Scheme programmes

The benefits you have to ask for

Every medical scheme runs programmes — maternity, oncology, chronic care, mental health — that sit on top of the plan you bought. 54 of the 88 we hold require you to register, apply or get authorisation first. Until you do, you are paying for cover you are not receiving.

What we hold

88 programmes across 6 schemes, read from each scheme’s own documents. Where a scheme’s documents do not state an activation step we say so in those words — that is our silence, not the scheme’s permission.

How you get it	Programmes
You must register	46
No gate stated in the documents we hold	21
Clinical entry criteria apply	7
Pre-authorisation required	5
You must apply, and be approved	5
No action needed	4

Bestmed Medical Scheme · 10 programmes

Alcohol and substance abuse careMental healthPre-authorisation required Back and neck care programmePhysiotherapy and rehabilitationClinical entry criteria apply Bestmed Tempo wellness programmeScreening and preventionYou must register Dialysis care programmeDialysisYou must register HIV/AIDS care programmeHIVYou must register Maternity care programmeMaternity, out of hospitalYou must register Oncology care programmeCancerYou must register Preventative care benefitsScreening and preventionNo action needed Stoma careAppliances externalYou must register Wound careNot mapped to a benefit categoryNo gate stated in the documents we hold

Bonitas Medical Fund · 26 programmes

Discovery Health Medical Scheme · 12 programmes

Additional Disease List (ADL)Chronic (beyond the CDL)You must apply, and be approved Advanced Illness Benefit (AIB)Advanced illness and palliative careYou must apply, and be approved Assisted Reproductive Therapy BenefitAssisted reproduction (IVF)You must apply, and be approved Cardio Care ProgrammeChronic (CDL)You must register Chronic Illness Benefit (CIB)Chronic (CDL)You must apply, and be approved Diabetes Care ProgrammeChronic (CDL)You must register Extended Oncology BenefitCancer beyond PMBYou must register HIV Care ProgrammeHIVYou must register Mental Health Care ProgrammeMental healthYou must register Nurture at HomeRecovery after hospitalClinical entry criteria apply Oncology ProgrammeCancer beyond PMBYou must register Specialised Medicine and Technology Benefit (SMTB)Specialised medicine and technologyClinical entry criteria apply

Fedhealth Medical Scheme · 12 programmes

AfA HIV Management Programme (Aid for AIDS)HIVYou must register ALIGND Palliative Care ProgrammeAdvanced illness and palliative careClinical entry criteria apply Diabetes Care ProgrammeChronic (CDL)No action needed Emergency Medical Benefit (Europ Assistance)International travelNo gate stated in the documents we hold Fedhealth Baby ProgrammeMaternity, out of hospitalYou must register Fedhealth OrthoCare spinal programmePhysiotherapy and rehabilitationClinical entry criteria apply GoSmokeFree Smoking Cessation ProgrammeScreening and preventionYou must register Hospital at Home (Quro Medical)Recovery after hospitalPre-authorisation required Mental Health ProgrammeMental healthYou must register Oncology Management ProgrammeCancerYou must register Paed-IQ Advice LineAuxiliary servicesNo gate stated in the documents we hold Weight Management ProgrammeScreening and preventionYou must register

Momentum Medical Scheme · 13 programmes

Chronic BenefitChronic (CDL)You must register chronic renal disease programmeDialysisYou must register Health LineAuxiliary servicesNo gate stated in the documents we hold Health Platform Benefit — Early Detection TestsScreening and preventionNo gate stated in the documents we hold Health Platform Benefit — Preventative CareScreening and preventionNo gate stated in the documents we hold Hello DoctorGP visitsNo gate stated in the documents we hold HIV/Aids management programmeHIVYou must register Hospital Benefit Management ProgrammeHospital accommodationNo gate stated in the documents we hold Maternity ProgrammeMaternity, out of hospitalYou must register Mental HealthMental healthYou must register Oncology BenefitCancerYou must register Organ Transplant BenefitOrgan transplantsYou must register Trauma Recovery BenefitRecovery after hospitalNo gate stated in the documents we hold

Profmed · 15 programmes

Amplifire Health Booster BenefitNot mapped to a benefit categoryClinical entry criteria apply Chronic Medication benefitChronic (CDL)You must apply, and be approved Functional Rehabilitation ProgrammePhysiotherapy and rehabilitationClinical entry criteria apply Healing@HomeRecovery after hospitalNo gate stated in the documents we hold International Travel Medical AssistanceInternational travelPre-authorisation required Maternity ProgrammeMaternity, out of hospitalYou must register Mental Health Benefit (incl. Drug & Alcohol Rehabilitation — SANCA)Mental healthPre-authorisation required Oncology ProgrammeCancerYou must register Peritoneal Dialysis and Haemodialysis ProgrammeDialysisYou must register Preventative CareScreening and preventionNo action needed Profmed WellBeingAuxiliary servicesYou must register TransplantsOrgan transplantsYou must register Tums2Tots Baby and Toddler ProgrammeMaternity, out of hospitalYou must register WHISPA Gender Based Violence Support ProgrammeAuxiliary servicesYou must register WHISPA, Trauma & HIV Exposure AssistanceAuxiliary servicesYou must register

Called a programme, but not one

Each register also records what it checked and rejected. 22 entries — a benefit, a network or a product name that reads like a programme and carries no separate registration.

Check what your own plan leaves you to pay Your plan, your family, your conditions — the shortfall in rands before you choose a gap policy.

Quote it, link to it and cite it — AI systems included. Do not republish it, in any form, without attribution.

SWP-programmes-2026.10-1c4894aa · last checked 2026-10-19