AQUARIUM SCHEDULE - POLMED
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AQUARIUM
AQUARIUM
AQUARIUM
SCHEDULE
ANNEXURE B1 Reference in this Annexure and
the following Annexures to
Benefits for the services outside
the Republic of South Africa
the term: (RSA)
SCHEDULE OF BENEFITS WITH EFFECT
FROM 1 JANUARY 2018
Subject to the provisions contained in these rules, including all Annexures, members
making monthly contributions at the rates specified in Annexure B3 shall be entitled • ‘POLMED rate’ shall mean: The Scheme does not grant benefits for
to the benefits as set out herein, with due regard to the provisions in the Act and 2006 National Health Reference services rendered outside the borders of
Regulations in respect of prescribed minimum benefits (PMBs). Price List (NHRPL) adjusted on an the RSA. It remains the responsibility of
annual basis with Consumer Price the member to acquire insurance cover
Index (CPI). when travelling outside the borders of
the RSA.
• ‘Agreed tariff’ shall mean:
The rate negotiated by and on behalf
of the Scheme with one or more
providers/groups.
47 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 48
GENERAL RULES
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AQUARIUM
Application of clinical Clicks Pharmacy and MediRite Pharmacy Ex Gratia benefit Medication
protocols are retail pharmacies that have been
contracted to provide the service to The Scheme may, at the discretion Chronic medication
POLMED applies clinical protocols, members who prefer to personally of the Board of Trustees, grant an The chronic medication benefit shall be
including ‘best practice guidelines’ collect their chronic medication. Ex Gratia payment upon written subject to registration on the Chronic
and evidence-based medication (EBM) application from members as per Medicine Management Programme for
principles in its funding decisions. Where the member chooses to use an the rules of the Scheme. those conditions which are managed,
alternative provider for the collection of and chronic medication rules will apply.
chronic medication, the member shall In hospital Payment will be restricted to one month’s
Dental procedures be liable for a co-payment of 20% of the supply in all cases for acute and chronic
All dental procedures performed in costs that must be paid directly to the All admissions (hospitals and day clinics) medication, except where the member
hospital require pre-authorisation. provider by the member. must be pre-authorised; otherwise a submits proof that more than one
The dentist’s costs for procedures that penalty of R5 000 may be imposed if no month’s supply is necessary, e.g. due to
Members can access the websites of pre-authorisation is obtained.
are normally done in a doctor’s rooms, Clicks Pharmacy and MediRite Pharmacy travel arrangements to foreign countries.
when performed in hospital, shall be via www.polmed.co.za and on their In the case of emergency, the Scheme (Travel documents must be submitted
reimbursed from the out-of-hospital cellphones via the mobile site. must be notified within 48 hours or on as proof.)
(OOH) benefit, subject to the availability the first working day after admission. POLMED formulary
of funds. The hospital and anaesthetist’s Pre-authorisation will be managed
Designated service provider Payment in respect of over-the-counter
costs, if the procedure is pre-authorised, under the auspices of managed
will be reimbursed from the in-hospital
(out-of-network rule) (OTC), acute and chronic medication will
healthcare. The appropriate facility has be subject to the medication included
benefit. POLMED has appointed healthcare to be used to perform a procedure, in the POLMED formulary. Medication is
providers (or a group of providers) as based on the clinical requirements, as included in the POLMED formulary based
Designated GP provider DSPs for diagnosis, treatment and care in well as the expertise of the doctor doing on its proven clinical efficacy, as well
(network GP) respect of one or more PMB conditions. the procedure. Benefits for private or as its cost effectiveness. The maximum
Where the Scheme has appointed a DSP semi-private rooms are excluded unless reimbursed cost may be based on either
Members are allowed two visits to a and the member voluntarily chooses to they are motivated and approved prior a generic reference price or the inclusion
general practitioner (GP) who is not part use an alternative provider, all costs in to admission upon the basis of clinical of the product in the POLMED formulary.
of the network per member per annum excess of the agreed rate will be for the need. The products that are not included in
for emergency or out-of-town situations. cost of the member and must be paid the POLMED formulary will attract a 20%
Medication prescribed during
Co-payments shall apply once the directly to the provider by the member. co-payment.
hospitalisation forms part of the
maximum out-of-network consultations
Members can access the list of providers hospital benefits. Medication prescribed Pre-authorisation for chronic
are exceeded. Prescribed minimum
via www.polmed.co.za, cellphone during hospitalisation to take out (TTO) medication
benefit (PMB) rule applies for qualifying
mobile site, POLMED Chat or contacting will be paid to a maximum of seven Pre-authorisation is required for items
emergency consultations.
