Chronic Benefit

If you choose Connect Networkopen_in_new hospitals, you need to obtain your chronic prescription, medication and treatment from State facilities. If you voluntarily choose to get your chronic medication from a non-State pharmacy, or chronic medication that is not on the State formulary, co-payments may apply.

If you choose Ingwe Network hospitalsopen_in_new or Any hospital, benefits are only available from your chosen Ingwe Primary Care Networkopen_in_new provider and are subject to a Fixed formulary for medicine. Chronic medication is delivered via Medipost courier pharmacy.

You must choose one of the designated State facilities to get your chronic prescription and medication, subject to the State formulary and medical management (including the doctor, pharmacy, blood tests, x-rays, etc.).

If you voluntarily choose to get your chronic medication from a non-State pharmacy or outside of the State formulary, co-payments may apply.

The chronic provider that you have chosen determines how you get your chronic prescription and medication.

Any provider
You may get your chronic prescription and medication from any provider, subject to your option-specific formulary.

If you choose to get your medication from the preferred list of medicines and within the generic reference price, if applicable, you will not pay a co-payment. If you choose to get your medication from outside the formulary (i.e. non-preferred items), a co-payment is payable.

A dispensing fee co-payment may also be payable when using pharmacies not contracted to Momentum Medical Scheme.

Associated provider
You need to get your chronic prescription from an Associated GPget_app and your chronic medication from Medipost, subject to an entry-level formulary.

If you choose to get your medication from outside the formulary, or your chronic prescription from a non-Associated GP, or your chronic medication from a pharmacy other than Medipost, copayments will apply. These co-payments will vary depending on your option.

State provider
You need to choose one of the designated State facilities to get your chronic prescription and medication, subject to the State formulary and medical management (including the doctor, pharmacy, blood tests, x-rays etc.).

If you choose to get your chronic medication from outside the State formulary, or your chronic medication from a pharmacy other than the State, co-payments will apply. These co-payments will vary depending on your option.

You have the freedom of choice to get your chronic prescription and medication from any provider, subject to a comprehensive formulary.

You have the freedom of choice to get your chronic prescription and medication from any provider, subject to a comprehensive formulary. A co-payment is payable if you choose to get your medication from outside the formulary. A dispensing fee co-payment may also be payable when using pharmacies not contracted to Momentum Medical Scheme.