Medihelp uses the MHRP to calculate benefits for medicine used for the treatment of a PMB condition. The MHRP works as follows:
- It is the maximum price (indicated per unit that can be dispensed) that Medihelp pays for specific medicine items for the treatment of the 25 conditions on the Chronic Diseases List (CDL).
- This price is based on the smallest unit that can be dispensed, for example one tablet or capsule, one millilitre of syrup, one ampoule or vial, one disposable pen or penfill or one metered dose inhaler.
- The MHRP applies only to medicines registered for PMB.
- It varies per benefit option.
- If you use a medicine item of which the price exceeds the MHRP, you must pay the difference in price as a co-payment directly to the pharmacy or dispensing doctor. To avoid co-payments, always use generic equivalents of the medicine, if possible.
- One or more alternative medicine items will usually be available to which no co-payments will apply.