More information on medicine and chronic conditions

Your have extensive and flexible cover for chronic conditions, HIV and AIDS and cancer.

Cover for chronic conditions

If you are diagnosed with one or more of the Chronic Disease List conditions, you have full cover for approved medicine on the Scheme’s medicine list (formulary). We pay for approved medicine up to a maximum of the Scheme medication Rate. Please note that the medicine list (formulary) may change from time to time.

With every change to the medicine authorised for your condition, or if you’re diagnosed for the first time with a listed chronic illness condition, you and your doctor will have to complete an application form. You may get this from the Scheme’s website or by calling 0860 103 933.

To apply your doctor would need to complete the Chronic Illness Benefit application form and send it back to us for review:

Email cib_app_forms@discovery.co.za

Fax: 011 539 7000

  Anglovaal Chronic Illness Benefit guide

Additional cover

You have cover for an additional 22 chronic conditions on our Additional Disease List. These conditions are covered up to a monthly Chronic Drug Amount. If your medicine for any of the additional chronic conditions costs more than the Chronic Drug Amount, you’ll need to pay the rest from your pocket.

Prescribed Minimum Benefits (PMBs)

What we cover as a Prescribed Minimum Benefit:

We cover the diagnosis, consultations and medicine for a defined list of chronic conditions including HIV, AIDS and Cancer according to the Prescribed Minimum Benefit treatment guidelines.

The Chronic Illness Benefit covers a limited number of diagnostic tests and consultations for these conditions. The benefit includes tests and consultations for both the diagnosis and management of each condition. These tests and consultations are grouped into “baskets of care”, depending on the member’s condition. Discovery Health manages the baskets of care for Anglovaal Group Medical Scheme, and SwiftProtocolManager manages the approval of medicines. For more information on the baskets of care, please call 0860 100 693.

The Oncology Programme

You have cover for treating cancer through our Oncology Programme:

Our case managers will coordinate your cancer benefits together with your treating doctor. We’ll approve your treatment as long as it is in line with our clinical guidelines and up to the annual limit. We’ll send you these treatment guidelines when you register on the Oncology Programme.

The DiscoveryCare Programme

Your cover for HIV and AIDS        

For members living with HIV and AIDS, the HIVCare Programme provides comprehensive disease management.  We take utmost care to protect the right to privacy and confidentiality of our members.

To have access to cover for hospitalisation for conditions related to HIV and to antiretroviral therapy, you must enrol on the HIVCare Programme.   

HIV and AIDS are covered through our DiscoveryCare Programme. For more information contact: 0860 100 417. This information is kept strictly confidential.

HIV prophylactics

We cover HIV prophylactics should you need to prevent HIV infection from mother-to-child transmission, occupational and traumatic exposure to HIV or sexual assault, call us on 0860 100 417.