What is the HIV Care Programme?
HIV and AIDS can be a sensitive matter, whether one has the condition or not. Our skilled and professional consultants respect your right to privacy and will help you get access to clinically sound and cost-effective treatment for your individual case. We will always deal with each case with complete confidentiality.
The HIV Care Programme, together with your GP, will help you actively manage your condition. The programme gives you and your doctor access to various tools to monitor and manage your condition and to ensure you get high-quality coordinated healthcare and the best outcomes.
As a Remedi member, when registered on the HIV Care Programme, you will also have access to additional benefits when your GP is part of the Premier Plus GP Network. Your GP can enroll you on the HIV Care Programme through HealthID, provided you have given consent to do so. Members who are enrolled on the HIV Care Programme will have, for example, access to one additional social worker consultation over and above your available day-to-day benefits per your chosen benefit option.
Enrolling for the HIV Care Programme
The HIV Care team will only speak to you, the patient, or your treating doctor about any HIV-related query. You can register on the Remedi HIV Care Programme by:
- Calling us on: 0860 116 116
- Emailing us on: HIV_Diseasemanagement@yourremedi.co.za
HIV Care Programme application form
What does the HIV Care Programme cover?
When registered for the HIV Care Programme, you have cover for an additional basket of care consisting of:
- Four GP consultations with your nominated GP and one specialist consultation for HIV per person, each year
- HIV-specific blood tests, up to a defined annual limit
- Antiretroviral medicine that is on our HIV medicine list (formulary). Additionally, we will fund for supportive medicine when conditions meet our requirements for cover
Please refer to the HIV Care Programme benefit guide.
Additional cover
We cover certain out-of-hospital treatments related to HIV infection as a Prescribed Minimum Benefit (PMB). You can ask for additional cover, if your condition requires this, through an appeals process. We will review the individual circumstances of the case, however, it is important to note that this process does not guarantee a positive outcome and neither does it change the way Remedi covers PMBs.
Request for additional Prescribed Minimum Benefit cover for HIV
Designated Service Providers (DSP), GP and specialist consultations
You have full cover at your chosen GP if registered on the Standard Option and doctors and specialists who we have a payment arrangement with on the Classic and Comprehensive Options. We will pay the account up to the agreed rate. If you don't use a healthcare provider who we have an arrangement with, you will be responsible for any shortfall between what the provider charges and what Remedi pays.
Comprehensive and Classic benefit options
You must consult with a GP who we have a payment arrangement with to manage your condition to avoid a 20% co-payment.
Standard benefit option
You must consult with your chosen Standard Option Network GP to avoid a 20% co-payment.
Medicine
You have full cover for approved medicine on our HIV medicine list (formulary) if your healthcare provider charges the Remedi Rate for Medicine and if you use a DSP.
The DSPs for HIV medicine are pharmacies in our HIV Network for non-formulary medication. Pharmacies that form part of the HIV Network includes any Dischem or Clicks pharmacy which are situated country wide. If you don't use a for your monthly chronic medicine orders, a 20% co-payment will apply, which means you will have to pay this amount. The co-payment applies to HIV antiretroviral medicines only. Members registered on the Standard Option can also get their HIV medicine from their dispensing Remedi Standard Option GP, where applicable.
HIV Basket of Care medicine list (formulary) (PDF)
HIV Care antiretroviral medicine list (formulary) (PDF)
HIV Care supportive medicine list (formulary) (PDF)