Note: We are updating 2024 benefits as they are released. Some plans show old benefits until schemes release new plans.

List of PMB conditions: Pregnancy and Childbirth

PMB list

Below is a list of the PMB condition treatment pairs for Pregnancy and Childbirth.. 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.

Pregnancy and Childbirth

CODE CONDITION TREATMENT
67N # Low birth weight (under 1000g) with respiratory difficulties # Medical management not including ventilation
967N # Low birth weight (under 2500 grams & > 1000g) with respiratory difficulties # Medical management, including ventilation; intensive care therapy
71N Birth trauma for baby Medical management; surgery
901N Congenital systemic infections affecting the newborn Medical management, ventilation
904N Haematological disorders of the newborn Medical management
54N Necrotizing enterocolitis in newborn Medical and surgical management
74N Neonatal and infant GIT abnormalities and disorders, including malrotation and atresia Medical and surgical management
902N Neonatal endocrine, metabolic and toxin-induced conditions Medical management
903N Neurological abnormalities in the newborn Medical management
52N Pregnancy Antenatal and obstetric care necessitating hospitalisation, including delivery
56N Respiratory conditions of newborn Medical management; ventilation

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.


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