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| What
are PMBs? |
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| Prescribed Minimum Benefits (PMB) is a set of defined benefits
to ensure that all medical scheme members have access to certain minimum health
services, regardless of the benefit option they have selected. The aim is to
provide people with continuous care to improve their health and well-being and
to make healthcare more affordable. |
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| PMBs are a feature of the Medical Schemes Act, in terms of
which medical schemes have to cover the costs related to the diagnosis,
treatment and care of: |
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| When deciding whether a condition is a PMB, the doctor should
only look at the symptoms and not at any other factors, such as how the injury
or condition was contracted. This approach is called diagnosis-based. Once the
diagnosis has been made, the appropriate treatment and care is decided upon as
well as where the patient should receive the treatment (at a hospital, as an
outpatient or at a doctor's rooms). |
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