/ProcSet [/PDF /1bbae381f3f2b25a3bb56301dbb12627 240 0 R 0000004068 00000 n /PageMode /UseNone /381b21b2e4648d32ae9388afadb4e230 242 0 R /ImageI] /ViewerPreferences 253 0 R 270 0 obj endobj /AP << Please note that application to waive the non-DSP override will not be considered unless sufficient proof is provided that treatment at the DSP could not be reasonably accessed. /TU () /DA (/Verdana-Bold 7 Tf 0 0 0 rg) SCHEME RULES PMB BENEFIT GUIDES FORMS GEMS EVENTS BOOKING ONLINE FORM MEMBER GUIDES NEWSLETTERS ... HIV/AIDS Disease Management Programme registration form: Application for continued medical assistance (Z583 form) Chronic medicine application form: Chronic medicine delivery amendment form: 0000013132 00000 n Chronic Illness Benefit application form 2020 ' ' 0 0 < < < < ' ' 0 0 < < < < NETCIB001 Netcare Medical Scheme, registration number 1584, is administered by Discovery Health (Pty)Ltd, registration number 1997/013480/07, an authorised financial services provider. /AcroForm 254 0 R You need to complete section 1 of this form. /Root 252 0 R /Type /XObject /Flags 32 /T (phonenumber_7_remedchronappliformc_fax-2) /Ff 16777216 /S /GTS_PDFA1 endstream endobj 150 0 obj <>/Subtype/Form/Type/XObject>>stream >> 257 0 obj You also have access your digital membership card, should you need it and you do not have the physical card with you. /Yes 275 0 R 267 0 obj /EvoPdf_meenmfnjggkakngcaibdfkalaihenock 294 0 R 0000004326 00000 n /Subtype /Form /FT /Tx endobj %PDF-1.4 s 2. Medihelp forms. 0000013812 00000 n /Encoding /Identity-H /Filter /FlateDecode Alternatively members can phone 0860 99 88 77 and health professionals can phone 0860 44 55 66. 0.5 0.5 9.086 9.086 re 143 0 R 144 0 R 145 0 R 146 0 R /49db0ed0ece4285dd6d04c1c127ea7e6 239 0 R 271 0 obj l ��Ks �n D /TU () 266 0 R 267 0 R 268 0 R 277 0 R /Rect [461.6074 399.0957 567.2207 410.4902] 119 0 R 120 0 R 121 0 R 122 0 R /W [3 /Verdana-Bold 249 0 R endstream endobj 149 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 76 0 R 77 0 R 78 0 R 79 0 R >>] 269 0 obj /Encoding /WinAnsiEncoding /Ff 16777216 /DA (/Verdana-Bold 7 Tf 0 0 0 rg) /Filter /FlateDecode [350] /Type /Font Application for special payments made from the PMSA. /Rect [130.5332 418.0703 325.7852 429.4648] /Ff 16777216 >> 111 0 R 112 0 R 113 0 R 114 0 R /Rect [129.8789 437.0449 566.5664 448.4395] /Type /Annot 266 0 obj 1000 1000 1000 1000 1000 1000 1000 277 1000 1000 /Ff 16777216 /MaxWidth 0 /BaseFont /Helvetica /FitWindow false >> /Subtype /Widget 252 0 obj >> /FT /Tx Administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider. >> 4. Your scheme may decide for which medicines it will pay for each chronic condition, but the treatment No, the regulations state that schemes cannot use your medical savings account to pay for PMBs. 889 610 610 610 610 389 556 333 610 556 endstream endobj 145 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Prescribed Minimum Benefits (PMBs) are a set of predefined conditions that form part of South Africa’s Medical Schemes Act.With PMBs, anyone who is part of a medical scheme, no matter what medical aid plan they’re on, can receive treatment for 270 hospital-based and 25 chronic conditions, and the price of these will be covered in full. /N 281 0 R >> 253 0 obj �@E��}�+c3����nll��N1���"Z�[�*�[M�����`4�/�?