Chronic Medicine Cover & Benefits
Ever tried picking a medical cover while managing diabetes, asthma, or hypertension? It’s a bit like trying to order lunch with no menu — you know what you need, but not every option has it. Chronic medicine cover isn’t just a bonus; it’s the difference between peace of mind and monthly surprises at the chemist counter.
South African medical covers are legally required to cover Prescribed Minimum Benefits (PMBs), which include 26 chronic conditions like diabetes, epilepsy, and asthma. But what about the medicines not on that list? That’s where plans start to differ — some cover non-CDL treatments generously, others limit you to specific pharmacies or slap on co-payments.
Comparative Overview of Medical Aid Providers
Provider | Plan Name | Chronic Med Limit | Network Pharmacies | Co-Payment Rules | Acute Med Source |
Fedhealth | flexiFED 1 Elect Savings Plan | Limited | Mail order pharmacy only | Not listed | Savings |
Fedhealth | flexiFED 1 Hospital Plan | No Benefit | Private network | Not listed | No Benefit |
Fedhealth | flexiFED 1 Savings Plan | Limited | Private network | Not listed | Savings |
Fedhealth | flexiFED 2 Elect Savings Plan | Limited | Mail order pharmacy only | No | Savings |
Fedhealth | flexiFED 2 GRID Savings Plan | Limited | Private network | No | Savings |
Key Considerations Before Choosing a Plan
Does the plan cover non-PMB conditions?
- Are meds restricted to a network?
- What is the chronic limit?
- Can gap cover explained here help?
FAQs
All medical schemes must cover PMB chronic conditions learn more as listed by law. Cover outside this list (non-CDL) depends on the scheme and your plan level.
Yes — if you are diagnosed and registered for a PMB condition like diabetes, your insulin and related treatments should be covered in full through the scheme's DSP (designated chemist).
Yes, for non-PMB or non-authorised items, you may use MSA funds — but note, this depletes your day-to-day benefits.