Check Scheme Protocols 2021 | Uncategorised | Medikredit disclaimer


REFERENCE pricing (RP) is the maximum price for which the Scheme will be liable for specific medicine or classes of medicine listed on the relevant scheme's CONDITION MEDICINE LIST (CML). The reference price varies per option and where a drug is above the reference price it is indicated that a co-payment will apply. The reference price applies per 30-day month and is inclusive of VAT. The RP indicator is based on a patient using/claiming the most commonly prescribed therapeutic dose of the medication and where a patient uses a higher quantity there may be a co-pay. If greater quantities are required, then motivation by the treating doctor is required. The reference may apply to a DRUG CLASS or EXACT GENERIC and not only to an individual drug. This implies that where more than one product within a category is used in treatment, the sum of the cost of the two products will be compared against the scheme's reference price. A member will need to pay the difference between the cost of the drug and reference price at the point of dispensing. Please note that medicine quantity limits may apply. .

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