��Ę�ϗ��/јw�D5�K�b�B���tÎ���8b` ��e << /EvoPdf_eljbpaaclaofkicgabogmhlknllejalf 257 0 R >> /TimesRoman 247 0 R /FontDescriptor 292 0 R /Type /XObject << 10 0000005519 00000 n Abbreviations. /DW 1000 0000002751 00000 n /TU () /N << 279 0 obj >> 0000010244 00000 n Please complete this form for cover of out-of-hospital management of a Prescribed Minimum Benefit (PMB) condition. >> /Q 0 1 G 167 0 obj <>/Filter/FlateDecode/ID[<4F666D7464DF8946A0B0824EED918C9D>]/Index[139 65]/Info 138 0 R/Length 98/Prev 194375/Root 140 0 R/Size 204/Type/XRef/W[1 3 1]>>stream /Subtype /Widget /Type /Annot [190 333 333] /Widths [237 333 333 1000 1000 277 333 277 1000 556 /StemV 80 /Rect [190.7285 380.1211 296.3418 391.5156] /Ff 16777216 h�b```�/���B cc`a���0Y�@�Ê���,��-�M=���h�`� �P]@����{��bU��YA�m�� �,�<1�0]`��\j�ߺT$�I��J���?��TzX7 ��tu�fd``���li�r�;�JOz��Z|����*Q��aR-��t�D5� g`���g�0 *7 265 0 obj /Type /Page /Ff 16777216 /RegistryName () h�bbd```b``��L{��%�d�&=��_0 &σI0��>�,�g����&c�.1��R�$S[���$�M�]k�&���� ��� >> << 278 0 R] /Type /Catalog /TU () 256 0 obj /FontName /XRUJUB+ArialMT >> Here are your most important forms for easy download: AfA Application form: Application form for HIV+ patients requiring ART. yourself with the Fund Rules prior to filling in this application. /MaxLen 3 /Subtype /Widget /DA (/Verdana-Bold 7 Tf 0 0 0 rg) /Type /Annot stream Application for continued membership. /NeedAppearances true 0000011062 00000 n /N << 777 666 1000 722 666 610 1000 1000 943 1000 �@���a�������� �o\ >> 3. /ProcSet [/PDF /TU () >> /V () Please FAX completed form to: 086 651 8009 Or mail to: PO Box 38632, Pinelands, 7430 Member telephone: 0860 004 367 Provider telephone: 0860 100 608 MEDICINE MANAGEMENT CHRONIC MEDICINE BENEFIT APPLICATION ONLY COMPLETE THIS FORM IF YOU ARE A FULLY REGISTERED MEMBER OF GEMS D D M M Y Y Y Y D M Y [556] endstream endobj 146 0 obj <>/Subtype/Form/Type/XObject>>stream [666 666 722 722 666 610 777 722 277] /Type /Annot 131 0 R 132 0 R 133 0 R 134 0 R Page 1 of 2 €31.12.2020 endobj /HideWindowUI false [889] >> /V /Off all PMB conditions have been published in the Government Gazette, and are known as treatment algorithms (benchmarks for treatment). /Type /Font /AP << Registration of dependants 2020. The applicant is familiar with the information requested in the application form and all the relevant information was provided by the applicant. >> /Type /FontDescriptor Download the forms you need to do your medical aid business with Medihelp. /MK << /P 256 0 R /Subtype /Type1 /S 148 /Ff 16777216 /FT /Btn >> /P 256 0 R /TU () /MK << DHMPMB001 /Type /Font endobj Permission for third-party access. /F 4 /E 178830 47 0000000017 00000 n >> >> ʚ������/����~�eߝ���k��=�{�{��n�����94ih�������:|���tIݘ�"Y��ӧ|?�?������˾��n���t����>e���R_�t�u��GZ.