The Chronic Illness Benefit

Malcor Plan A

Medicine cover for Chronic Disease List conditions
The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Medicine on the Chronic Illness Benefit medicine list or medicine with the same active ingredient as the medicine on the medicine list will be approved and funded up to the Maximum Medical Aid Price (MMAP).

Medicine cover for Additional Disease List conditions
You have further cover for Additional Disease List (ADL) conditions. A medicine list applies to the ADL conditions.
Medicine on the medicine list or medicine with the same active ingredient as the medicine on the medicine list will be approved and funded up to the Maximum Medical Aid Price (MMAP).

Malcor Plan B and C

Medicine cover for Chronic Disease List conditions
The Chronic Illness Benefit covers approved medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Chronic Illness Benefit medicine list (formulary) or medicine with the same active ingredient as the medicine on the medicine list will be approved and funded up to the Maximum Medical Aid Price (MMAP).

Malcor Plan A, B and C

How to access the Chronic Illness Benefit
If you want to access cover from the Chronic Illness Benefit, you must apply for it. You must complete a Chronic Illness Benefit application form with your doctor and submit it for review. If your doctor uses HealthID, your doctor can apply for cover online, provided you have given your consent.

You need to meet the benefit entry criteria for your condition(s) to be registered on the Chronic Illness Benefit. You or your doctor may need to provide certain test results or extra information as indicated on the CIB application form for the condition(s) you are applying for. Please ensure that these documents are submitted with your application to avoid any delays in the process.

Treatment baskets for your approved CDL conditions
The Chronic Illness Benefit will also cover a limited number of selected tests, procedures and specialist consultations each year for the ongoing management of your condition(s). You also have cover for four (4) GP consultations related to your approved PMB CDL condition(s) per year.

Documents for your Chronic Illness Benefit (CIB) cover:

Chronic Illness Benefit application form

 

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