How to get authorisation
To access your chronic medication benefits, your treatment needs to be approved first. Alliance-Midmed uses Mediscor PBM to manage chronic medicine authorisations.
In most cases, your doctor or pharmacist will handle this for you. They can contact ChroniLine® directly to request approval on your behalf. If needed, you can also send your prescription yourself.
Chronic Medicine Authorisation
Changes to Your Chronic Medication
If your doctor changes your prescription, or you are starting chronic medication for the first time, please remember to send a copy of your prescription to preauth@mediscor.co.za for authorisation.
Alternatively, you can contact Mediscor ChroniLine® on 0860 119 553 for assistance.
Helpful article on
The Meaning Behind Medicine Schedules.
Mediscor ChroniLine® may contact your doctor or pharmacist for more information before authorising your chronic medication. You’ll be advised of any co-payments or medicines not covered by your benefit option.
Helping you prepare for planned healthcare
Some healthcare services need to be approved by Alliance-Midmed before you receive treatment. This is known as pre-authorisation.
Pre-authorisation allows the Scheme’s clinical team to review the planned treatment, confirm that it meets the relevant clinical guidelines and Scheme Rules, and guide you through any requirements before treatment begins.
Important: Pre-authorisation is not a guarantee that all costs will be paid in full. Your cover remains subject to the Scheme Rules, available benefits, clinical protocols and applicable rates.
You may need to contact Alliance-Midmed before receiving certain healthcare services, including:
- Planned hospital admissions
- Psychiatric hospital admissions
- Sub-acute and rehabilitation facility admissions
- Specialised radiology, including certain scans and MRI examinations
- Certain in-hospital physiotherapy and associated healthcare services
- Chronic medication
- Certain procedures, treatments and other services identified by the Scheme
If you’re unsure whether your treatment requires authorisation, contact us before receiving treatment. Our team can guide you on what is required.
Get authorisation before you’re admitted
For a planned hospital admission, contact Alliance-Midmed in advance to request pre-authorisation.
The Scheme may require information from you, your doctor and other healthcare providers involved in your treatment before the request can be assessed.
For emergency admissions that take place after hours, contact the Scheme on the first working day following the admission.
What You’ll Need for Hospital Pre-Authorisation
Before contacting us for hospital pre-authorisation, have the following information ready. Your healthcare provider can help you with the medical details you may not know.
- Your Alliance-MidMed membership number
- Details of the dependant receiving treatment
- Name and address of the admitting healthcare professional
- Name and address of the referring healthcare professional, if applicable
- Planned date of admission
- Name of the hospital or clinic
- ICD-10 diagnosis code and/or CPT procedure code, provided by your healthcare professional
- Details of the planned procedure or operation, if applicable
- Expected length of your hospital stay, provided by your healthcare professional
- A quotation from your healthcare professional for any planned or booked procedure
Tip: Ask your doctor or healthcare provider for the relevant medical codes, procedure details, expected length of stay, and quotation before contacting us. Having everything ready will help make the pre-authorisation process smoother.
Certain specialised radiology services, including scans and MRI examinations, require pre-authorisation.
Before having the scan, contact Alliance-Midmed to confirm whether authorisation is required and what supporting clinical information needs to be provided.
Certain physiotherapy and associated healthcare services received while you are in hospital also require pre-authorisation.
The Scheme may require the healthcare provider’s practice details, treatment or care plan, and relevant tariff codes when assessing the request.
Chronic medication must be registered and authorised before it can be funded from the applicable chronic medicine benefit.
If you’re starting chronic medication for the first time, or your doctor changes your prescription, make sure the updated prescription is submitted for authorisation.
ChroniLine: 0860 119 553
Alliance-Midmed: 0860 002 101, option 2
Email: preauth@mediscor.co.za
For Alliance-Midmed clinical support relating to chronic medication, contact 0860 002 101, option 3.
You don’t have to work through the process alone. The Alliance-Midmed clinical team can guide you on the information required and assist with your authorisation request.
Call: 0860 002 101, option 1
Email: auths@alliancemidmed.co.za
Clinical service hours: Weekdays, 07:30 to 16:00
Not sure whether you need authorisation?
Contact us before treatment and we’ll help you understand the next steps.
We’re here to help!
Our Member Support team is available Monday to Friday, 08:00 to 16:00.
If you contact us after hours, we’ll respond as soon as possible.
24-Hour Medical Emergency
0860 255426 (0860 ALLIANCE)
- Always present your membership card when receiving medical care
- Medical professionals are required to assist
in emergencies - Alliance-Midmed is a medical scheme,
not insurance
Scheme Call Centre
CALL: 0860 002 101
Hours: 07:00 to 16:30, Monday to Friday
After-hours membership confirmation is available on the same number.
For general queries after hours, please use the Member App or website.
Ambulance Services & Health Counsellor
0860 255 426
Available 24/7/365 for emergency ambulance services and access to health counselling when you need medical guidance or support.
After-Hours AZOZA
0860 00 2101
For after-hours emergency treatment and hospital admission assistance when the Scheme’s regular support services are closed.
Membership-Related Services
0860 00 2101 AZOZA
For assistance with membership confirmation and other membership-related enquiries during normal operating hours.
How to submit your claim
Submitting a claim is simple. Once you have your account or supporting documents ready, you can send your claim directly to Alliance-MidMed for processing.
Email your claim
Send your claim and supporting documents to service@alliancemidmed.co.za.
Use the Member App
Submit your claim quickly and conveniently through the free Alliance-MidMed Member App, wherever you are.
Simple to submit. Easy to manage.
Seeing a specialist
Before visiting a specialist, it’s important to understand how costs work. Alliance-Midmed pays specialists up to a set rate, based on what is affordable for the Scheme. If a specialist charges above this rate, you may need to pay the difference.
Tip: Always confirm the specialist’s rates before your appointment, including anaesthetists.
For more information on rates or co-payments, contact us on 0860 002 101. Some specialists may charge lower co-payments or none at all.
First consultation benefit
To support your access to specialist care, benefits are provided in line with the Scheme Rules and applicable protocols.