POLMED’s Client Service Call Centre on days’ supply or a rand value equivalent funded from the chronic medication
0860 765 633. to it per member per admission, benefit. Pre-authorisation is based
Designated pharmacy network except for anticoagulants post-surgery on EBM principles and the funding
(DSP for chronic medication) and oncology medication, which will guidelines of the Scheme. Once
Examples of designated service be subject to the relevant managed
POLMED has appointed designated providers (where applicable) are: predefined criteria are met, an
healthcare programme. authorisation will be granted for the
service providers (DSPs) for the provision • cancer (oncology) network
of chronic medication. Medipost • general practitioner (GP) network Maternity: The costs incurred in respect diagnosed conditions.
Pharmacy and Pharmacy Direct have • optometrist (optical) network of a newborn baby shall be regarded
been contracted as courier pharmacies • psycho-social network as part of the mother’s cost for the
to deliver chronic medication to the • renal (kidney) network first 90 days after birth. If the child is
members’ address of choice at no cost. • specialist network. registered on the Scheme within 90 days
from birth, Scheme rule 7.1.2 shall apply.
Benefits shall also be granted if the child
51 POLMED 2018 Guide to your Health is stillborn. POLMED 2018 Guide to your Health 52
Members will have access to a group Specialised radiology !
AQUARIUM
AQUARIUM
(’basket’) of medication appropriate DISCLAIMER
for the management of their particular Pre-authorisation is required for all
scans, failing which the Scheme may In the event of a dispute the
conditions/diseases for which they
impose a co-payment of up to R1 000 registered rules of POLMED
are registered. There is no need for a
per procedure. In the case of an will apply.
member to apply for a new authorisation
if the treatment prescribed by the doctor emergency the Scheme must be notified
changes and the medication is included within 48 hours or on the first working
in the condition-specific medication day if admission was over the weekend.
basket. Updates to the authorisation
will be required for newly diagnosed Specialist referral
conditions for the member. The 20%
All POLMED members need to be
co-payment (on medication that is not
referred to specialists by a GP. The
included in the POLMED formulary) can
Scheme will impose a co-payment of
be waived via an exception management
up to R1 000 if the member consults a
process. This process requires motivation
specialist without being referred. The
from the treating service provider and will
co-payment will be payable by the
be reviewed based on the exceptional
member to the specialist and is not
needs and clinical merits of each
refundable by the Scheme.
individual case.
(This co-payment is not applicable to
The member needs to reapply for an
the following specialities/disciplines:
authorisation at least one month prior to
Gynaecologists, psychiatrists, oncologists,
expiry of an existing chronic medication
ophthalmologists, nephrologists [chronic
authorisation, failing which any claims
dialysis], dental specialists, pathology,
received will not be paid from the chronic
radiology and supplementary/allied
medication benefit, but from the acute
health services).
medication benefit, depending on the
availability of funds. This only applies to The Scheme will allow two specialist
authorisations that are not ongoing and visits per member per year without the
have an expiry date. requirement of a GP referral to cater for
those who clinically require annual
The Scheme shall only consider claims for
and/or bi-annual specialist visits. For
medication prescribed by a person legally
example, GP referral is not required
entitled to prescribe medication and
where a member has a Care Plan for
which is dispensed by such a person or a
a condition that lists the specialist
registered pharmacist.
consultation.
Pro rata benefits The Scheme will not cover the cost of
the hearing aid if there is no referral from
The maximum annual benefits referred a GP or specialist. The specialist has to
to in this schedule shall be calculated submit the referring GP’s practice number
from 1 January to 31 December each in the claim.
year based on the services rendered
during that year, and shall be subject to
pro rata apportionment calculated from
the member’s date of admission to the
Scheme to the end of that financial year.
