(Prescribed Minimum Benefits)


Prescribed Minimum Benefits (PMB) is 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.

PMB’s cover a wide range 270 medical conditions (DTP – diagnosis treatment pairs) and includes 25 common chronic diseases (CDL – chronic disease list) as well as medical emergency conditions.

PMB conditions’ treatment are also not limited to in hospital treatment only, as treatment can be received out of hospital at clinics, outpatient settings or at home, which and wherever it is most appropriate. Medical Schemes are obliged by law to pay for claims on PMB conditions, but may require the use of designated service providers (DSP’s).

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