KeyCare dental medicine list (formulary)
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1 KeyCare dental list (ulary) 2018
2 This document lists the KeyCare dental list (ulary) for 2018 Disclaimer The ination contained in this document may be subject to change. The KeyCare dental benefit and the utilisation of the benefits and programmes associated with the KeyCare dental benefit is subject to specific conditions and rules. Members must ensure that they are familiar with these rules and conditions. The scheme rules are available on Any instruction or advice we give about s and the management of the member s condition is intended as a supplement to, and not a substitute for, the knowledge, expertise, skill and judgement of the member s doctor, pharmacist or other healthcare professional. Discovery Health Medical Scheme reserves the right to change the benefit at any time. We will communicate any changes to the way we pay s when we make these. The updated version of this document is available on our website at all times. PAGE 2 OF 11
3 KeyCare dental This list (ulary) contains s for acute (short term) use only. We have set the of for each sub- (s with similar therapeutic effects) according to a specified. For example, a member can claim up to a maximum of 30 Moxymax 250mg capsules once every 120 days or 200ml Augmaxcil S suspension once every 120 days. Please note: A prescription may only include one from each sub- in the specified time period. For example: a prescription may not include Disprin and Paracetamol within 120 days of each other, because both s are in the same sub-. sub Analgesics Analgesics and anti-pyretics Syrup Actamol red (boxed) 120mg/5ml 200ml Actamol red (un-boxed) 120mg/5ml Adco-Paracetamol 120mg/5ml Feverpain 120mg/5ml Feverpain (boxed) 120mg/5ml Go-Pain P 120mg/5ml Painblok (plastic bottle) 120mg/5ml Painogesic 120mg/5ml Paracetamol elixir SAD (alcohol free) 120mg/5ml Pyralen 120mg/5ml Tablet Adco-Napacod 500mg/10mg Adco-Napamol 500mg Adco-Prolief 500mg Antalgic 500mg Codorol 500mg/8mg Cogesic 500mg/8mg PAGE 3 OF 11
4 sub Analgesics Analgesics and anti-pyretics Tablet Disprin 300mg Painamol Plus 500mg Painogesic 500mg Varipan Co 500mg/8mg Anti-protozoals Suspension Flagyl 200mg/5ml 200ml 120 Tablet Adco-Metronidazole 200mg Amzole 400mg Anaerobyl 400mg Bemetrazole 200mg Bemetrazole 400mg Bio-Metronidazole 200mg Bio-Metronidazole 400mg Metazol 200mg Metazol 400mg Metrazole 400mg Trichazole 200mg Beta-lactams Capsule Allmox 250mg Allmox 500mg Amyn 500mg Austell-Amoxicillin 250mg Austell-Amoxicillin 500mg Moxymax 250mg PAGE 4 OF 11
5 sub Beta-lactams Capsule Moxymax 500mg Promoxil 250mg Promoxil 500mg Ranceph 250mg Ranceph 500mg Cloxin 250mg Cloxin 500mg Suspension Adco-Amoclav S 156mg/5ml 200ml Allmox S 125mg/5ml Allmox SF 250mg/5ml Amoclan S 156mg/5ml Amoclan SF 312mg/5ml Amyn S 125mg/5ml Amyn SF 250mg/5ml Athlone Phenoxymethylpenicillin 125mg/5ml Augmaxcil S 156mg/5ml Augmaxcil SF 312mg/5ml Betamox S 125mg/5ml Bio-Amoksiklav S 156mg/5ml Clamentin S 156mg/5ml CPL Alliance Cephalexin 125mg/5ml Curam BD 457mg/5ml PAGE 5 OF 11
6 sub Beta-lactams Suspension Moxymax S 125mg/5ml 200ml Moxypen S 125mg/5ml Promoxil S 125mg/5ml Promoxil SF 250mg/5ml Ranceph 125mg/5ml Ranceph 250mg/5ml Ranclav 156mg/5ml Ranclav Forte 312mg/5ml Saltermox SF 250mg/5ml Sandoz Co-Amoclav SF 312mg/5ml Sandoz Co-Amoxyclav BD SF 457mg/5ml Sandoz Co-Amoxyclav S 156mg/5ml Zaloxy 125mg/5ml Zaloxy 250mg/5ml Zoxil S 125mg/5ml Tablet Adco-Amoclav 375mg Amoclan 375mg Apex-Clavutin 375mg Apex-Clavutin 625mg Augmaxcil 375mg Augmaxcil 625mg PAGE 6 OF 11