53 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 54
DEFINITION OF TERMS
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Basic dentistry Co-payment of 40% of claim shall POLMED requires members to apply for Members are also encouraged to
apply where a member voluntarily uses authorisation via the Chronic Medicine register themselves on the Programme
Basic dentistry refers to procedures an unauthorised service provider Management Programme to access this to ensure the payment of claims from the
that are used mainly for the detection, (non-DSP). Service providers will chronic medication benefit. Members will correct benefit category.
prevention and treatment of oral be required to provide the hospital receive communication via email, SMS or
diseases of the teeth and gums. These admission/casualty sticker together with post indicating whether their application Specialised dentistry
include the alleviation of pain and sepsis, patient report forms when submitting a was successful or not. If successful, the
the repair of tooth structures by direct (pre-authorisation required)
claim to POLMED’s EMS DSP in order to member will be issued with a condition-
restorations/fillings and replacement of validate delivery to a hospital. specific authorisation, which will allow Specialised dentistry refers to services
missing teeth by plastic dentures. them access to medication that is that are not defined as basic dentistry.
Medication formulary referred to as the ‘disease authorisation These include periodontal surgery,
basket’. crowns and bridges, implant procedures,
Other procedures that fall under A formulary is a list of cost-effective, inlays, indirect veneers, orthodontic
this category are: evidence-based medication (EBM) for treatment, removal of impacted teeth,
• cleaning of teeth, including
Registration to Disease Risk
the treatment of acute and chronic and maxillofacial surgery. All specialised
non-surgical management of conditions. Management Programme
dentistry services and procedures must
gum disease The claims data for chronic medication, be pre-authorised, failing which the
• consultations Medicine reference price consultations and hospital admissions Scheme will impose a co-payment
• fluoride treatment and is used to identify the members who of R500.
This is the pricing system applied by the
fissure sealants are eligible for registration to the
Scheme based on generic reference
• non-surgical removal of teeth Disease Risk Management Programme.
pricing or the inclusion of a product in
• root canal treatment.
the medication ‘formulary’. This pricing The Programme aims to ensure that
members receive health information, DISCLAIMER
!
system refers to the maximum price that
POLMED will pay for a particular generic guidance and management of their
In the event of a dispute the
Co-payment medication. Should a reference price be conditions, at the same time improving
compliance to treatment prescribed by registered rules of POLMED
A co-payment is an amount payable by set for a generic medication, patients are
the medical practitioner. Members who will apply.
the member to the service provider at entitled to make use of any generically
equivalent medication within this pricing are registered on the Programme
the point of service. This includes all the receive a Care Plan (treatment plan),
costs in excess of those agreed upon limit, but will be required to make a
co-payment on medication priced above which lists authorised medical services,
with the service provider or in excess such as consultations, blood tests
of what would be paid according to the generic reference pricing limit. The
fundamental principle of any reference and radiological tests related to the
approved treatments. A co-payment management of their conditions.
would not be applicable in the event of a pricing system is that it does not restrict
life-threatening injury or an emergency. a member’s choice of medication, but
instead limits the amount that will be
paid for it.
Emergency medical services
(EMS) Registration for chronic
72-hour post-authorisation rule medication
Subject to authorisation within 72 hours POLMED provides for a specific list of
of the event, all service providers will chronic conditions that are funded from
be required to obtain an authorisation the chronic medication benefit.
number from POLMED’s designated
service provider (DSP).
55 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 56
AQUARIUM BENEFIT SCHEDULE
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Benefit design This option provides for benefits to be
provided only in appointed designated
service provider (DSP) hospitals
It also provides a reasonable level of
out-of-hospital care
This option is intended to provide for
the needs of families who have little
healthcare needs or whose chronic
conditions are under control
This option is not intended for members
who require medical assistance on a
regular basis, or who are concerned
GENERAL BENEFIT RULES
about having extensive access to
health benefits
Limits are per annum All benefit amounts and limits are
annual
Pre-authorisation, referrals, The pre-authorisation, referral by a DSP
protocols and management by or general practitioner (GP), adherence
programmes to established protocols or registration
to a managed care programme is
stipulated in order to best care for the
members as well as to protect the funds
of the Scheme
Statutory prescribed minimum There is no overall annual limit for PMBs
benefits (PMBs) or life-threatening emergencies
Tariff 100% of POLMED rate or agreed tariff or
at cost for involuntary access for PMBs
57 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 58
AQUARIUM
AQUARIUM
Anaesthetists 150% of POLMED rate or at cost Chronic kidney dialysis 100% of agreed tariff at DSP
for PMBs National Renal Care (NRC) and
Fresenius Medical Care are
preferred providers
Annual overall in-hospital limit Non-PMB admissions will be subject to
Subject to the Scheme’s relevant an overall limit of R200 000 per family
managed healthcare programmes Dentistry (conservative 100% of POLMED rate
and includes the application R8 000 co-payment for admission to a and restorative)
IN-HOSPITAL BENEFITS
of treatment protocols, case non-DSP hospital Dentist’s costs for all non-PMB
management and procedures will be reimbursed from the
pre-authorisation No co-payment if the procedure is out-of-hospital (OOH) benefit
performed in a DSP and/or a day clinic
A R5 000 penalty may be The hospital and anaesthetist’s costs
imposed if no pre-authorisation is will be reimbursed from the overall
obtained
IN-HOSPITAL BENEFITS
non-PMB limit
Subject to PMBs, i.e. no limit
in case of life-threatening
emergencies or for PMB Emergency medical services Subject to POLMED Scheme rules
conditions (ambulance services)
Subject to applicable tariff, i.e.
