Bestmed Chronic Conditions List

Table of Contents:

All the plans on Bestmed cover the 27 CDL chronic conditions.

In addition, on some plans Bestmed also offers cover for an additional 28 chronic conditions, as listed below. Note that medication for the non-CDL conditions requires a co-payment, and that there is an additional co-payment for non-formulary medicine. See each plan’s medicine benefit for specifics.

Quick links to chronic medicine benefit for each plan:

Beat 1 | Beat 2 | Beat 3 | Beat 4
Pace 1 | Pace 2 | Pace 3 | Pace 4
Pulse 1

What are the 27 CDL chronic conditions?

Addison’s Disease, Asthma, Bipolar Mood Disorder, Bronchiectasis, Cardiac Failure, Cardiomyopathy, Chronic Renal Disease, Chronic Obstructive Pulmonary Disease, Coronary Artery Disease, Crohn’s Disease, Diabetes Insipidus, Diabetes Mellitus Types 1 & 2, Dysrhythmias, Epilepsy, Glaucoma, Haemophilia, Hyperlipidaemia, Hypertension, Hypothyroidism, Multiple Sclerosis, Parkinson’s Disease, Rheumatoid Arthritis, Schizophrenia, Systemic Lupus Erythematosus, Ulcerative Colitis.

Bestmed will cover the diagnosis, treatment and managed care for these conditions. You must use a designated service provider, or you might have a co-payment.

What other chronic conditions are covered by Bestmed?

Acne – severe, ADD/ADHD, Allergic rhinitis, Eczema, Migraine prophylaxis
Beat 3, Beat 4, All Pace plans

Gout prophylaxis, Major Depression
Beat 4, All Pace plans

OCD, GORD
Beat 4, Pace 2, Pace 3, Pace 4

Osteoperosis, Psoriasis, Urinary incontinence, Paget’s disease, Osteoarthritis, Alzheimer’s Disease:
Pace 2, Pace 3, Pace 4

Ankylosing spondylitis, Collagen Disease, Dermatomyositis:
Pace 2, Pace 3, Pace 4

Neuropathy:
Pace 3, Pace 4

Hypopituitarism, Motor Neuron Disease, Polyarteritis nodosa, Scleroderma, Sjorgen’s disease, Trigeminal neuralgia, Psoriatic arthritis, Blepharospam, Dystonia:
Pace 4

To read more about chronic conditions, or PMBs in general, see our full PMB guide.

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What does a “PMBs only” restriction mean?
In this case, the scheme will only pay for diagnosis, treatment and management of a claim for one of 270 pre-defined conditions (PMBs). Read more, and see full list of PMB conditions. 

What does “From Risk” mean?
The scheme will pay for this claim from its own funds, not from your savings or other day-to-day benefits. 

What is a DSP?
A Designated Service Provider. The scheme has a network of providers, and will often only pay claims in full if you use a DSP. If you choose another provider, you might have a co-payment, or even no cover. 

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