^�. /T (date_8_remedchronappliformc_date-1) x�+T0R(W0THW0 B#0*JUHrЄ��B��]�@!i << /Length 64 /MK << /Type /Annot >> >> /N 285 0 R /FT /Tx stream /BBox [0 0 20 20] /V () 1 G /Subtype /Widget /BaseFont /ZapfDingbats /S /Transparency /TU () endobj 556 500 722 500 500 500] /ID [ 203 0 obj <>stream H�2�37�402VH�2P0P04�3�0���f /Rect [132.4961 361.1465 566.5664 372.541] /F 4 251 45 >> /MK << << 259 0 obj We have developed a Remedi Application which will make managing your plan easier in just a few taps. /F 4 /Name /XRUJUB+ArialMT 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 /DestOutputProfile 238 0 R /de2d95356a5c885ccd5791fd25f6b460 245 0 R 1D���)�Y7��(66B@�S������a�=Fe�v��JePђ�w�����$��]�l?x5X:/3?���Fl+V����,���0�%��-�;����z�h`���'| �F P 1000 1000 1000 1000 610 975 722 722 722 722 2. /N 283 0 R Page 1 of 7 €09.07.2020 139 0 obj <> endobj /Parent 237 0 R [556 556 500 556 556 277 556 556 222 222 >> 7. /Q 0 /F 4 149 /Descent -210 0000009986 00000 n /d7fb9ba8ca5562471276649348f6395a 243 0 R 0.5 0.5 9.086 9.0859 re >> >> << >> /Ordering (Identity) /Filter /FlateDecode /Length 169 >> 0000008929 00000 n /Font << /T (text_13_remedchronappliformc_dateofbirthoridnumbe-1) 181 << 53 Minimum Benefits (PMB) are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. 556 610 556 333 610 610 277 1000 556 277 Benefits for PMB will apply from the date on which these are approved and PMB services are first paid from the day-to-day benefits applicable to the relevant service. 36 /MaxLen 8 H�2Tp�2�3U aK=SKU��U�U�e�`�`��K�s�q9�p�G%�$)����Y*��q�Y*�Y�*��p���+��pik*�dq��pr 9� Discovery Health (Pty) Ltd is an authorised financial services provider. >> /AP << /N 291 0 R 277 0 obj /Type /Annot << /Text endstream endobj 160 0 obj <>/Subtype/Form/Type/XObject>>stream /T (fullwidth_1_remedchronappliformc_nameandsurna-1) Application for out-of-hospital treatment* Condition ICD-10 Code Consultation or procedure code** Motivation Quantity 3OHDVHFOHDUO\VSHFLI\ZKDWLVUHTXLUHG IRUH[DPSOHFRQVXOWDWLRQV SDWKRORJ\ UDGLRORJ\DQG RUSURFHGXUH AMSAOM001 Please note that this form expires on 31/03/2021. /Rect [401.4121 399.0957 446.8301 410.4902] 53 0 R 54 0 R 55 0 R 56 0 R 44 0 R 45 0 R 46 0 R 86 0 R /Subtype /Widget 254 0 obj /Ascent 728 Application for additional out-of-hospital treatment over and above that provided by the Prescribed Minimum Benefits. 95 0 R 96 0 R 97 0 R 98 0 R /Q 0 Registration of newborn baby 2020. �\z� 135 0 R 136 0 R 137 0 R 138 0 R s /NonFullScreenBehavior /UseNone /BaseFont /Arial-BoldMT /EvoPdf_kaokapomcagjkhllaaknnblkidpiigle 246 0 R 0000005229 00000 n endstream endobj 157 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 0000009802 00000 n 777 1000 556 500 1000 1000 1000 1000 1000 1000 /OutputCondition () /CA (3) << /V /Off << How to complete this form: 260 0 obj 87 0 R 88 0 R 89 0 R 90 0 R << 123 0 R 124 0 R 125 0 R 126 0 R >> Bariatric surgery application form. /F 4 /Type /Group 5. /Ff 16777216 /CenterWindow false /MediaBox [0 0 595 842] /AvgWidth 277 /MaxLen 7 DHMCIB002 139 0 R 140 0 R 141 0 R 142 0 R /Q 0 /Fields [258 0 R 259 0 R 260 0 R 261 0 R /CS /DeviceRGB /DA (/Verdana-Bold 7 Tf 0 0 0 rg) /TU () /T (phonenumber_7_remedchronappliformc_cellp-2) /DA (/Verdana-Bold 7 Tf 0 0 0 rg) endobj 26 0 R 27 0 R 28 0 R 29 0 R 0 Chronic Illness Benefit application form. Registration