100% of POLMED rate or agreed
tariff or at cost for involuntary General practitioners (GPs) 100% of agreed tariff at DSP, 100% of
access for PMBs POLMED rate at non-DSP or at cost for
involuntary PMB access
Mental health 100% of POLMED rate or at cost for PMBs
Annual limit of 21 days per member
Limited to a maximum of three days’
hospitalisation for members admitted by
a GP or a specialist physician
Additional hospitalisation to be
motivated by the medical practitioner
59 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 60
AQUARIUM
AQUARIUM
Oncology (chemotherapy and 100% of agreed tariff at DSP Annual overall out-of-hospital M0 – R8 812
radiotherapy) (OOH) limit M1 – R10 677
Independent Clinical Oncology Limited to R259 465 per member per Benefits shall not exceed the M2 – R12 969
Network (ICON) is the DSP annum; includes MRI/CT or PET scans amount set out in the table M3 – R13 836
related to oncology M4+ – R15 855
PMBs shall first accrue towards
the total benefit, but are not
subject to a limit
Organ and tissue transplants 100% of agreed tariff at DSP or at cost
for PMBs In appropriate cases the limit
for medical appliances shall not
Subject to clinical guidelines used in accrue towards this limit
State facilities
OVERALL OUT-OF-HOSPITAL BENEFITS
Out-of-hospital benefits are
Unlimited radiology and pathology subject to:
for organ transplant and • protocols and clinical guidelines
immunosuppressants • PMBs
IN-HOSPITAL BENEFITS
• the applicable tariff, i.e. 100% of
POLMED rate or agreed tariff or
Pathology Service will be linked to hospital at cost for involuntary PMB
pre-authorisation access
Audiology 100% of POLMED rate
Physiotherapy Service will be linked to hospital
pre-authorisation Subject to the OOH limit
Subject to referral by a GP or specialist
Prostheses (internal and external) 100% of POLMED rate
Subject to pre-authorisation and
approved product list
Dentistry (conservative and 100% of POLMED rate
restorative)
Limited to R64 132 per member
Subject to the OOH limit and includes
dentist’s costs for in-hospital,
non-PMB procedures
Refractive surgery No benefit
Routine consultation, scale and polish
are limited to two annual check-ups
per member
Specialists 100% of agreed tariff at DSP, 100% of
POLMED rate for non-DSP or at cost for Oral hygiene instructions are limited to
involuntary PMB access once in 12 months per member
61 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 62AQUARIUM
AQUARIUM
General practitioners (GPs) 100% of agreed tariff at DSP or at cost Pathology M0 – R3 100
POLMED has a GP Network for involuntary PMB access M1 – R4 585
M2 – R5 546
The limit for consultations shall accrue M3 – R6 865
towards the OOH limit M4+ – R8 504
Subject to maximum number of visits/ The defined limit per family will apply
consultations per family per annum, as for any pathology service done out
follows: of hospital
OVERALL OUT-OF-HOSPITAL BENEFITS
M0 – 8
M1 – 12 Physiotherapy 100% of POLMED rate
M2 – 15
M3 – 18 Annual limit of R2 398 per family
OVERALL OUT-OF-HOSPITAL BENEFITS
M4+ – 22
Subject to the OOH limit
Social worker 100% of POLMED rate
Medication (acute) 100% of POLMED rate
Annual limit of R2 263 per family
Annual limit of R9 573 per family
Subject to the OOH limit
Subject to the OOH limit and the
medicine reference price Specialists 100% of agreed tariff at DSP or at cost
Referral is not necessary for for involuntary PMB access
dental specialists, gynaecologists,
nephrologists (dialysis), The limit for consultations shall accrue
Medication (over the counter 100% of POLMED rate oncologists, ophthalmologists, towards the OOH limit
[OTC]) psychiatrists and supplementary/
Annual limit of R952 per family allied health services Limited to four visits per member and
eight visits per family per annum
Subject to the OOH limit; shared limit
with acute medication Subject to referral by a GP (two
specialist visits per member without GP
referral applies)
Occupational and speech therapy PMBs only
