Organisation : Momentum Health
Facility : Apply For Chronic Benefits
Location : Centurion
Website : http://www.ingwehealth.co.za/
Download Guideline : https://www.southafricain.com/uploads/7506-ChronicBenefit.pdf
Apply For Chronic Benefits :
** The Chronic Benefit covers certain life-threatening conditions that need ongoing treatment and includes cover for the 26 Chronic Disease List conditions, which form part of the Prescribed Minimum Benefits.
Related : Imperial Group Medical Scheme : www.southafricain.com/4693.html
** Chronic benefits are subject to registration and approval.
** You need to get your chronic prescription from an Ingwe Active Network doctor, and benefits are subject to the Network entry-level formulary, which is a list of medication.
** Your chronic medication will be delivered by Medipost pharmacy.
** Ask your Ingwe Active Network doctor to call us on 0860 11 78 59.
** The chronic benefit consultant will approve or decline the benefit telephonically.
** Additional information may be required from your provider, such as test results, in order to complete the registration process for your condition or medicine.
** You need to send your prescription to Medipost Pharmacy and let them know where your medication(s) should be delivered to.
How to obtain Chronic Benefits :
** You need to get your chronic prescription from your Ingwe Primary Care Network or Ingwe Active Primary Care Network doctor, and your chronic medication from Medipost pharmacy.
** Remember that benefits are subject to the Network entry-level formulary.
** A formulary is a list of medicines covered on your option, from which a doctor can prescribe the appropriate medication for your chronic condition.
** If your treating doctor prescribes medicine that is not on the formulary and the medicine is clinically appropriate, then you would need to pay a 30% co-payment.
How to register for chronic medication :
** Ask your Primary Care doctor to phone us on 0860 11 78 59. Should your doctor fill out the Ingwe Chronic application form, this can be faxed or emailed to us.
** The chronic benefit consultant will either approve or decline the benefit telephonically.
** We may need additional information from your doctor, such as the correct ICD 10 code (diagnosis code) and applicable test results, in order to complete the registration process for your condition or medicine.
** Once your chronic registration has been approved, you need to send your prescription to Medipost to arrange for your chronic medication to be delivered to you.
** You can contact Medipost on 012 426 4000, email at mhealth AT medipost.co.za or fax on 0866 82 33 17.
Important Notes :
** You need to register on the chronic management programme and get approval for chronic medication to be paid from the Chronic Benefit.
** Please refer to the list of chronic conditions in your member brochure for more information on the conditions covered on your option.
** Our chronic management programmes ensure that each member who registers for a chronic condition receives the most appropriate treatment and medication.
** When a chronic illness is managed effectively, it results in fewer acute and long-term medical complications or side effects. Momentum Health uses set guidelines and protocols to clinically assess every Chronic Benefit application to make sure that the medicines used are appropriate, cost-effective and prescribed in the correct therapeutic dosages.
Medipost’s contact details :
Tel: 012 426 40 00
Fax: 0866 82 33 17