number 1430 is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. /DR << You need to complete section 1 of this form. 556 556 556 556 556 556 556 556 1000 333 >> /Contents [280 0 R] 30 0 R 31 0 R 32 0 R 33 0 R /T (phonenumber_3_remedchronappliformc_fax-1) endstream /Resources << 0000011783 00000 n /Linearized 1 /ImageC /Type /Annot 3. /T (checklist_1_remedchronappliformc_outcoofthisapplimust-1) /MK << My Medihelp application form 2020 Enquiries: 086 0100 678 Fax: 012 336 9534 Email: newbusiness@medihelp.co.za Postal address: PO Box 26004, ARCADIA, 0007 www.medihelp.co.za Thank you for choosing to join Medihelp medical scheme. << /F 4 /Off 276 0 R 0000010502 00000 n << Page 1 of 9 €01.07.2020 x�]��n�@��H����!����%��a�d �!���8�~�.�+�O��@W�Ym��}׎���p�i��m��v�ꔝ�G�- 8KvVF/K8lfQ5e1EC7jeWmPrZ1cPAYtaWpdkxQ4nGEg=) /ProcSet [/PDF 0.5 0.5 9.0859 9.086 re >> /Prev 277227 /BC [1 1 1] /V () endobj endobj /XObject << 268 0 obj Alternatively members can phone 0860 103 933 and health professionals can phone 0860 44 55 66. 6. >> H�4ȱ /F 4 << /Q 0 /FT /Tx /CIDToGIDMap /Identity >> /N 286 0 R 61 0 R 62 0 R 70 0 R 71 0 R /MK << /DisplayDocTitle false 34 8 /V () �\z� >> /AP << 277 0 R 278 0 R 10 0 R 11 0 R /Type /Font /N 287 0 R endstream endobj 143 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream /F 4 /Subtype /Widget >> The latest version of the application form is available on www.lahealth.co.za. Please complete this form for cover of out-of-hospital management of a Prescribed Minimum Benefit (PMB) condition. H�2�37�402VH�2P0P04�3�0���E�\i\� >> startxref endobj /Subtype /Form /DA (/Verdana-Bold 7 Tf 0 0 0 rg) [222] << /Info (sRGB IEC61966-2.1) Please email completed and signed form with any supporting documents to PMB_APP_FORMS@bankmed.co.za or fax it to 011 539 1136 5. /MaxLen 7 500 222 833 556 556 556 556 333 500 277 endstream endobj 153 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream [556 833 722 777 666] trailer /Q 0 2. >> 262 0 obj /Subtype /Widget /Font << 0000006357 00000 n /OutputConditionIdentifier (Custom) ; AfA PEP Application Form: Application form for post-exposure prophylaxis. /AP << ... PMB and CDL. login and Reupload all documents in jpg format and study certificate in pdf format within 2 days. /Text /Type /Annot endobj 0 103 0 R 104 0 R 105 0 R 106 0 R 262 0 R 263 0 R 264 0 R 265 0 R l ����s �a� /Type /OutputIntent Remedi SeniorCare is a leading pharmacy innovator servicing long-term care facilities and communities, as well as other adult-congregant living environments. 107 0 R 108 0 R 109 0 R 110 0 R endobj 44058) • Block A, Glenffeld Ofice Park, 361 Oberon Avenue, Faerie Glen, Pretoria, … /T (phonenumber_3_remedchronappliformc_telep-1) �\z� 275 0 obj /Rect [423.0039 342.8262 433.0898 352.9121] 0000014266 00000 n /d17d3c6ad1f76d4b1e18ff13c5dfe6d5 244 0 R /XHeight 0 endobj 0.5 0.5 9.0859 9.0859 re >> /Dests << Instructions: We cannot process your application if it is incomplete, incorrect or if you have not attached the correct supporting documents. Through the navigation of this application you will be able to keep track of your Personal Medical Savings Account details