| Please Note: There is a serious problem with the dispensing fee promulgated by GEMS for Government Employees.Contact us for details.
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| SPECIAL NOTE: # – Changes since last list and highlighted in Bold | |||||||||
| EFFECTIVE JUNE 2012 | |||||||||
| SCHEME / PLAN/ OPTIONS | ADMINISTRATOR | FAMCHECK | MARK-UP/DISPENSING FEE % (Incl. VAT) | MMAP, REF or URP | |||||
| SEP PRODUCTS | NON-SEP PRODUCTS | ||||||||
| A | AECI DD | MedScheme | |||||||
| AECI P&C | MedScheme | ||||||||
| AFROX BASE ACUTE | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 35 | N | ||||
| AFROX BASE CHRONIC | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 35 | N | ||||
| AFROX P&C | MHG | F | |||||||
| ALLIANCE MIDMED DD | Momentum | F | |||||||
| ALLIANCE MIDMED P&C | Momentum | F | |||||||
| ALTRON DD | Discovery | F | |||||||
| ALTRON P&C | Discovery | F | |||||||
| ANGLO MEDICAL MANAGED CARE ACUTE | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% – Max R18.24 | N | ||||
| ANGLO MEDICAL MANAGED CARE CHRONIC | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% – Max R18.24 | Y | ||||
| ANGLO MEDICAL MANAGED CARE GP & SPECIALIST | Momentum | F | |||||||
| ANGLO MEDICAL STANDARD ACUTE | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% – Max R18.24 | Y | ||||
| ANGLO MEDICAL STANDARD CHRONIC | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% – Max R18.24 | Y | ||||
| ANGLO MEDICAL STANDARD GP & SPECALIST | Momentum | F | |||||||
| ANGLO VALUE CARE GP P&C | Prime Cure | ||||||||
| ANGLO VALUE CARE SPECIALIST P&C | Prime Cure | ||||||||
| ANGLOVAAL DD | Discovery | F | |||||||
| ANGLOVAAL P&C | Discovery | F | |||||||
| B | BANKMED BASIC ACUTE | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | N | |||
| BANKMED BASIC CHRONIC (PMB ONLY) | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| BANKMED COMPREHENSIVE ACUTE | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | N | ||||
| BANKMED COMPREHENSIVE CHRONIC | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| BANKMED COMPREHENSIVE GP & SPECIALIST | MHG | F | |||||||
| BANKMED CORE SAVER ACUTE | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | N | ||||
| BANKMED CORE SAVER CHRONIC | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| BANKMED CORE SAVER GP & SPECIALIST | MHG | F | |||||||
| BANKMED NAMIBIA GP & SPECIALIST | MHG | F | |||||||
| BANKMED PLUS ACUTE | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| BANKMED PLUS CHRONIC | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| BANKMED PLUS GP & SPECIALIST | MHG | F | |||||||
| BANKMED TRADITIONAL ACUTE | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| BANKMED TRADITIONAL CHRONIC | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| BANKMED TRADITIONAL GP & SPECIALIST | MHG | F | |||||||
| BARLOWORLD DD | MedScheme | ||||||||
| BARLOWORLD P&C | MedScheme | ||||||||
| BCIMA (Building & Construction Industry) | Universal Health | F | |||||||
| BCIMA (Building & Construction Industry) | Universal Health | F | |||||||
| BESTMED PULSE 1 GP P&C | Prime Cure | F | |||||||
| BESTMED PULSE 1 SPECIALIST P&C | Prime Cure | F | |||||||
| BESTMED DD | Bestmed | ||||||||
| BESTMED P&C | Bestmed | ||||||||
| BIMAF (BUILDING INDUSTRY) | Building Industries | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | N | ||||
| BIMAF GP & SPECIALIST | Building Industries | F | |||||||
| BMW DD | MedScheme | ||||||||
| BMW P&C | MedScheme | ||||||||
