CDL – CHRONIC DISEASE LIST
- By law, each scheme must cover the medicine and treatment for 27 Chronic Diseases. These are listed below.
- For every CDL condition there is a basic treatment plan. This can include consultations, pathology and radiology and medicine.
- Each Scheme must pay for this treatment plan out of risk, without forcing you to have out-of-pocket expenses.
PAYMENT FOR CHRONIC MEDICINE
- However, each Scheme is allowed to:
- set its own protocols,
- insist that you to use Designated Service Providers (DSP) and
- enforce a pre-set list of acceptable medicines per each condition.
- If you deviate from any of these, you might incur out-of-pocket expenses
- Discovery has a set reference price for each medicine, and will not pay more than that price for a medicine
FORMULARIES
- A formulary is a list of medicines that a Scheme will pay for, per condition
- Using a medicine that is not on the formulary will usually result in a co-payment
| All the plans | ||
|---|---|---|
| CDL 1 | Addison’s Disease | Yes |
| CDL 2 | Asthma | Yes |
| CDL 3 | Bipolar Mood Disorder | Yes |
| CDL 4 | Bronchiectasis | Yes |
| CDL 5 | Cardiomyopathy | Yes |
| CDL 6 | Chronic Renal Failure | Yes |
| CDL 7 | COPD | Yes |
| CDL 8 | Congestive Heart Failure | Yes |
| CDL 9 | Coronary Artery Disease | Yes |
| CDL 10 | Crohn’s Disease | Yes |
| CDL 11 | Diabetes Insipidius | Yes |
| CDL 12 | Diabetes Mellitus Type 1 | Yes |
| CDL 13 | Diabetes Mellitus Type 2 | Yes |
| CDL 14 | Dysrhythmia | Yes |
| CDL 15 | Epilepsy | Yes |
| CDL 16 | Glaucoma | Yes |
| CDL 17 | Haemophilia | Yes |
| CDL 18 | HIV/AIDS | Yes |
| CDL 19 | Hyperlipidaemia | Yes |
| CDL 20 | Hypertension | Yes |
| CDL 21 | Hypothyroidism | Yes |
| CDL 22 | Multiple Sclerosis | Yes |
| CDL 23 | Parkinson’s Disease | Yes |
| CDL 24 | Rheumatoid Arthritis | Yes |
| CDL 25 | Schizophrenia | Yes |
| CDL 26 | Systemic Lupus | Yes |
| CDL 27 | Ulcerative Colitis | Yes |
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