Chronic Disease List (CDL)

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This Chronic Disease List (CDL) is a prescribed minimum benefits list that ensures all medical aid schemes fund the cost of the diagnosis, medical management (consultations and procedures) and medication of a specified list of 26 chronic conditions.

These conditions are covered in full in terms of the Scheme rules if services are rendered according to the Scheme’s benefits, treatment plans and protocols, CDL medication lists, and claimed with the correct diagnostic (ICD-10) codes.

These conditions are covered on all of Profmed’s options, but benefits will be more or less restrictive depending on the benefit option that you have chosen.

Prescribed Minimum Benefit CDL conditions

Addison’s Disease

Asthma

Bipolar Mood Disorder

Bronchiectasis

Cardiac Failure

Cardiomyopathy Disease

Chronic Obstructive Pulmonary Disorder

Chronic Renal Disease

Coronary Artery Disease

Chron’s Disease

Diabetes Insipidus

Diabetes Mellitus Types 1 & 2

Dysrhythmias

Epilepsy

Glaucoma

Haemophilia

HIV/Aids

Hyperlipidaemia

Hypertension

Hypothyroidism

Multiple Sclerosis

Parkinson’s Disease

Rheumatoid Arthritis

Schizophrenia

Systemic Lupus Erythematosis

Ulcerative Colitis

Other non-CDL conditions

Relevant Diagnostic & Treatment Pairs (DTPs)

Prescribed Minimum Benefit CDL conditions

Addison’s Disease

Asthma

Bipolar Mood Disorder

Bronchiectasis

Cardiac Failure

Cardiomyopathy Disease

Chronic Obstructive Pulmonary Disorder

Chronic Renal Disease

Coronary Artery Disease

Chron’s Disease

Diabetes Insipidus

Diabetes Mellitus Types 1 & 2

Dysrhythmias

Epilepsy

Glaucoma

Haemophilia

HIV/Aids

Hyperlipidaemia

Hypertension

Hypothyroidism

Multiple Sclerosis

Parkinson’s Disease

Rheumatoid Arthritis

Schizophrenia

Systemic Lupus Erythematosis

Ulcerative Colitis

Other non-CDL conditions

Relevant Diagnostic & Treatment Pairs (DTPs)

Prescribed Minimum Benefit CDL conditions

Addison’s Disease

Asthma

Bipolar Mood Disorder

Bronchiectasis

Cardiac Failure

Cardiomyopathy Disease

Chronic Obstructive Pulmonary Disorder

Chronic Renal Disease

Coronary Artery Disease

Chron’s Disease

Diabetes Insipidus

Diabetes Mellitus Types 1 & 2

Dysrhythmias

Epilepsy

Glaucoma

Haemophilia

HIV/Aids

Hyperlipidaemia

Hypertension

Hypothyroidism

Multiple Sclerosis

Parkinson’s Disease

Rheumatoid Arthritis

Schizophrenia

Systemic Lupus Erythematosis

Ulcerative Colitis

Other non-CDL conditions

Allergic Rhinitis – in patients with asthma

Alzheimer’s Disease

Ankylosing Spondylitis

Attention Deficit Hyperactivity Disorder

Benign Prostatic Hypertrophy

Major Depressive Disorder

Obsessive Compulsive Disorders

Osteoporosis

Paraplegia and Quadriplegia

Pituitary Adenomas / Hyperfunction of Pituitary Gland

Psoriatic Arthritis

Pulmonary Interstitial Fibrosis

Relevant Diagnostic & Treatment Pairs (DTPs)

Valvular Heart Disease

Prescribed Minimum Benefit CDL conditions

Addison’s Disease

Asthma

Bipolar Mood Disorder

Bronchiectasis

Cardiac Failure

Cardiomyopathy Disease

Chronic Obstructive Pulmonary Disorder

Chronic Renal Disease

Coronary Artery Disease

Chron’s Disease

Diabetes Insipidus

Diabetes Mellitus Types 1 & 2

Dysrhythmias

Epilepsy

Glaucoma

Haemophilia

HIV/Aids

Hyperlipidaemia

Hypertension

Hypothyroidism

Multiple Sclerosis

Parkinson’s Disease

Rheumatoid Arthritis

Schizophrenia

Systemic Lupus Erythematosis

Ulcerative Colitis

Other non-CDL conditions

Allergic Rhinitis – in patients with asthma

Alzheimer’s Disease

Ankylosing Spondylitis

Attention Deficit Hyperactivity Disorder

Benign Prostatic Hypertrophy

Major Depressive Disorder

Obsessive Compulsive Disorders

Osteoporosis

Paraplegia and Quadriplegia

Pituitary Adenomas / Hyperfunction of Pituitary Gland

Psoriatic Arthritis

Pulmonary Interstitial Fibrosis

Relevant Diagnostic & Treatment Pairs (DTPs)

Valvular Heart Disease

Prescribed Minimum Benefit CDL conditions

Addison’s Disease

Asthma

Bipolar Mood Disorder

Bronchiectasis

Cardiac Failure

Cardiomyopathy Disease

Chronic Obstructive Pulmonary Disorder

Chronic Renal Disease

Coronary Artery Disease

Chron’s Disease

Diabetes Insipidus

Diabetes Mellitus Types 1 & 2

Dysrhythmias

Epilepsy

Glaucoma

Haemophilia

HIV/Aids

Hyperlipidaemia

Hypertension

Hypothyroidism

Multiple Sclerosis

Parkinson’s Disease

Rheumatoid Arthritis

Schizophrenia

Systemic Lupus Erythematosis

Ulcerative Colitis

Other non-CDL conditions

Allergic Rhinitis – in patients with asthma

Alzheimer’s Disease

Ankylosing Spondylitis

Attention Deficit Hyperactivity Disorder

Benign Prostatic Hypertrophy

Cushing’s Syndrome

Cystic Fibrosis

Deep Vein Thrombosis

Gastro-oesophageal Reflux Disorder

Gout

Hypoparathyroidism

Major Depressive Disorder

Malabsorption Syndrome

Menopause (Calcium)

Meniere’s Disease

Motor Neuron Disease

Myasthenia Gravis

Obsessive Compulsive Disorders

Osteoarthritis

Paget’s Disease

Osteoporosis

Peripheral Vascular Disease

Post-Organ Transplant (non-DTPs)

Paraplegia and Quadriplegia

Psoriatic Arthritis

Pituitary Adenomas / Hyperfunction of Pituitary Gland

Pulmonary Interstitial Fibrosis

Relevant Diagnostic & Treatment Pairs (DTPs)

Systemic Connective Tissue Disorders

Stroke / Cerebrovascular Accident

Tuberculosis

Valvular Heart Disease

Note: MMAP® and reference pricing apply on all options.