| BONITAS BONCAP GP P&C | Prime Cure | F | |||||||
| BONITAS BONCAP SPECIALIST P&C | Prime Cure | F | |||||||
| BONITAS DD | MedScheme | ||||||||
| BONITAS P&C | MedScheme | ||||||||
| BP DD | MHG | ||||||||
| BP P&C | MHG | ||||||||
| C | CAMAF ALLIANCE ACUTE | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | N | |||
| CAMAF ALLIANCE CHRONIC | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| CAMAF DOUBLE PLUS ACUTE | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | N | ||||
| CAMAF DOUBLE PLUS CHRONIC | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| CAMAF ESSENTIAL CHRONIC | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| CAMAF FIRST CHOICE ACUTE | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| CAMAF FIRST CHOICE PMB | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| CAMAF VITAL CHRONIC | Eternity | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| CAPE MEDICAL PLAN DD | Cape Medical Plan | ||||||||
| CAPE MEDICAL PLAN P&C | Cape Medical Plan | ||||||||
| COMPCARE DD | Universal Health | F | |||||||
| COMPCARE P&C | Universal Health | F | |||||||
| D | DE BEERS DD | De Beers | F | ||||||
| DE BEERS P&C | De Beers | F | |||||||
| DISCOVERY DD | Discovery | F | |||||||
| DISCOVERY P&C | Discovery | F | |||||||
| DISCOVERY KEYCARE DD | Discovery | F | |||||||
| DISCOVERY KEYCARE P&C | Discovery | F | |||||||
| E | ELLERINE HOLDINGS DD | MedScheme | |||||||
| ELLERINE HOLDINGS P&C | MedScheme | ||||||||
| ENGEN DD | MHG | F | |||||||
| ENGEN P&C | MHG | F | |||||||
| EYETHUMED DD | MedScheme | ||||||||
| EYETHUMED P&C | MedScheme | ||||||||
| EYETHUMED PRIME CURE GP P&C | Prime Cure | ||||||||
| F | FEDHEALTH DD | MedScheme | |||||||
| FEDHEALTH P&C | MedScheme | ||||||||
| FISHMED DD | MHG | F | |||||||
| FISHMED P&C | MHG | F | |||||||
| G | GEMS BERYL & SAPPHIRE DD | MHG | |||||||
| GEMS BERYL & SAPPHIRE P&C | MHG | ||||||||
| GEMS EMERALD, ONYX & RUBY DD | MHG | ||||||||
| GEMS EMERALD, ONYX & RUBY P&C | MHG | ||||||||
| GENESIS COMPREHENSIVE CHRONIC | Genesis | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) | N | ||||
| GENESIS COMPREHENSIVE PMB CHRONIC | Genesis | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) | Y | ||||
| GENESIS PRIVATE PLUS CHRONIC | Genesis | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) | N | ||||
| GENESIS PRIVATE PLUS & COMPREHENSIVE ACUTE | Genesis | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64 Max R29.64 | N | ||||
| GENESIS PRIVATE PLUS PMB CHRONIC | Genesis | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 18.24% (Incl. VAT) – Max R18.24 (Incl. VAT) | Y | ||||
| GOLDEN ARROW DD | MHG | F | |||||||
| GOLDEN ARROW P&C | MHG | F | |||||||
| GOLDFIELDS DD | Providence | F | |||||||
| GOLDFIELDS P&C | Providence | F | |||||||
| GOLDFIELDS PRIDE GP P&C | Prime Cure | ||||||||
| GRINTEK DD | Universal Health | F | |||||||
| GRINTEK P&C | Universal Health | F | |||||||
| H | HARMONY HEALTH SERVICES DD | Providence | F | ||||||
| HARMONY HEALTH SERVICES P&C | Providence | F | |||||||
| I | IBM DD | Discovery | F | ||||||
| IBM P&C | Discovery | F | |||||||
| IMPALA DD | Providence | F | |||||||
| IMPALA P&C | Providence | F | |||||||
| IMPERIALMED DD | MHG | ||||||||
| IMPERIALMED P&C | MHG | ||||||||
| K | KEYCARE DD | Discovery | F | ||||||
| KEYCARE P&C | Discovery | F | |||||||
| KEYHEALTH EQUILIBRIUM ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH EQUILIBRIUM CHRONIC | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH EQUILIBRIUM GP & SPECIALIST | PMSA | F | R0-R100: 41.04% >R100.01; R41.04 |