7 sub Beta-lactams Tablet Auro-Amoxiclav 375mg Auro-Amoxiclav 625mg Austell-Co-Amoxiclav 375mg Austell-Co-Amoxiclav 625mg Bindoclav 375mg Bindoclav 625mg Bio-Amoksiklav 375mg Bio-Amoksiklav 625mg Sandoz Co-Amoxiclav 625mg Sandoz Co-Amoxyclav 375mg Sandoz Co-Amoxyclav 625mg Combinations of penicillins Capsule Macropen 500mg Apen 500mg Suspension Apen S 250mg/5ml 200ml Macropen S 250mg/5ml Flucloxacillin Capsule Sandoz Flucloxacillin 250mg Lincosamides Capsule Clindahexal 150mg Macrolides Capsule Adco-Erythromycin 250mg Purmycin 250mg Xeramel 250mg Granule Claren granules 125mg/5ml 180ml Claren granules 250mg/5ml Suspension Betamycin 125mg/5ml 100ml 120 PAGE 7 OF 11
8 sub Macrolides Suspension Erymycin P 125mg/5ml 100ml Erymycin PF 250mg/5ml Purmycin 125mg/5ml Purmycin 250mg/5ml Xeramel S 125mg/5ml Xeramel SF 250mg/5ml Tablet Klaribin 250mg Klaribin 500mg Klarithran 500mg Klaryvid 250mg Klaryvid 500mg Eryko 250mg Oral Anti-fungals Suspension Candacide u/1ml 40ml Canstat oral u/1ml Nystacid u/1ml Quinolones Tablet Austell Ciprofloxacin 250mg Austell Ciprofloxacin 500mg Biotech Ciprofloxacin 250mg Biotech Ciprofloxacin 500mg Cifran 500mg Ciprogen 250mg Ciprogen 500mg Ciprol 250mg PAGE 8 OF 11
9 sub Quinolones Tablet Ciprol 500mg CPL Alliance Ciprofloxacin 250mg CPL Alliance Ciprofloxacin 500mg Flopro 500mg Loxip 500mg Orpic 500mg Sulphonamides Suspension Doctrim 240mg/5ml 200ml Livitrim 240mg/5ml Purbac 240mg/5ml Tablet Ilvitrim 480mg Lagatrim 480mg Nucotrim 480mg Trixazole 480mg Tetracyclines Capsule A-Lennon Doxycycline HCl 100mg Cyclidox 100mg Doxycyl 100mg Doxytet 100mg Nucotet 250mg Pharmatet (yellow/orange) 250mg Musculoskeletal Non-steroidal antiinflammatories (NSAIDs) Capsule Amdocin 25mg Betacin 25mg PAGE 9 OF 11
10 sub Musculoskeletal Non-steroidal antiinflammatories (NSAIDs) Capsule Gulf Indomethacin 25mg Suspension Adco-Mefenamic acid 50mg/5ml 200ml Fenamin 50mg/5ml Ibucine (was Ibumax) 100mg/5ml Ibugesic 100mg/5ml Ponac 50mg/5ml Ponstan 50mg/5ml Tablet Adco-Diclofenac 50mg A-Lennon Diclofenac 25mg A-Lennon Diclofenac 50mg Betaprofen 200mg Betaprofen FC 400mg Bren 400mg Diclofenac Biotech 25mg Diclohexal 25mg Ibucine (was Ibumax) 200mg Ibucine (was Ibumax) 400mg Ibunate 200mg Ibusor 200mg Inza 200mg Inza 400mg Mylan Diclofenac 25mg PAGE 10 OF 11
11 sub Musculoskeletal Non-steroidal antiinflammatories (NSAIDs) Tablet Mylan Diclofenac 50mg Panamor AT 50mg Ranfen 200mg Ranfen 400mg Contact us You can call us on or visit for more ination. Complaints process The following channels are available for your complaints and we encourage you to follow the process: Step1 To take your query further: If you have already contacted the Discovery Health Medical Scheme and feel that your query has still not been resolved, please complete our online complaints on We would also love to hear from you if we have exceeded your expectations. Step 2 To contact the Principal Officer: If you are still not satisfied with the resolution of your complaint after following the process in Step 1 you are able to escalate your complaint to the Principal Officer of the Discovery Health Medical Scheme. You may lodge a query or complaint with Discovery Health Medical Scheme by completing the online on or by ing principalofficer@discovery.co.za. Step 3 To lodge a dispute: If you have received a final decision from Discovery Health Medical Scheme and want to challenge it, you may lodge a al dispute. You can find more ination of the Scheme s dispute process on the website. Step 4 To contact the Council for Medical Schemes: Discovery Health Medical Scheme is regulated by the Council for Medical Schemes. You may contact the Council at any stage of the complaints process, but we encourage you to first follow the steps above to resolve your complaint before contacting the Council. Contact details for the Council for Medical Schemes: Council for Medical Schemes Complaints Unit, Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion 0157 complaints@medicalschemes.com PAGE 11 OF 11
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