Mediscor Formulary look-up
Your medical scheme could be using custom medicine lists, also called formularies, to manage certain medicine benefits, especially the CDL PMBs (Chronic Disease List for Prescribed Minimum Benefits) and chronic benefits.
This could either be a Mediscor formulary (called Extended, Standard, Basic or Core) or a formulary from another organisation. To see if your medicines are included in the formulary, choose the relevant formulary below (listed next to your particular chronic condition. You will find an alphabetical list of all the medicines covered under that formulary.
If your medicines are included in the applicable formulary, and you have registered your condition, your medicine will automatically be covered under your PMB or chronic benefit. However, for certain medicines you may still have to obtain additional authorisation. If your medicine is marked with a "YES" under the column "Authorisation Required", then you need to obtain special authorisation from ChroniLine™, at 086 011 9553. If there is a "NO" in the column, then the medicine is automatically covered after authorisation and no further procedures are necessary. The medicines can then be obtained from your pharmacy after registration. *Please note: Medicine for CDL PMBs and other chronic conditions must in some instances, be obtained from a Designated Service Provider (DSP) and not from your usual supplier. Please acquaint yourself with your schemes' rules regarding DSPs.
If a medicine is not on the list, then it will not be covered 100% as a CDL PMB or chronic medicine. It may be covered with a co-payment as a PBM /chronic medicine, or from another benefit, or not covered at all, subject to your schemes' applicable rules.
You can contact ChroniLine™ to register your chronic condition or for queries regarding your chronic medicine.
Phone : 0860 11 9553
e-Mail : preauth@mediscor.co.za
What formulary is my scheme using?
*Please note: Within the Excel spreadsheet, please use "CTRL-F" to search for 'Medicine Name', 'Active Ingredient', 'Therapeutic Class' or 'NAPPI Code'.
Mediscor Formularies for Chronic Disease List Conditions (CDLs) - 2010
Condition |
Mediscor CDL PMB Formularies 2010 |
Addison’s Disease
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| Asthma |
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Bipolar Mood Disorder
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Bronchiectasis
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Cardiac Failure
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Cardiomyopathy
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COPD
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Chronic Renal Disease
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Coronary Artery Disease
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Crohn's Disease
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| Diabetes Insipidus |
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Diabetes Mellitus Type I
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Diabetes Mellitus Type II
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Dysrhythmias
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Epilepsy
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Glaucoma
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Haemophilia
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Hyperlipidaemia
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Hypertension
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Hypertension with Coronary Artery Disease
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Hypothyroidism
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Multiple Sclerosis
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Parkinson’s Disease
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Rheumatoid Arthritis
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Schizophrenia
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| Systemic Lupus Erythematosus |
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Ulcerative Colitis
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Other Formularies for Chronic Disease List Conditions (CDLs) - 2010
Condition |
Medicross Formulary 2010 |
Prime Cure Formulary 2010 |
Mediscor Formulary Reference Price 2010 |
Addison’s Disease
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| Asthma |
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Bipolar Mood Disorder
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Bronchiectasis
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Cardiac Failure
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Cardiomyopathy
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COPD
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Chronic Renal Disease
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| Coronary Artery Disease |
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Crohn's Disease
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| Diabetes Insipidus |
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Diabetes Mellitus Type I
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Diabetes Mellitus Type II
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Dysrhythmias
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Epilepsy
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Glaucoma
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Haemophilia
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Hyperlipidaemia
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Hypertension
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Hypothyroidism
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Multiple Sclerosis
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Parkinson’s Disease
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Rheumatoid Arthritis
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Schizophrenia
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| Systemic Lupus Erythematosus |
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Ulcerative Colitis
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Spectramed Chronic Formularies - 2010
Condition |
Spectramed Plus |
Spectramed Elite |
Spectramed Alliance |
Spectramed Hospital and Hospital Elite
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CDL conditions
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Addison’s Disease
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| Asthma |
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Bipolar Mood Disorder
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Bronchiectasis
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Cardiac Failure
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Cardiomyopathy
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COPD
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Chronic Renal Disease
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| Coronary Artery Disease |
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Crohn's Disease
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| Diabetes Insipidus |
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Diabetes Mellitus Type I
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Diabetes Mellitus Type II
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Dysrhythmias
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Epilepsy
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Glaucoma
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Haemophilia
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Hyperlipidaemia
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Hypertension
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Hypothyroidism
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Multiple Sclerosis
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Parkinson’s Disease
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Rheumatoid Arthritis
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Schizophrenia
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| Systemic Lupus Erythematosus |
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Ulcerative Colitis
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Additional chronic conditions
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Alzheimer’s Disease
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| Ankylosing Spondylitis |
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Attention Deficit Hyperactivity Disorder
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Benign Prostatic Hypertrophy
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Cystic Fibrosis
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Endometriosis
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Gord
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| Gout |
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Obsessive Compulsive Disorder
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| Osteo-Arthritis |
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Osteoporosis
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| Paget’s Disease |
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Psoriasis
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| Wilson’s Disease |
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Members are advised to verify that their relevant conditions are covered by their Medical Scheme.