R0-R100: 41.04% >R100.01; R41.04 |
Y | ||||
| KEYHEALTH ESSENCE ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH ESSENCE CHRONIC (PMB ONLY) | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH ESSENCE GP & SPECIALIST | PMSA | F | R0-R100: 41.04% >R100.01; R41.04 |
R0-R100: 41.04% >R100.01; R41.04 |
Y | ||||
| KEYHEALTH GOLD ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH GOLD CHRONIC (PMB ONLY) | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH GOLD GP & SPECIALIST | PMSA | F | R0-R100: 41.04% >R100.01; R41.04 |
R0-R100: 41.04% >R100.01; R41.04 |
Y | ||||
| KEYHEALTH PLATINUM ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH PLATINUM CHRONIC | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH PLATINUM GP & SPECIALIST | PMSA | F | R0-R100: 41.04% >R100.01; R41.04 |
R0-R100: 41.04% >R100.01; R41.04 |
Y | ||||
| KEYHEALTH SILVER ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH SILVER CHRONIC | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 0-R64.99: 34.20&, Max R22.80 | Y | ||||
| KEYHEALTH SILVER GP & SPECIALIST | PMSA | F | R0-R100: 41.04% >R100.01; R41.04 |
R0-R100: 41.04% >R100.01; R41.04 |
Y | ||||
| L | LA HEALTH DD | Discovery | F | ||||||
| LA HEALTH KEYCARE DD | Discovery | F | |||||||
| LA HEALTH KEYCARE P&C | Discovery | F | |||||||
| LA HEALTH P&C | Discovery | F | |||||||
| LIBCARE DD | VMed | ||||||||
| LIBCARE P&C | VMed | ||||||||
| LIBERTY DD | MedScheme | ||||||||
| LIBERTY P&C | MedScheme | ||||||||
| LONMIN DD | Discovery | F | |||||||
| LONMIN P&C | Discovery | F | |||||||
| M | MAMOTH DD ACUTE | Mamoth Health | Y | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | N | |||
| MAMOTH DD CHRONIC | Mamoth Health | Y | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | N | ||||
| MASSMART DD | MedScheme | ||||||||
| MASSMART P&C | MedScheme | ||||||||
| MBMED DD | MedScheme | ||||||||
| MBMED P&C | MedScheme | ||||||||
| MEDIHELP DD | Medihelp | F | |||||||
| MEDIHELP P&C | Medihelp | F | |||||||
| MEDIMED DD | Providence | F | |||||||
| MEDIMED P&C | Providence | F | |||||||
| MEDIPOS DD | MHG | F | |||||||
| MEDIPOS P&C | MHG | F | |||||||
| MEDSHIELD DD | Medshield | ||||||||
| MEDSHIELD P&C | Medshield | ||||||||
| METROCARE FULL BENEFIT DD | MedScheme | ||||||||
| METROCARE FULL BENEFIT P&C | MedScheme | ||||||||
| METROPOLITAN STAFF DD | MHG | ||||||||
| METROPOLITAN STAFF P&C | MHG | ||||||||
| MINEMED AFFORDABLE GP P&C | Prime Cure | ||||||||
| MINEMED DD | Providence | F | |||||||
| MINEMED P&C | Providence | F | |||||||
| MOMENTUM ACCESS (MEDICROSS) GP P&C | Prime Cure | ||||||||
| MOMENTUM ACCESS (MEDICROSS) SPECIALIST P&C | Prime Cure | ||||||||
| MOMENTUM ACCESS GP P&C | Prime Cure | ||||||||
| MOMENTUM ACCESS SPECIALIST P&C | Prime Cure | ||||||||
| MOMENTUM DD | Momentum | F | |||||||
| MOMENTUM P&C | Momentum | F | |||||||
| MOREMED DD | Lethimvula | ||||||||
| MOREMED P&C | lethimvula | ||||||||
| MOTO HEALTHCARE DD | Momentum | F | |||||||
| MOTO HEALTHCARE P&C | Momentum | F | |||||||
| N | NAMPAK DD | Momentum | F | ||||||
| NAMPAK P&C | Momentum | F | |||||||
| NATIONAL BARGAINING COUNCIL FOR THE ROAD FREIGHT AND LOGISTICS INDUSTRY (NBCRFLI) DD | Universal Health | ||||||||
| NATIONAL BARGAINING COUNCIL FOR THE ROAD FREIGHT AND LOGISTICS INDUSTRY (NBCRFLI) P&C | Universal Health | ||||||||
| NASPERS DD | Discovery | F | |||||||
| NASPERS MMED DD | Discovery | F | |||||||
| NASPERS MMED P&C | Discovery | F | |||||||