and balance. /MaxLen 3 /AP << 0000006913 00000 n The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable. Specialist networks. /Subtype /CIDFontType2 /Q 0 >> /F 4 endstream endobj 144 0 obj <>/Subtype/Form/Type/XObject>>stream /Subtype /Type1 /MaxLen 7 80 0 R 81 0 R 82 0 R] endstream endobj 162 0 obj <>stream 0000013358 00000 n /Annots [258 0 R 259 0 R 260 0 R 261 0 R /FT /Tx >> endstream endobj 148 0 obj <>/Subtype/Form/Type/XObject>>stream /FT /Tx 135 /Type /Annot << 34 0 R 35 0 R 36 0 R 37 0 R Where you must send the completed application form(s) to You must send the completed PMB application form using either of the following methods: Fax to: 011 539 2780 Email to: PMB_APP_FORMS@ malcormedicalaid.co.za Post to: Malcor Medical Aid Scheme, PMB Department, PO Box 652509, Benmore, 2010. /AP << H�4�1 >> /F 4 /Type /Font /P 256 0 R >> 182 4. H�4�� /Text] /Rect [130.5332 399.0957 175.9512 410.4902] 147 0 R 148 0 R 149 0 R 150 0 R endstream endobj 140 0 obj <>/Metadata 20 0 R/OutputIntents[<>]/PageLayout/OneColumn/PageMode/UseNone/Pages 137 0 R/Type/Catalog/ViewerPreferences 169 0 R>> endobj 141 0 obj <>/MediaBox[0 0 595 842]/Parent 137 0 R/Resources<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/Type/Page>> endobj 142 0 obj <>/Subtype/Form/Type/XObject>>stream 3 0 R 4 0 R 5 0 R 6 0 R /Pages 237 0 R H�2Tp�2�3U aK=SKU��U�U�e�`�`��K�s�q9�p�G%�$)����Y*��q�Y*�Y�*��p���+��pik*�dq��pr 9� endstream endobj 151 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream /Off 276 0 R /DA (/Verdana-Bold 7 Tf 0 0 0 rg) /TU () /Resources << 0000007193 00000 n 0000012677 00000 n Please complete this form for cover of out-of-hospital management of a Prescribed Minimum Benefit (PMB) condition. /FT /Tx endobj 1000 277] Please attach the following documents to this form: /N 284 0 R OPMED APPLICATION FORM FOR Chronic Disease List Conditions (CDL) and other Chronic Conditions ATTENDING MEDICAL PRACTICIONER TO KINDLY COMPLETE THE RELEVANT SECTIONS AND RETURN ALL PAGES TO: PO Box 8796, Centurion, 0046, fax to 0866 151 503 or email to opmed@mediscor.co.za NB: Please complete one application form per patient. �)�?X���H1�3*�uQ��T���4����*����ː_��6���g��،m��r�ݘ�c*�\R6�K�h�w$Q�����X�%���~ ��� 3. H�1D���)�Y7��(66‚`��X���')����Q٬]-s�R�T���y`@�*���̽�/�� �ͤuq�k�� �.�ݍU�Tg0�-�ĭ0V2�E^2��N� 0 ^?e /N 289 0 R /F 4 0000005797 00000 n >> stream /P 256 0 R endobj /AP << >> /V () /F 4 >> x�c```f`� �� uD� ٪@,�b ���L}W�!R� ���+��1����f`Q� �@�V rc/��ć���P|��� -� �c�4#T\�MPU���^@��� �$4�``�(���-����� Pl./ tJ(� /T (checklist_1_remedchronappliformc_outcoofthisapplimust-2) endobj /FontDescriptor 272 0 R [722 666 610 722 666 943 666 666] 258 0 obj 2020 Group application form (editable) 2020 New application form (editable) 2021 Bonitas Change of Option Form: ... 2020 Request for additional pmb cover for hiv: 2020 Request for extended supply of medicine: 2020 Request for pre exposure prophylaxis: 2020 Transfer to individual capacity form: /T 277239 << >> /Subtype /Widget 2. /CA (3) /P 256 0 R E�\i\� 155 0 R 156 0 R 157 0 R 158 0 R 0000006635 00000 n %PDF-1.6 %���� endobj /AP << /Font << /MissingWidth 277 H��������{W��������� �����g_�a4����OxaW؞/ӕ)�Y�d3�K�`ݐ�#��.