Call centre & authorisations 0861 083 084


Important questions from our members


A generic drug is medication that is the same as the brand-name or originator medicine. However, it comes at a lower cost than the brand or originator, making it more affordable for everybody.

Generic medication works in the same way and provides the same clinical benefit as the brand-name medicine as it has the same dosage form, safety, strength, route of administration, quality, performance characteristics and intended use as the brand or originator medication.

Your prescription or certain items on it may be rejected at the pharmacy for several reasons. Some of them are for administrative reasons, e.g. funds depleted, incorrect claim code used by the pharmacist, or a person is not registered for one or more chronic conditions. Rejection for administrative reasons can mostly be attended to by the pharmacist.

Other rejections are clinical in nature, e.g. drug interactions or drug dosage modifications. This will require interaction between your doctor and the pharmacist.

You need to register for chronic benefits should your doctor diagnose you with a chronic disease condition.

Umvuzo will cover treatment, subject to the formulary, for the following chronic conditions:

1. Addison’s Disease 15. Epilepsy
2. Asthma 16. Glaucoma
3. Bipolar Mood Disorder 17. Haemophilia
4. Bronchiectasis 18. HIV
5. Cardiac Failure 19. Hyperlipidaemia
6. Cardiomyopathy 20. Hypertension
7. Chronic Renal Failure 21. Hypothyroidism
8. COPD 22. Multiple Sclerosis
9. Coronary Artery Disease 23. Oncology
10. Crohn’s Disease 24. Parkinson’s Disease
11. Diabetes Insipidus 25. Rheumatoid Arthritis
12. Diabetes Mellitus 1 26. Schizophrenia
13. Diabetes Mellitus 2 27. Systemic Lupus Erythematosus
14. Dysrhythmia 28. Ulcerative Colitis

A formulary is a list of medicines registered for the treatment of chronic conditions that will be covered by the Scheme.

Your doctor or pharmacist may call to obtain authorisation using:

Medicines for the treatment of minor ailments can be obtained from a pharmacy under your OTC benefit without a prescription from your doctor e.g., cold and flu remedies.


When the clinical team knows in advance what medical conditions the members have, this allows them to be better prepared to assist them. This also ensures that the beneficiaries are registered on the relevant Disease Management Programme timeously and get the correct treatment without any unnecessary delays. Not completing the medical disclosure form or withholding important information is a very serious offense that can lead to the cancellation of your membership with the Scheme.

To ensure us that the details are captured correctly on the system and the ID is a unique way to identify each person, as no two persons have the same ID.

We must have contact details of the member should we need to contact the member or send important documents. It is also important to notify us when your address has changed to ensure we always have the latest details on our records.

Benefits allocated to members are calculated and provided for a 12-month cycle, from January to December. The Scheme’s contributions also change from January of each year. Allowing changes during the course of the year will cause great confusion in terms of benefits used and entitled to, as these differ by benefit Option.

Copyright © 2004-2024 Umvuzo Health  Archives