A lot of research and development goes into the development of new medicine, which is very expensive. Once the medicines are approved and placed on the market, the company who developed it receives exclusive rights, called a patent, for a period of 10 to 20 years in which other pharmaceutical companies cannot manufacture the same medication. This medication is known as brand-name/original medication. Once the patent period has expired, any pharmaceutical company can manufacture the same medication, as it is relatively simple to analyse the product chemically. These companies can manufacture the same medication at a much lower cost, as they do not need to pay for the research and development costs (already done with the brand-name/original product). This medication is known as generic medication. Therefore, generic medicines have the same active ingredients as the brand-name/original product and is identical in dosage, strength, quality and performance.

SELF-MEDICATION/OVER-THE-COUNTER (OTC) MEDICATION

info Self-medication is schedule 1 and 2 medicine that does not require a prescription, but is dispensed by a pharmacist over the counter.

Paid at 100% of Mediscor Reference Price.
Health plan up to a maximum of R240 per event and R1 400 per family per annum, subject to the acute medication limit below
Budget plan up to a maximum of R240 per event and R460 per family per annum, subject to the acute medication limit below

Acute Medicine

info Is prescribed medication for a temporary condition or illness or prescribed medication to relieve the symptoms of infections, sprains, etc. and include injection material and flu vaccines.

Approved acute medication is paid at 100% of the Mediscor Reference Price from the individual annual limit. Members should request healthcare providers to prescribe the less expensive generic equivalent of a medication, where available.

The Mediscor Reference Pricing (MRP) model is applicable to all medicines with generic equivalents. The MRP sets a maximum reimbursable price for a list of similar generic products with a lower cost than that of the original medicine. If a member chooses to use medicine that is more expensive than the MRP, the member will have to pay the difference between the price of the chosen medicine and the MRP. This is applicable to both preferred and non-preferred formulary medicines. Co-payments can be avoided or reduced by using a generic equivalent that costs less than the MRP. We encourage the use of generic equivalent medicines in the interest of cost-effective care.

Imperial Motus Med Health Plan

Acute medicines and injection material, including flu vaccines

warning Member family limit per annum, calculated as follows:
      R7 640 per member
      R4 800 per adult dependant
      R1 450 per child dependant (maximum of three children)

Imperial Motus Med Budget Plan

Acute medicines and injection material, including flu vaccines

warning Member family limit per annum, calculated as follows:
      R2 550 per member
      R1 610 per adult dependant
      R500 per child dependant (maximum of three children)

Chronic Medicine

info A chronic condition is a medical condition that is persistent or otherwise long-lasting in its effects and requires ongoing, regular medication to manage the condition. The term chronic is often applied when the course of the medical condition lasts for more than three months.

The Scheme provides unlimited benefits for the treatment of 26 medical conditions that appear on the prescribed minimum benefit (PMB) chronic disease list (CDL). In addition to the PMB CDL, members will also receive benefits for the listed non-PMB chronic conditions.

Click here to view the chronic reference price formulary.

Imperial Motus Med Health Plan

Prescribed for PMB conditions and/or additional chronic conditions.
Subject to the chronic medicine formulary only.
A 10% Co-payment applies when using a non-formulary medicine.

warning Member family limit per annum, calculated as follows:
      Subject to pre-authorisation
     R26 170 per beneficiary

Imperial Motus Med Budget Plan

Prescribed for PMB conditions only.
Subject to the chronic medicine formulary only.
A 25% Co-payment applies when using a non-formulary medicine.

warning Member family limit per annum, calculated as follows:
      Subject to pre-authorisation
      PMBs only