Register for Chronic Medicine
To get cover for your chronic medicine, consultations, tests and treatment baskets, you need to register for the Chronic Illness Benefit.
Before registering, it helps to know what you're applying for. The benefit covers:
- Approved medicine for 27 Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions
- Medicine on the formulary (medicine list) funded in full up to the Scheme Rate
- Medicines not on the list, funded up to the Chronic Drug Amount (CDA)
- A limited number of specialist consultations, tests and procedures each year for your approved condition
- Four GP consultations per year linked to your chronic condition(s)
You and your doctor must complete the Chronic Illness Benefit application form with the correct diagnosis, ICD-10 code, and medical test results, and include all supporting documents to avoid delays. If your doctor uses HealthID and you give consent, they can submit the form online, which makes the process faster.
The Scheme will review the application to check if you qualify for the benefit and what treatment, medicine, tests, or specialist visits are covered. If approved, you will receive an authorisation letter that explains what is covered and any limits for your condition.