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| 1.1 | The cost for hiring and purchasing medical, surgical, orthopaedic and other appliances, including surgical stockings. |
| 1.2 | The treatment of acne and skin conditions. |
| 1.3 | Patent medicine, beauty preparations, bandages, cotton wool and similar material, patent foods including baby food, contraceptives and apparatus to prevent pregnancies, tonics, slimming preparations, household and biochemical remedies, contact lens solutions, homeopathic medicine, vitamins, and any drug or remedies not registered with the SA Medicines Control Council or similar institution. |
| 1.4 | All costs related to the treatment of sickness conditions that were specifically excluded from benefits when the beneficiaries joined the Scheme as per the waiting periods. |
| 1.5 | The cost of medicine purchased from a person not legally entitled to supply or prescribe medicine. |
| 1.6 | Any expenses incurred by a beneficiary in respect of general practitioner services, procedures and dispensed medicine other than those services provided by the beneficiary’s selected general practitioner, and other than the out-of-area benefits, subject to Annexure 2. |
| 1.7 | Any expenses incurred by a beneficiary in respect of optical and dental services, other than the services provided by the beneficiary’s selected optometrist/dentist. |
| 1.8 | The cost of any services rendered by a specialist without recommendation and/or referral of the beneficiary’s selected general practitioner, subject to Annexure 2. |
| 1.9 | Appointments cancelled and/or not kept. |
| 1.10 | The cost involved in any surgical procedure, treatment, equipment, agent or medicine of experimental nature. |
| 1.11 | The treatment of snoring, rhinoplasty, mammoplasty or uvulopalatopharyngioplasty. |
| 1.12 | Immunisations normally available from State facilities and anti-malaria agents used as prophylaxis against malaria. |
| 1.13 | Injuries sustained during participation in a strike, unlawful action, revolt or violent behaviour. |
| 1.14 | All biological and other medicine items as per Medihelp's exclusion list, unless when indicated and prescribed for the treatment of a PMB condition. |