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PRESCRIBED MINIMUM BENEFITS

Prescribed Minimum Benefits and Chronic Medication Prescribed Minimum Benefits (PMBs) are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide people with continuous care to improve their health and well-being and to make healthcare more affordable.

PMBs are a feature of the Medical Schemes Act, in terms of which medical schemes have to cover the costs related to the diagnosis, treatment and care of:

  • any emergency medical condition;
  • a limited set of 270 medical conditions; and
  • 25 chronic conditions defined in the Chronic Diseases List (CDL).