Your day-to-day benefits won't last long if you use them to treat lasting conditions, such as asthma, diabetes or high blood pressure. This is because you need to take regular medicine and often visit the doctor who treats your condition to make sure the treatment works.
We want you to be as healthy as possible, so the PMB Chronic Illness Benefit pays for specific medicine, tests and doctor's visits once you register your chronic condition with us. This means you get to keep your day-to-day benefits for unexpected illness.
Remember you must go to one of the Scheme's Designated Service Provider GPs or Specialists for your treatment and care if you want to ensure the Scheme will pay their claims in full.
Register on the Chronic Illness Benefit that pays for chronic conditions on our lists
Medicine for the Chronic Illness Benefit
The Chronic Illness Benefit covers authorised medicine for the 26 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions. Approved medicine on the Chronic Illness Benefit medicine list (formulary) will be paid in full up to the Scheme Rate. Chronic Drug Amount (CDA).
Medicine cover for Additional Disease List conditions
You have further cover for Additional Disease List (ADL) conditions. There is no medicine list (formulary) for the ADL conditions. Approved medicine for these conditions will be funded up to the CDA.
If your condition is one of the PMB/ additional disease list conditions and you meet the clinical entry criteria (that is, specific tests must show you have the condition) you can register on the Chronic Illness Benefit.
How to register