���Œ� ��� x�+T0R(W0THW0 B#0*JUHrЄ��B��]�@!i /BaseFont /Helvetica 263 0 obj Application for out of hospital management of a PMB condition. /82d38e75303d9839b42d6f0e4ef81773 241 0 R endobj /BaseFont /XRUJUB+ArialMT /BBox [0 0 20 20] /FT /Tx /Subtype /Widget Your Healthcare professional must complete section 2 and 3 and included detailed documents to support this application for acute and/or ongoing treatment for a Prescribed Minimum Benefit. /Type /Annot 1 G Chronic Illness Benefit application form 2020 7KLVDSSOLFDWLRQIRUPLVWRDSSO\IRUWKH&KURQLF,OOQHVV%HQHILWDQGLVRQO\YDOLGIRU < < < < 0 0 ' ' REMCIB001 Remedi Medical Aid Scheme. /MaxLen 3 /DA (/Verdana-Bold 7 Tf 0 0 0 rg) endobj /Group << 261 0 obj << Application for out-of-hospital management of a Prescribed Minimum Benefit condition 2020 This is applicable to the Essential and Basic Plans Please note that is form expires on 31/03/2021. endobj 15 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 H�2�37�402VH�2P0P04�3�0�QE�\i\� >> << 49 0 R 50 0 R 51 0 R 52 0 R /FT /Tx /DA (/Verdana-Bold 7 Tf 0 0 0 rg) Chronic Illness Benefit application form 2020 7KLVDSSOLFDWLRQIRUPLVWRDSSO\IRUWKH&KURQLF,OOQHVV%HQHILWDQGLVRQO\ YDOLGIRU ' ' 0 0 < < < < MALCIB001 Malcor Medical Aid Scheme, registration number 1547. 127 0 R 128 0 R 129 0 R 130 0 R endobj /ZaDb 274 0 R E�\i\� /Name /XRUJUB+Arial-BoldMT 556 556 556 556 277] /Q 0 << /Rect [431.5098 418.0703 567.2207 429.4648] %%EOF /Length 64 [277 333 277 277 556 556 556 556 556 556 << /Q 0 Chronic Medicine Application Form 2020-11-23 BMF-1401 V11.00 Bestmed Medical Scheme 2020 Bestmed Medical Scheme is an Authorised Financial Services Provider (FSP no. 278 0 obj • To avoid administrative delays, please ensure that all sections are completed in full and in the case of pre-authorisation a written quotation must accompany the fully completed PMB application form. Online Application for Govt. /BC [1 1 1] Once the day-to-day benefits are depleted, PMB conditions will be paid from the unlimited core benefits. >> /Text] 276 0 obj 0000009906 00000 n 0000001938 00000 n /N 7 Your doctor must complete section 2, 3 and section 4 and include detailed documentation to support your application. << stream /Type /Annot >> 0000014494 00000 n 0000007740 00000 n H�4ȱ /ProcSet [/PDF endobj /P 256 0 R /MK << /T (text_9_remedchronappliformc_membenumbe-1) Benefit (PMB) Chronic Disease List (CDL) conditions registered on the Chronic Illness Benefit (CIB) LHRACF001 LA Health Medical Scheme, registration number 1145, is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. 115 0 R 116 0 R 117 0 R 118 0 R 0000014040 00000 n /AS /Off /ImageB /P 256 0 R /V () /ZaDb 274 0 R 0000009522 00000 n 0000015214 00000 n >> 0.5 0.5 9.0859 9.0859 re Your doctor needs to complete the rest of the form and include detailed documentation to support this application. /ItalicAngle 0 The latest version of the application form is available on www.discovery.co.za. /Length 639 ; AfA PrEP Application form: Application form for HIV- patients requiring PrEP. /T (phonenumber_7_remedchronappliformc_telep-2) /Font << /MK << /L 282309 0000012904 00000 n /Subtype /TrueType s /Rect [431.5098 297.6797 552.1719 309.0742] Chronic Illness Benefit Application form 2020 ' ' 0 0 < < < < ' ' 0 0 < < < < Please note that this form expires on 31/03/2021. 