Mediscor Formularies for non-CDL Chronic Conditions - 2010
Condition |
Mediscor Chronic Disease Formularies 2010 |
Mediscor FRP |
Mediscor FRP Plus |
Acne
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| Allergic Rhinitis |
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| Alzheimer's Disease |
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| Ankylosing Spondylitis |
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| Anxiety Disorder |
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| Aplastic Aneamia |
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| Attention Deficit Hyperactivity Disorder |
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Barrets Disease
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Benign Prostatic Hypertrophy
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Cerebral Palsy
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Chronic Anaemia
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Collagen Disease
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Cystic Fibrosis
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| Deep Vein Thrombosis |
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| Depression |
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| Dermatomyositis |
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Eczema
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Embolism and Thrombosis
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Endocarditis
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Endometriosis
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Fibrosing Alveolitis
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| Gord |
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Gout
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Graves Disease
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Hyperthyroidism
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Hypoparathyroidism
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Hypophyseal Adenoma
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Hypopituitarism
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Incontinence
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| Menopause |
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| Migraine |
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Motor Neuron Disease
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Muscular Dystrophy
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Myasthenia Gravis
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Narcolepsy
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Neuropathy
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Obsessive Compulsive Disorder
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Oncology Pain
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Osteo-Arthritis
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Osteopenia
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| Osteoporosis |
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Paget's Disease
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Panic Disorder
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Paraplegia
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Paroxysmal Tachycardia
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Pemphigus
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Peripheral Vascular Disease
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Phlebitis and Thrombophlebitis
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Pituitary Disease
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Pituitary Microadenomas
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Polyarteritis Nodosa
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Polycystic Ovarian Syndrome
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Post Traumatic Stress Syndrome
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Pregnancy
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Prolactinoma
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| Psoriasis |
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| Psoriatic Arthritis |
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Psychotic Disorders
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Pulmonary Embolism
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Pulmonary Interstitial Fibrosis
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Quadriplegia
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Sarcoidosis
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Scleroderma
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| Sjogrėns Disease |
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| Stroke |
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| Systemic Sclerosis |
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| Thromboangiitis Obliterans |
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| Thrombocytopenic Purpura |
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| Tourette's Syndrome |
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| Trigeminal Neuralgia |
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| Unipolar Disorder |
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| Valvular Heart Disease |
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| Vertigo |
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| Wilson's Disease |
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Other Formularies
| Scheme |
Acute Formulary |
OTC |
Chronic |
| |
|
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| Getmed |
|
|
- |
| Medicross |
|
- |
- |
| Prime Cure |
|
- |
- |
| Compcare Networx |
|
- |
- |
| |
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Disclaimer
| Please note that the Mediscor Formularies are reviewed regularly by the Mediscor Pharmaceutical and Therapeutics Committee to ensure that they comply with the latest industry norms for the treatment of these conditions. Mediscor PBM Pty Ltd reserves the right to change medicines to comply with the latest industry norms for the treatment of the listed conditions. Mediscor PBM Pty Ltd reserves the right to change medicines included in the formulary when important or new information is made available, e.g. on new findings regarding the safety of medicine. |
Reservation of Copyright
| Mediscor PBM reserves its copyright and all its other rights in or in respect of the Mediscor Formularies. No part of the Mediscor Formularies may be reproduced, photocopied, recorded or stored in any retrieval system, or transmitted by any means, electronic, mechanical or otherwise, without the written permission of Mediscor PBM. |
Last update: 1 January 2010
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