Prescribed Minimum Benefits (PMB) is a set of defined benefits that ensure members have access to certain minimum health services, regardless of the benefit option they have selected. In accordance with the Medical Scheme’s Act, medical schemes have to cover the costs related to these conditions which include:
- Any emergency medical admission
- A limited set of 270 pre-defined medical conditions
- Twenty-five (25) chronic medical conditions
- Your doctor will guide you in determining whether your condition falls into one of the PMB conditions. It is vital that you obtain a pre-authorisation for any PMB condition as your scheme may require you to be referred to a designated service provider so that all associated costs are in line with SAMWUMED’s Scheme Rules.