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PMB and chronic disease

Questions on PMBs

FAQs and other facts about PMBs, medical schemes, healthcare providers and chronic conditions.

Why do we have PMBs?

The reason why PMBs were created basically comes down to two facts, medical schemes and healthcare.

The importance of ICD-10 codes

One code that appears on a healthcare provider account is ICD-10 codes. These codes are used to inform medical schemes about the conditions the members were treated for.

Which conditions are covered?

The Regulations to the Medical Schemes Act in Annexure A provide a long list of conditions identified as Prescribed Minimum Benefits.

What are PMBs?

PMBs are a set of defined benefits that ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected.

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Medical scheme beneficiaries

PMBs are very good news for medical scheme beneficiaries and give them considerable rights as far as healthcare is concerned.

HIV and your medical scheme

HIV is a PMB. Medical schemes are increasingly geared towards giving people living with HIV/Aids that much-needed extra bit of support for a healthy and productive life.

List of chronic diseases

All medical schemes are obligated to provide cover for the 'diagnosis and medication' of the following conditions.

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