosch

Medi-Health Pharmacy - Stellenbosch Cape Town

Medigate Pharmacy Cape Town

Medley Pharmacy Cape Town

DIis-Chem Ballito Lifestyle Pharmacy Cape Town

Clicks Pharmacy Delft Mall Cape Town



• WHAT IS A CO-PAYMENT?

This is the part of the account that a member might have to pay out of their own pocket where benefits do not cover the treatment or medication received.

• WHAT IS THE SCHEME TARIFF?

The rate at which the Scheme pays for health services to service providers on behalf of members. It is based on the National Reference Price List published by the Department of Health.

• MUST I GIVE NOTICE TO THE SCHEME IF I WISH TO TERMINATE MEMBERSHIP?

Yes, members must comply with the notice period stipulated in the Rules.

• CAN A MINOR BECOME A MEMBER?

Yes, based on the following:

• Only if minor was a dependant on the medical aid when the main member passed away

• CAN I OR MY DEPENDANTS BELONG TO MORE THAN ONE MEDICAL SCHEME AT A TIME?

• No, the Medical Schemes Act 131 of 1998 prohibits it. No person shall be a member or dependant of more than one (1) medical scheme.

• IS MEMBERSHIP OF A MEDICAL SCHEME AVAILABLE TO ANY PERSON?

Yes, except in a restricted membership scheme, where a particular employer, profession, trade, industry, calling or association has established a scheme exclusively for its employees or members.

• MUST MY EMPLOYER SUBSIDISE MY CONTRIBUTIONS TO THE MEDICAL SCHEME?

No, subsidies are conditions of employment and the Act does not address such conditions.

• IF I DO NOT CLAIM FROM MY MEDICAL SCHEME, MAY I RECEIVE A NO-CLAIM BONUS OR REBATE?

No, the Act prohibits the payment of bonuses, rebates or re-funding of a portion of contributions other than in respect of savings accounts in certain circumstances.

• WHAT IS A DESIGNATED SERVICE PROVIDER (DSP)?

A healthcare provider or group of providers that the Scheme has chosen to provide certain medical care for Prescribed Minimum Benefits.

FAQ'S FREQUENTLY ASKED QUESTIONS

0860 104 117 (Share Call) or 021 697 9000

OPERATING HOURSContact Centre: 08h30 - 16h00, Mon - Fri

Physical Address: Cnr Trematon & Lascelles Streets, Athlone, Cape TownPostal Address: P.O. Box 134, Athlone, 7760

Email: [email protected]: www.samwumed.org

MEDSCHEMEHospital Benefit Management: 0860 33 33 87Email: [email protected]

Chronic Medicine Management: 0860 33 33 87Email: [email protected]

Oncology Management: 0860 33 33 87Email: [email protected]

HIV MANAGEMENT - Aid for AidsMember Enquiries: 0860 100 646Email: [email protected]

FRAUD HOTLINETel: 0800 112 811 SMS: 33490 (R1,50)Email: [email protected]

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AMBULANCE SERVICESNETCARE 911 Tel: 082 911

DISCLAIMER:This Member Guide is prepared and distributed for purposes of providing you with essential information to help you select the best benefit option for you and your family. It is not a full guide to the Scheme Rules and Benefits and does not supersede the Scheme Rules. All contributions and benefit options presented in the Member Guide are subject to the approval by the Council for Medical Schemes. Kindly familiarise yourself with your chosen benefit option and note where pre-authorisations, motivations and or letters of referral are required to access benefits.

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