Prescribed minimum benefits (PMBs)
The Medical Schemes Act, No. 131 of 1998 provides a prescribed minimum benefit (PMB) list that indicates the minimum chronic conditions a medical scheme must cover by law - for example, high blood pressure, diabetes and cholesterol. The diagnoses, treatment and medical management of these conditions are covered according to the Scheme algorithms and designated service providers (DSPs).
Cover includes costs relating to the diagnosis and treatment of:
- The 26 common chronic health conditions on the Chronic Disease List (CDL).
- 270 other listed health conditions known as the Diagnosis and Treatment Pairs (DTPs).
- An emergency medical condition that results in hospitalisation.
Click here to read more and view the Chronic Disease List (CDL) Prescribed Minimum Benefit (PMB) conditions.
Understanding prescribed minimum benefits (PMBs)
The following extracts from the Council for Medical Schemes' (CMS) website will assist you in understanding prescribed minimum benefits (PMBs).
For more information on PMBs, please visit the CMS website at www.medicalschemes.com.
PMB application form
If you have been diagnosed with a PMB condition, please make an appointment with your treating doctor, so that they can examine you and assist you in completing this application form.