| NASPERS P&C | Discovery | F | |||||||
| NEDGROUP P&C | Medscheme | ||||||||
| NETCARE DD | MHG | ||||||||
| NETCARE P&C | MHG | ||||||||
| NIMAS DD | MHG | F | |||||||
| NIMAS P&C | MHG | F | |||||||
| O | OM STAFF DD | Medscheme | |||||||
| OM STAFF P&C | Medscheme | ||||||||
| P | PARMED DD | Medscheme | |||||||
| PARMED P&C | Medscheme | ||||||||
| PG GROUP DD | MHG | ||||||||
| PG GROUP P&C | MHG | ||||||||
| PICK N PAY ACUTE | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PICK ‘N PAY CHRONIC | MHG | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PICK N PAY P&C | MHG | F | |||||||
| POLMED DD | MHG | ||||||||
| POLMED P&C | MHG | ||||||||
| PROFMED PROACTIVE GP & SPECIALIST (AUTHORISED PMB AND SCREENING TESTS ) | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROACTIVE PMB CHRONIC | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROPINACCLE CHRONIC | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROPINNACLE ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROPINNACLE GP & SPECIALIST | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROSECURE ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROSECURE CHRONIC | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROSECURE GP & SPECIALIST | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROSECURE PLUS ACUTE | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROFMED PROSECURE PLUS CHRONIC | PMSA | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| PROSANO DD | Prosano | ||||||||
| PROSANO P&C | Prosano | ||||||||
| Q | QUANTUM DD | Discovery | F | ||||||
| QUANTUM KEYCARE DD | Discovery | F | |||||||
| QUANTUM KEYCARE P&C | Discovery | F | |||||||
| QUANTUM P&C | Discovery | F | |||||||
| R | RAND WATER PLAN A ACUTE | Rand Water | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | |||
| RAND WATER PLAN A CHRONIC | Rand Water | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | N | ||||
| RAND WATER PLAN B PLUS ACUTE | Rand Water | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RAND WATER PLAN B PLUS CHRONIC | Rand Water | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| REMEDI DD | Discovery | F | |||||||
| REMEDI P&C | Discovery | F | |||||||
| RESOLUTION FOUNDATION CHRONIC (PMB ONLY) | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION HOSPITAL CHRONIC (PMB ONLY) | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION PRESTIGE ACUTE | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION PRESTIGE CHRONIC | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION PROGRESSIVE FLEX ACUTE | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION PROGRESSIVE FLEX CHRONIC (PMB ONLY) | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION PROGRESSIVE SAVER ACUTE | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION PROGRESSIVE SAVER CHRONIC (PMB ONLY) | Agility Global Health | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 29.64% Max R29.64 (Incl VAT) | Y | ||||
| RESOLUTION HL P&C | Agility Global Health | F | |||||||
| RETAIL DD | Discovery | F | |||||||
| RETAIL P&C | Discovery | F | |||||||
| RUMED DD | Providence | F | |||||||
| RUMED P&C | Providence | F | |||||||
| S | SABC DD | MedScheme | |||||||
| SABC P&C | MedScheme | ||||||||
| SAB ESSENTIAL ACUTE | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| SAB ESSENTIAL CHRONIC | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| SAB ESSENTIAL GP | Momentum | F | |||||||
| SAB COMPREHENSIVE GP & SPECIALIST | Momentum | F | |||||||
