All about PMBs, and how schemes have to pay for them

PMBs are 270 conditions that schemes have to cover without requiring co-payments or savings from you, even if the treatment is provided out-of-hospital. This applies to every plan.
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How do I complain about a medical aid issue?

"I have a complaint about how my medical aid handled my claim. What do I do now?" Medical Aid rules and administration is complicated and there is often misunderstanding and disagreement between the scheme administrator and the member. You should know that when a medical aid refuses to pay for...

All the jargon explained

DSP A Designated Service Provider (DSP) is a healthcare provider (doctor, pharmacist, hospital, etc) that is a medical scheme’s first choice when its members need diagnosis, treatment or care for a PMB condition (see below for definition of PMBs). (source: Council for Medical Schemes) Formulary This is a list of approved medicines...

Medical Aid 101

10 REAL ways to save money on your medical aid in 2019

Chances are, you are not happy with the new price of your medical aid for 2019. The good news is that you can change...

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...