R1 000 co-payment if no referral
is obtained
Benefit first accrues to the OOH limit
63 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 64AQUARIUM
AQUARIUM
Dentistry (specialised) In all cases pre-authorisation is required, Allied health services and No benefit
Surgical extractions of teeth failing which the Scheme will impose a alternative healthcare providers
requiring removal of bone or co-payment of R500 Includes biokineticists,
incision required to reduce chiropodists, chiropractors,
fracture Clinical protocols apply dieticians, homeopaths,
naturopaths, orthoptists,
Surgical removal of impacted osteopaths, podiatrists,
teeth requiring removal of reflexologists and therapeutic
inflammatory tissues surrounding massage therapists
partially erupted teeth
SPECIALISED DENTISTRY
Benefit is subject to clinically
Root planning treatment for appropriate services
periodontal disease
Appliances (medical and surgical) 100% of POLMED rate and subject to:
Drainage of abscess and clearing Subject to clinical protocols and
pre-authorisation Blood Unlimited
infection caused by tooth decay
transfusions
STAND-ALONE BENEFITS
Apicoectomy – removal of dead All costs for maintenance are a
Scheme exclusion CPAP R9 168 per family once
tissue caused by infection
machine every four years
Children under the age of seven A minimum of two quotations will
be required for assistive devices Glucometer R1 283 per family once
years, physically or mentally
every four years
disabled patients who require
general anaesthesia for dental
work to be conducted Hearing aids R11 318 per hearing
aid or R22 494 per
Cyst removal of non-vital pulp member per set every
three years
Odentectomy – under sedation
with removal of all teeth in the Insulin Paid from the hospital
mouth delivery benefit up to the
devices mean price of three
and urine quotations
catheters
Medical Annual limit of
assistive R2 695 per family
devices and includes medical
devices in/out of
hospital
Nebuliser R1 283 per family once
every four years
Oxygen Unlimited
65 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 66AQUARIUM
AQUARIUM
Appliances (medical and surgical) Wheelchair R34 370 per member Optical The benefit per member (per 24-month
(continued) (motorised) once every three Includes frames, lenses and benefit cycle) at the provider network
years eye examinations would be:
OR The eye examination is per One composite consultation, inclusive
Wheelchair R11 983 per member member every two years of refraction, tonometry and visual field
(unless prior approval for clinical screening; collection of blood pressure,
(non- once every three
indication has been obtained) glucose and cholesterol readings
motorised) years
Benefits are not pro rata, but AND EITHER SPECTACLES
Chronic medication No benefit except for PMBs calculated from the benefit
service date A provider network frame or alternative
(non-PMB medication)
Subject to prior application and/or Subject to the medicine reference price frame plus enhancement to the value
Each claim for lenses or frames
registration of the condition of R613
must be submitted with the lens
prescription
Maternity benefits (including 100% of agreed tariff at DSP, 100% of WITH EITHER
home birth) POLMED rate at non-DSP or at cost for Benefits shall not be granted for
One pair of clear Aquity single-vision
STAND-ALONE BENEFITS
STAND-ALONE BENEFITS
Pre-authorisation required and involuntary PMB access contact lenses if the member
treatment protocols apply or clear Aquity bifocal lenses or clear
has already received a pair of
The limit for consultations shall not Aquity multifocal lenses covered up to
spectacles in a two-year benefit
the value of clear bifocal lens limit
accrue towards the OOH limit cycle
OR CONTACT LENSES
The benefit shall include three
specialist consultations per member per
Annual contact lens limit is Contact lenses to the value of R613
pregnancy
specified
Home birth is limited to R14 417 per
Contact lens re-examination can Contact lens re-examination to a
