The set rate at which the Scheme will pay for a service. If the service costs more than this, you need to pay the difference out-of-pocket.
Medical Aid 101
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.
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...
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...