2020 Guide to Prescribed Minimum Benefits 2016 Guide to Prescribed Minimum Benefits - 2020 Guide to Prescribed Minimum Benefits 2019 APPLICATION FORM – CHRONIC MEDICINE BENEFIT 2019 Remedi … Medicine Please complete a PMB/chronic medicine application form, /MK << /H [4068 258] /MK << >> Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents and your certificates. /EvoPdf_eljbpaaclaofkicgabogmhlknllejalf 257 0 R endstream endobj 155 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 0000014722 00000 n /F 4 0000004803 00000 n /Encoding /WinAnsiEncoding Application (Healthcare professional to complete) 2.1. 7 0 R 8 0 R 9 0 R 43 0 R /FT /Btn 0000012449 00000 n /FontBBox [-664 -211 2000 939] Please familiarise . /Subtype /Type1 >> How to complete this application form 1. 0000145481 00000 n /V () 0000126172 00000 n << 6. 0000008012 00000 n 0000006077 00000 n >> 68 QD�~�bʵ�I����e��Fv�ZX����bq�p�[���h��]�u�O�����<0���|f�Gv� .ٌ.��X�����A��uǦ��G� �&� /MK << /Q 0 /MK << /FT /Tx /V () [548] • PMB’s are subject to pre-authorisation and in the case of emergencies the application must be received within 48 hours. 0000014950 00000 n Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents and your certificates. /V () 0000008757 00000 n xref /Encoding /WinAnsiEncoding >> s /TU () endobj 1 G /N 282 0 R /BaseFont /XRUJUB+ArialMT endstream 274 0 obj 177 72 0 R 73 0 R 74 0 R 75 0 R 57 0 R 58 0 R 59 0 R 60 0 R �\z� /Ff 16777216 /DA (/Verdana-Bold 7 Tf 0 0 0 rg) >> 666 1000 1000 1000 1000 1000 1000 1000 556 610 >> Up-to-date forms are always available on www.bankmed.co.za Who we are x��VQo�0~G�?�c:��m06/�ֵ]5�R�f�*MLC��,��; �i�M��&Ap`�}�}w6ܹ��?�C. /Ff 16777216 endstream endobj 147 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 0000004954 00000 n 266 0 R 267 0 R 268 0 R 2 0 R >> endstream endobj startxref 0000013586 00000 n endobj /Subtype /Widget /Subtype /Widget /DA (/Verdana-Bold 7 Tf 0 0 0 rg) /FontFile2 295 0 R endobj >> >> %%EOF /Leading 1088 Dear students if your application for PMB 2020 counseling is rejected. /CapHeight 716 >> /FirstChar 39 << The applicant is familiar with the information relating to the Protection of Personal Information (POPI) Act as displayed on www.fedhealth.co.za 8. /LastChar 160 >> >> << /Size 296 151 0 R 152 0 R 153 0 R 154 0 R 91 0 R 92 0 R 93 0 R 94 0 R /Name /EvoPdf_eljbpaaclaofkicgabogmhlknllejalf 273 0 obj H�1D���)�Y7��(66B@�S����c�+���`����"G(�AEK�Wr�x�J�/޵���W��2�3�moĶbu��n�b);� �\B��[b�#�Z���~��E\�N�W��` �� P ] >> >> l ����s ��� 666 610 777 722 277 1000 722 610 833 722 endstream endobj 159 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream /Source (WeJXFxNO4fJduyUMetTcP9+oaONfINN4+d777urKGk0RlnK5P3m/b5cRDXxh7FtPB9khgm8VtCFmyd8gIrwOjQRAIjPsWhM4vgMCV\ /TU () endstream endobj 156 0 obj <>/Subtype/Form/Type/XObject>>stream 0000007473 00000 n /CIDSystemInfo << >> [277] /HideMenubar false /Q 0 /P 256 0 R /AP << H�2�37�402VH�2P0P04�3�0�P�� Providing