Chronic cover and exclusion list

Members registered on the Comprehensive and Classic Options get access to cover for an additional list of conditions.

This list of conditions is often referred to as "Additional Disease List" or "ADL" and provides additional chronic condition cover to members registered on the Comprehensive and Classic benefit options over and above the 27 Chronic Disease List (CDL) conditions (including HIV).

The additional disease list of conditions excludes several chronic conditions per the table below:

Acute bacterial and viral infections

Halitosis

Alcoholic liver cirrhosis

Headaches (non-specific)

Alopecia

Haemorrhoids

Arthralgia

Hirsutism

Athlete's foot

Hyperacidity/indigestion - needs specific diagnosis not only symptoms

Backache

Hypotension

Constipation - unless diagnosis is diverticular disease or if it is a consequence of chemotherapy

Insomnia - allow for terminally ill, current members over 70 years, 6 months as withdrawal therapy. No new applications

Contraception

Irritable bowel syndrome

Dandruff/seborrhoea

Mastalgia

Dermatophytes, onychomycosis, dermatophytic onychia

Obesity

Diarrhoea

Oedema - allow in cases of cardio-vascular conditions

Disorders of the conjunctiva

Oral and vaginal thrush/candida

Dysmenorrhoea/menorrhagia

Pain, non-specific

Dyspepsia

Restless legs/cramps

Dysuria

Senile dementia/cognitive dysfunction - exclude medicine, such as Nootropil; Encephabol; Reactivin

Erectile dysfunction

Sinusitis

Fever blisters

Solar keratosis

Fibromyalgia/myalgia

Superficial fungal infections

Fibrositis

Unspecified cough

Flatulence

Urticaria

Folate deficiency

Varicose veins

Follicitis

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The normal Chronic Illness Benefit application process needs to be followed when applying for an Additional Disease List condition (subject to review and approval). Once the condition and medicine has been authorised, claims will accumulate to the available and applicable limits for your benefit option. For 2023 these limits on the Comprehensive and Classic benefit options are:

Benefit Option

Benefit amount/limit

 

Comprehensive

R2,315

Per person per month

Classic

R1,930

Per person per month

For more information about cover for your chronic condition, please visit our website, www.yourremedi.co.za, or contact us on 0860 116 116.

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