DRM Programme
Disease Risk Management (DRM) Programme
The importance of you managing your chronic condition effectively is undeniably vital for your long-term wellbeing, as this can avoid complications of your condition that could have been prevented. As your medical Fund, we want to offer our support by introducing the Disease Risk Management (DRM) Programme.
Key Features of the DRM Programme
Effectively managing your chronic conditions is crucial to your long-term wellbeing. By staying on top of your health, you can prevent complications that could otherwise be avoided. As your healthcare Fund, we are here to support you through the Disease Risk Management (DRM) Programme, designed to help you manage your chronic condition efficiently.
- Comprehensive Treatment Plan: The DRM Programme provides a tailored treatment plan for the 27 core chronic conditions, which includes essential consultations and tests specific to your diagnosis. For example, individuals with Diabetes require regular pathology tests to monitor disease.
- Optimal Health Management: Effective chronic disease management improves overall health and reduces the risk of complications and hospital admissions.
27 Core Chronic Conditions
The following chronic conditions are covered under the DRM Programme, ensuring access to necessary medication, treatments, consultations, and tests:
Addison’s Disease | Dysrhythmias (Abnormal Heart Beat) |
Asthma (Tight chest & shortness of breath) | Epilepsy (Fits /Falling condition) |
Bipolar Mood Disorder (Mental Illness) | Glaucoma (High pressure in the eyes) |
Bronchiectasis (Lung Disease) | Hemophilia (Blood clotting disorder) |
Cardiac Failure (Heart Failure) | Hyperlipidemia (Cholesterol) |
Cardiomyopathy Disease (Heart Disease) | Hypertension (High blood pressure) |
Chronic Kidney/Renal Failure (Kidney Disease) | Hypothyroidism (Under Function Thyroid) |
Chronic Obstructive Pulmonary Disorder (COPD) (Severe Lung Disease) | Major Depression (Severe Stress Disorder) |
Coronary Artery Disease (Heart Disease) | Multiple Sclerosis |
Crohn’s Disease | Parkinson’s Disease (Tremor or imbalance) |
Diabetes Insipidus | Rheumatoid Arthritis (Joint Inflammation Disease) |
Diabetes Mellitus 1 & 2 (Suikersiekte/Glucose) | Schizophrenia (Hallucinating Mental Disorder) |
HIV/AIDS | Systemic Lupus Erythematosus (Auto-immune Disease) |
Ulcerative Colitis (Inflammation of the bowel or intestines) |
If you have been diagnosed with one or more of the following conditions, you quality to register on the Disease Risk Management Programme. Complete the application form provided below to register.
19 Additional Chronic Conditions
Expansion of the DRM Programme - The Fund has expanded the DRM Programme to include 19 additional chronic conditions to support its members.
Unlike the 27 core conditions, these newly added conditions will only qualify for medication coverage under the Chronic Medicine Benefit. Consultations and tests for these conditions will be payable from your day-to-day benefits.
| Acne | Iron Deficiency Anaemia |
| Allergic Rhinitis | Menopause |
| Alzheimers Disease | Migraine |
| Benign Prostatic Hyperplasia | Myasthenia Gravis |
| Deep Vein Thrombosis | Osteoporosis |
| Diverticular Disease/Irritable Bowel Syndrome | Paraplegia& Quadriplegia |
| Gastro-Oesphageal Reflux Disease (GORD) | Peripheral Vascular Disease |
| Hyperthyroidism | Psoriasis |
| Hypoparathyroidism | Urinary Incontinence |
| Interstitial Fibrosis |
If you have been diagnosed with one or more of the following conditions, you quality to register on the Disease Risk Management Programme. Complete the application form provided below to register.
- Chronic conditions registered under the DRM Programme will continue to be covered under the Chronic Medicine Benefit, which has no monetary limit.
- The existing 27 chronic conditions will include a basket of tests and consultations for proper disease management.
- The 19 newly added chronic conditions qualify only for medication coverage under the Chronic Medicine Benefit. Consultations and tests for these conditions will be paid from your day-to-day benefits.
- The Acute Medicine Benefit varies based on family size; refer to the 2025 Schedule of Benefits for details.
- If your chronic condition is not registered under the DRM Programme, medication costs will be deducted from your Acute Medicine Benefit.
- To ensure claims are correctly processed, all qualifying chronic conditions must be registered on the DRM Programme.
- Chronic registrations will not be backdated.
- The RFMCF Medicine Formulary is available below. This document serves as a guideline for the available medication for the 27 Core Chronic Conditions. It outlines approximate pricing and potential co-payments. These co-payments exclude pharmacy dispensing fees.
- Register your condition before collecting medication from the pharmacy.
- Medicine Management and Clinical Protocols apply.
- Visit the RFMCF Schedule of Benefits for a comprehensive overview of the benefit structure: Schedule of Benefits
1.Download the relevant form:
- Use the “Self-Registration Chronic Application Form” if you have already been diagnosed and are receiving treatment.
- Use the “Chronic Application Form” for newly diagnosed conditions.
3. Once registered, your personalised treatment plan will be emailed to you and your treating provider.
We encourage you to review your treatment plan and discuss it with your healthcare provider. Ensuring proper registration allows you to fully benefit from the DRM Programme and receive the necessary support for managing your condition.
Chronic Condition Application Form
Complete this form if you have a newly diagnosed chronic condition. This needs to be completed by your medical practitioner and submitted to the Fund for processing
Self-Registration Chronic Form
Complete this form if you have an existing chronic condition that has not yet been registered by the Fund. This needs to be completed by you as the patient and must be submitted to the Fund for processing
RFMCF Medicine Formulary
A guideline for the available medication for the 27 Core Chronic Conditions. It outlines approximate pricing and potential co-payments.
Disease Risk Management – Journey to good healthcare
Click on the watch button to see the video
Fund Support - Real-life chronic related stories
Click on the watch button to see the video
Chronic Disease Flyers
Click here to obtain educational material relating to various chronic conditions.