personalized, attentive service, our team helps customers stay focused on providing exceptional person-centered care and delivering better business results through advanced technology solutions and clinical expertise. My Medihelp application form 2020 Enquiries: 086 0100 678 Fax: 012 336 9534 Email: newbusiness@medihelp.co.za Postal address: PO Box 26004, ARCADIA, 0007 www.medihelp.co.za Thank you for choosing to join Medihelp medical scheme. /P 256 0 R [556] /Fabc286 273 0 R /V () /O 256 4. 255 0 obj 251 0 obj /Supplement 0 DHMAOM001 /Registry (Adobe) /Rect [130.5332 380.1211 175.9512 391.5156] << 272 0 obj endstream %���� /T (phonenumber_3_remedchronappliformc_cellp-1) >> Application for out-of-hospital management of a Prescribed Minimum Benefit condition 2020 D D M M Y Y Y Y Please note that this form expires on 31/03/2021. /Subtype /Type0 l ��Ks �n D /Subtype /Widget /N 290 0 R H�1D���)�Y7��(66‚`��X���')����Q٬]-s�R�T���y`@�*���̽�/�� �ͤuq�k�� �.�ݍU�Tg0�-�ĭ0V2�E^2��N� 0 ^?e << >> >> endstream endobj 158 0 obj <>/Subtype/Form/Type/XObject>>stream ; AfA Pre-ART Application Form: Application form for HIV+ patients who do not yet require ART. Up to date forms are always available on www.discovery.co.za under Medical Aid > Find documents and your certificates. /AP << �@������������ ��I H�2�37�402VH�2P0P04�3�0���E�\i\� /FT /Tx 1 G /Ff 16777216 << /P 256 0 R endstream endobj 154 0 obj <>/Subtype/Form/Type/XObject>>stream �\z� /AP << /ToUnicode 279 0 R PLEASE FAX FORM TO +27 10 597 4706, EMAIL: pmb@medshield.co.za MSD - FR - CRD - 005 v1 2019 - PMB Programme Application - 24/05/2019 Page 4 /ImageC] /Type /Font /MaxLen 13 /Resources << endobj /OutputIntents [<< 0000002573 00000 n s [222]] /P 256 0 R endstream endobj 152 0 obj <>/Subtype/Form/Type/XObject>>stream /N 288 0 R /Info 250 0 R 38 0 R 39 0 R 47 0 R 48 0 R /MaxLen 9 endobj /HideToolbar false /P 256 0 R /DescendantFonts [271 0 R] endobj 262 0 R 263 0 R 264 0 R 265 0 R /AP << /Type /Annot /AS /Off l ��Is ��d Please fax this completed and signed form with any supporting documentation to 011 539 2780 or email PMB_APP_FORMS@discovery.co.za 5. Prescribed minimum benefits appeals form 2020 D D M M Y Y Y Y Please note that this form expires on 31/03/2021. 99 0 R 100 0 R 101 0 R 102 0 R 0000010782 00000 n B1D�9Ŕڬ��V! /StemH 0 /Filter /FlateDecode /V () >> /T (fullwidth_1_remedchronappliformc_email-1) endstream endobj 161 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream /MK << << 264 0 obj /P 256 0 R /PageLayout /OneColumn The Fund Rules are available at www.bonitas.co.za. /Rect [377.8574 342.8262 387.9434 352.9121] >> Quota Seats During Academic Year 2020-21 /Rect [190.7285 399.0957 296.3418 410.4902] >> /Subtype /Widget How to complete this form: /ABCpdf 10125 << endobj How to complete this application form 1. /Type /Annot /Yes 275 0 R On www.fedhealth.co.za 8 your Personal Medical Savings Account details and balance and above that provided by the applicant familiar! 2780 or email PMB_APP_FORMS @ bankmed.co.za or fax it to 011 539 1136 5 you also have access digital... 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