To manage risk and ensure appropriate standards
of healthcare, so-called treatment algorithms were developed for
the CDL conditions.
The algorithms, which have been published in the Government Gazette, can be regarded as benchmarks,
or minimum standards, for treatment. This means that the treatment
your medical scheme must provide for may not be inferior to the
algorithms.
If you have one of the 25 listed chronic diseases, your medical
scheme not only has to cover medication, but also doctors’ consultations
and tests related to your condition. The scheme may make use
of protocols, formularies (lists of specified medicines) and
Designated Service Providers (DSPs) to manage this benefit. |
