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List of PMB conditions: Haematological, Infectious and Misc systemic conditions

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PMB list

Below is a list of the PMB condition treatment pairs for Brain and Nervous System.. 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.

There’s more help here:

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