| SAB COMPREHENSIVE ACUTE | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| SAB COMPREHENSIVE CHRONIC | Momentum | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | ||||
| SAMWUMED DD | SAMWUMED | F | |||||||
| SAMWUMED P&C | SAMWUMED | F | |||||||
| SAPPI ACUTE | MHG | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | |||||
| SAPPI CHRONIC | MHG | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | |||||
| SAPPI P&C | MHG | ||||||||
| SASOLMED DD | MedScheme | ||||||||
| SASOLMED P&C | MedScheme | ||||||||
| SELFMED DD | VMED | ||||||||
| SELFMED P&C | VMED | ||||||||
| SIZWE DD | Sizwe | ||||||||
| SIZWE P&C | Sizwe | ||||||||
| SPECTRAMED DD | VMED | ||||||||
| SPECTRAMED P&C | VMED | ||||||||
| SUREMED EXPLORER GP P&C | Prime Cure | ||||||||
| SUREMED HEALTH DD | Providence | F | |||||||
| SUREMED HEALTH P&C | Providence | F | |||||||
| SWAZIMED DD | MedScheme | ||||||||
| SWAZIMED P&C | Medscheme | ||||||||
| T | TFG DD (Formerly Foschini) | Discovery | F | ||||||
| TFG P&C (Formerly Foschini) | Discovery | F | |||||||
| THLAKANO LEGALWISE GP P&C | Prime Cure | ||||||||
| THLAKANO BASIC GP P&C | Prime Cure | ||||||||
| THLAKANO COMPREHENSIVE GP P&C | Prime Cure | ||||||||
| THLAKANO MAHALA GP P&C | Prime Cure | ||||||||
| THLAKANO MBD GP P&C | Prime Cure | ||||||||
| THLAKANO MBP-MED GP P&C | Prime Cure | ||||||||
| THLAKANO MDB-HEALTH GP P&C | Prime Cure | ||||||||
| THLAKANO ST DAVIDS SCHOOL GP P&C | Prime Cure | ||||||||
| TIGER BRANDS DD | Universal Health | F | |||||||
| TIGER BRANDS P&C | Universal Health | F | |||||||
| TOPMED DD | Momentum | F | |||||||
| TOPMED P&C | Momentum | F | |||||||
| TRANSMED DD | MHG | F | |||||||
| TRANSMED P&C | MHG | F | |||||||
| TRANSMED STATE & NETWORK GP P&C | Prime Cure | ||||||||
| TRANSMED STATE & NETWORK SPECIALIST P&C | Prime Cure | ||||||||
| TSOGO DD | Discovery | F | |||||||
| TSOGO P&C | Discovery | F | |||||||
| U | UMVUZO STANDARD GP P&C | Prime Cure | |||||||
| UMVUZO ULTRA AFFORDABLE GP P&C | Prime Cure | ||||||||
| UNIVERSITY OF KWA-ZULU NATAL DD | Discovery | F | |||||||
| UNIVERSITY OF KWA-ZULU NATAL P&C | Discovery | F | |||||||
| UNIVERSITY OF WITWATERSRAND DD | MedScheme | ||||||||
| UNIVERSITY OF WITWATERSRAND P&C | MedScheme | ||||||||
| W | WITBANK COALFIELDS ACUTE | WCMAS | F | R0-R78: 34.20% (Incl. VAT) Max R26.68 (Incl. VAT) | 36 | Y | |||
| WITBANK COALFIELDS GP & SPECIALIST | WCMAS | F | |||||||
| WOOLTRU DD | MHG | F | |||||||
| WOOLTRU P&C | MHG | F | |||||||
| WORKER PLAN DD | Universal Health | F | |||||||
| WORKER PLAN P&C | Universal Health | F | |||||||
| X | XSTRATA ALLOYS DD | MedScheme | |||||||
| XSTRATA ALLOYS P&C | MedScheme | ||||||||
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| MMAP = Maximum Medical Scheme Price | |||||||||
| REF = Reference Pricing REF = Reference Pricing REF = Reference Pricing REF = Reference Pricing |
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| URP = Unit Reference Pricing | |||||||||
| MMAP, REF or URP: If Y, one or more may apply, if N, None Applies | |||||||||
| FAMCHECK/AUTHCHECK (Dependant on Vendor Development): F = FamilyCheck, A= AuthCheck, Blank = Not available | |||||||||
| CLAIM TYPE: DD = Dispensing, P&C = Procedures and Consults | |||||||||
| OPTION TYPE: HL = Delivery ONLY, P = Processing | |||||||||
| PRICING: Y= Yes, Blank = No | |||||||||
| Consultation and Procedure Tariffs: as per NRPL Guidelines | |||||||||
Patient management. Medical Billing. Revenue cycle management.