The Scheme has a continuously evolving list of high-cost drugs used for the treatment of oncology and certain chronic conditions such as inflammatory arthritides, inflammatory bowel disease, chronic demyelinating polyneuropathies, chronic hepatitis, and so on.

Where the use of such specialised drugs (if on the published list of approved drugs) is motivated by your doctor and approved by the Scheme, the drugs will be funded from your higher Hospital and Trauma Benefit limits, rather than from your Everyday Services Benefits provided you are registered on the Traditional, Comprehensive or Platinum Plan. In order to access this benefit, members on the Hospital or Savings Plan will have upgrade their Plan.

If you (or your healthcare provider) would like to apply for specialised drugs, remember that applications should be sent to Medscheme and not ScriptPharm. Applications take five working days to be considered for approval.