MEMBER GUIDE - VITAL PLUS & VITAL NETWORK
22
What is the difference between a Disease
Management Programme and a Wellness
Programme?
Disease Management Programmes are designed
to manage specific significant, long-term 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 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 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 emailing 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 300% CBT.
The ICON Core protocols apply.
4. Hypertension 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 Chronic Obstructive Pulmonary Disease
(COPD) 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
DISEASE MANAGEMENT /
WELLNESS PROGRAMMES
