dsp for chronic pmb medicine Dimension Prime network range DSP

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