You may have noted media coverage regarding the voluntary use of pharmacies and the use of Designated Service Providers (DSPs) and co-payments for medicine in particular, by your medical scheme. This is due to a Department of Health Notice, which aims to standardise how medical schemes select healthcare providers as DSPs to provide diagnosis and treatment in respect of prescribed minimum benefits.
The Council for Medical Schemes (CMS) will publish guidelines to assist the scheme with any changes to their rules and benefits that may be required and this will only become available towards the end of September 2021. Therefore, we would like to reassure our you that the current medical scheme rules as approved and registered by the CMS and current benefit structure will remain as is until the medical schemes have received this clarity from the CMS.
In the interim, you can continue to access all network pharmacies and Pharmacy Direct as you have done in the past, in line with the Scheme Rules for your particular option.
We are in the process of evaluating this Notice and will submit written comments to the CMS to request clarity where needed.
Please rest assured that we will always act in the best interests of you and your beneficiaries and will take all steps necessary to ensure that we continue to provide you with affordable, quality healthcare.