Requirements
- Completed advance supply request form
- Advance subscription payments or letter from Employer confirming employment status and assurance that subscriptions will be paid for the months of advance supply
- Copy of prescription (NB-only authorized chronic medication will be covered)
Copy of itinerary/proof of travel/ confirmation letter that member resides outside the country
Request for extended supply of medication
This form is used to apply for a sufficient supply of medicine for a maximum of three months. Please note: Should you leave your Medical Scheme within the authorization period for extended medicine, you will be billed for the remaining months.
How to complete this application
- One application form is to be completed per patient
- Please attach copy of your air ticket, itinerary or letter from employer confirming travel dates.
- Please complete ALL sections of the application in full. Incomplete applications will result in administrative delays.