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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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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Why do we have PMBs?
The reason why PMBs were created basically comes down to two facts. |
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What are emergency conditions?
An emergency medical condition means the sudden and, at the time, unexpected onset of a health condition that requires immediate medical treatment and/or an operation. |
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Why are designated service providers important?
A Designated Service Provider is a healthcare provider that is a medical scheme’s first choice when its members need diagnosis, treatment or care for a PMB condition. |
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The importance of ICD-10 codes
One of the types of codes that appear on healthcare provider accounts is known as ICD-10 codes. |
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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. |
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Questions
FAQs and other facts about PMBs and medical schemes. |
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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. |
