PMB list
Below is a list of the PMB condition treatment pairs for Haematological, Infectious and Misc conditions. Your medical aid has to pay for the treatment, and cannot use funds from your savings, even if the treatment is given out-of-hospital.
To see the rest of the 270 PMB conditions, please see our “List of PMBs” page.
For an explanation of general treatments (example: “Medical Management”) please read our explainer.
Haematological, Infectious and Misc systemic conditions
| CODE | CONDITION | TREATMENT |
|---|---|---|
| 50S | Syphilis – congenital, secondary and tertiary | Medical management |
| 168S | # HIV-infection | # HIV voluntary counseling and testing Co-trimoxazole as preventative therapy Screening and preventative therapy for TB, Diagnosis and treatment of sexually transmitted infections Pain management in palliative care Treatment of opportunistic infections, Prevention of mother-to-child transmission of HIV Post-exposure prophylaxis following occupational exposure or sexual assault Medical management and medication, including the provision of anti-retroviral therapy, and ongoing monitoring for medicine effectiveness and safety, to the extent provided for in the national guidelines applicable in the public sector |
| 260S | # Imminent death regardless of diagnosis | # Comfort care; pain relief; hydration |
| 113S | Acquired haemolytic anaemias | Medical management |
| 901S | Acute leukemias, lymphomas | Medical management, which includes chemotherapy, radiation therapy, bone marrow transplantation |
| 277S | Anaerobic infections – life threatening | Medical management; hyperbaric oxygen |
| 48S | Anaphylactic shock | Medical management; ventilation |
| 900S | Aplastic anemia; agranulocytosis; other life-threatening hereditary immune deficiencies | Bone marrow transplantation; medical management |
| 197S | Botulism | Medical management |
| 338S | Cholera; rat-bite fever | Medical management |
| 196S | Chronic Granulomatous disease | Medical management, which includes radiation therapy |
| 916S | Coagulation defects | Medical management |
| 246S | Cysticercosis; other systemic cestode infection | Medical management |
| 903S | Deep-seated (excluding nail infections), disseminated and systemic fungal infections | Medical management; surgery |
| 44S | Erysipelas | Medical management |
| 179S | Hereditary angioedema; angioneurotic oedema | Medical and surgical management |
| 174S | Hereditary haemolytic anaemias (e.g. sickle cell); dyserythropoietic anemia (congenital) | Medical management |
| 201S | Herpetic encephalitis; Reye’s syndrome | Medical management |
| 913S | Immune compromise NOS and associated life-threatening infections NOS | Medical management |
| 912S | Leprosy and other systemic mycobacterial infections, Excluding tuberculosis | Medical management |
| 336S | Leptospirosis; spirochaetal infections NOS | Medical management |
| 252S | Life-threatening anaemia NOS | Medical management; transfusion |
| 908S | Life-threatening conditions due to exposure to the elements, including hypo and hyperthermia; lighting strikes | Medical management |
| 907S | Life-threatening rickettsial and other arthropod-borne diseases | Medical management |
| 172S | Malaria; trypanosomiasis; other life-threatening parasitic disease | Medical management |
| 904S | Metastatic infections; septiceamia | Medical management |
| 910S | Multiple myeloma and chronic leukaemias | Medical management which includes chemotherapy and radiation therapy |
| 247S | Poisoning by ingestion, injection, and non-medicinal agents | Medical management |
| 911S | Sexually transmitted diseases with systemic involvement not elsewhere specified | Medical management |
| 128S | Tetanus; anthrax; Whipple’s disease | Medical management |
| 122S | Thalassemia and other haemoglobinopathies – treatable | Medical management; bone marrow transplant |
| 316S | Toxic effect of gasses, fumes, and vapors | Medical therapy |
| 11S | Tuberculosis | Diagnosis and acute medical management; successful transfer to maintenance therapy in accordance to DOH guidelines |
| 937S | Tumour of internal organ (excludes skin): unknown whether benign or malignant | Biopsy |
| 15S | Whooping cough, diptheria | Medical management |
To see the rest of the 270 PMB conditions, please see our “List of PMBs” page.
How does your medial aid plan cover this benefit?
What you see above is the minimum level of cover for each condition. Medical aids can offer more benefits than the limits above.To see how your plan pays out for a condition, find your plan here, and view your plan’s full benefits.
You can also compare any two medical aid plans side by side, to see which one suits your needs best.
Remember, a medical aid can still impose conditions on how PMBs are treated. For example, the scheme can impose network service providers (DSPs), a medicine formulary or even require that you be treated in a state hospital. You can read a full explanation on how medical aids must pay for PMBs here.
