2025 MEMBER GUIDE - NETWORK CHOICE
23
BACK TO CONTENTS PAGE
Disease Management /
Wellness Programmes
What is the difference between a Disease
Management Programme and a Wellness
Programme?
Disease Management Programmes are designed to
manage specific life threatening chronic diseases such
as Diabetes, HIV/AIDS and Hypertension. They assist
the member to improve control of the condition and to
prevent the progression of the disease or complications.
Wellness programmes are designed to keep members
healthy, whether they have a medical condition or not.
What Disease Management Programmes
are offered as a benefit by CAMAF?
1. Diabetes - members diagnosed with diabetes
should register on the Diabetes Management
Programme by contacting 0861 700 600 or email
diabetes@camaf.co.za to obtain fully comprehensive
treatment of their condition. The programme provides
all medication and testing kits, education about your
condition, foot and eye screening.
2. HIV / AIDS - members diagnosed with this condition
or who have had exposure to the condition e.g.,
through rape or injury should register on our HIV
Management Programme at 011 707 8910 or email
diseasemanagement@camaf.co.za. Members and
their families will be treated in total confidence
and obtain all medication, advice and counselling
required.
i) Once registered you should visit your nominated
network GP for consultations
ii) Any recognised laboratory may be used for
Pathology (blood tests)
iii) It is extremely important that the correct ICD 10
codes appear on these pathology accounts to
ensure payment is made from the HIV benefit
iv) Medication is authorised by our Disease and
Medicine Risk Management Department and
delivered by Pharmacy Direct. These medication
claims are submitted directly to CAMAF by
Pharmacy Direct.
3. Cancer - members diagnosed with cancer should
register on this programme by calling 011 707 8461 or
email oncology@camaf.co.za to obtain the benefits
and / or relevant advice. Your treating doctor should
submit a treatment plan for approval. Consultations
and procedures are paid at 100% DSP Tariff (the DSP
is the ICON network). The ICON Essential protocols
apply.
4. Hypertension and and Hyperlipidemia Programme -
members who have one or both conditions should
register on this programme by contacting 0861 700 600
or email cardiovascular@camaf.co.za.
5. Respiratory Programme - members who have asthma
or other chronic respiratory diseases should contact
0861 700 600 or email respiratory@camaf.co.za.
6. Musculo-skeletal Programe - contact 0860 100 544 or
send an email to musculoskeletal@camaf.co.za