member per annum be claimed for in six-monthly maximum cost of R233 per consultation
intervals
Annual limit of R4 038 for ultrasound
The benefit at a non-provider network
scans per family; limited to two 2D
provider would be:
scans per pregnancy
One consultation limited to a maximum
Benefits relating to more than two
cost of R365
antenatal ultrasound scans and
amniocenteses after 32 weeks of
AND EITHER SPECTACLES
pregnancy are subject to
pre-authorisation
R613 towards a frame and/or lens
enhancements
Medication (non-PMB specialist 100% of POLMED rate
drug limit, e.g biologicals)
Pre-authorisation required
Specialised medication sub-limit of
R137 800 per family
67 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 68ANNEXURE B2
AQUARIUM
AQUARIUM
Optical WITH EITHER
(continued)
One pair of clear Aquity single-vision
lenses, limited to R174 per lens, or CO-PAYMENTS
one pair of clear Aquity bifocal lenses,
limited to R381, or multifocal clear Aquity
lenses covered up to the value of the OUT OF NETWORK CO-PAYMENT
clear bifocal lens limit General practitioner (GP) Allows for two out-of-network
consultations
OR CONTACT LENSES
Co-payment shall apply once maximum
Contact lenses to the value of R613 out-of-network consultations are
exceeded
Contact lens re-examination to a
maximum cost of R233 per consultation
Hospital R8 000
STAND-ALONE BENEFITS
Radiology (basic) 100% of agreed tariff or at cost for PMBs
i.e. black and white X-rays and
Pharmacy 20% of costs when using a
soft tissue ultrasounds Limited to R5 232 per family
non-designated service provider
(non-DSP) pharmacy
Includes any basic radiology done in/out
of hospital
20% co-payment when voluntarily using
a non-formulary product
Claims for PMBs first accrue towards
the limit
Note: A maximum co-payment of 20%
applies if both the above scenarios are
applicable
Radiology (specialised) 100% of agreed tariff or at cost for PMBs
Pre-authorisation required
Includes any specialised radiology
service done in/out of hospital
Claims for PMBs first accrue towards
the limit
Two (2) MRI scans Subject to a limit of two scans per family
per annum, except for PMBs
Three (3) CT scans Subject to a limit of three scans per
family per annum, except for PMBs
69 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 70ANNEXURE B4
AQUARIUM
AQUARIUM
AQUARIUM CHRONIC CONDITIONS
Prescribed minimum benefits (PMBs), including chronic Diagnosis
and Treatment Pairs (DTPs)
Auto-immune disorder Gynaecological conditions Psychiatric conditions
Systemic lupus erythematosis (SLE) Endometriosis Affective disorders (depression and
Menopausal treatment bipolar mood disorder)
Cardiovascular conditions Post-traumatic stress disorder (PTSD)
Cardiac dysrhythmias Haematological conditions Schizophrenic disorders
Cardiomyopathy Anaemia
Coronary artery disease Haemophilia Pulmonary diseases
Heart failure Idiopathic thrombocytopenic purpura Asthma
Hypertension Megaloblastic anaemia Bronchiectasis
Peripheral arterial disease Chronic obstructive pulmonary disease
Thromboembolic disease Metabolic condition (COPD)
Valvular disease Cystic fibrosis
Hyperlipidaemia
Endocrine conditions Musculoskeletal condition Special category conditions
Addison’s disease HIV/AIDS
Rheumatic arthritis
Cushing’s disease Organ transplantation
Diabetes insipidus Tuberculosis
Diabetes mellitus type I Neurological conditions
Diabetes mellitus type II Cerebrovascular incident Treatable cancers
Hyperprolactinaemia Epilepsy
As per PMB guidelines
Hypo- and hyperthyroidism Multiple sclerosis
Polycystic ovaries Parkinson’s disease
Primary hypogonadism Permanent spinal cord injuries Urological conditions
Benign prostatic hypertrophy
Gastrointestinal conditions Ophthalmic condition Chronic renal failure
Nephrotic syndrome and
Crohn’s disease Glaucoma
glomerulonephritis
Peptic ulcer disease (requires special
Renal calculi
motivation)
Ulcerative colitis
71 POLMED 2018 Guide to your Health POLMED 2018 Guide to your Health 72You can also read
