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PMBs: Mental Conditions

PMB Mental Health conditions These PMB mental conditions must be covered by medical aids without charging the member out-of-pocket expenses, assuming that protocols and DSPs...

List of the 27 CDL (PMB) Chronic conditions

Chronic PMB conditions PMB (Prescribed Minimum Benefits), including chronic PMB conditions, are conditions that any medical aid needs to pay for, regardless of what plan...

Pregnancy cover if you don’t have medical aid

"I'm pregnant but not covered by medical aid. Can I join now?" One of the most common questions we get asked is from expectant mothers,...

Is your late joiner penalty worked out correctly?

We have found that some schemes and brokers misrepresent or miscalculate how the late joiner penalty is applied. We have laid three complaints with the Council of Medical Schemes. If you are paying a late joiner penalty, you can use the information on this page to determine if you are paying the correct penalty.

Should a medical aid scheme pay for experimental treatment?

Should medical schemes fund experimental treatments if they are a member's only option for survival?

How day-to-day benefit works (savings, threshold, etc)

Savings With plans that have a savings facility as part of the day-to-day benefit, you get an annual allowance, known as your savings account. It...