What is the meaning of PMB?
Prescribed Minimum Benefits.
This means there are certain life treating conditions that your medical aid needs to pay for as a PMB condition.
What is the meaning of life threatening conditions and what conditions are they ?
Life threatening conditions means you as the patient or your family member or friend needs immediate treatment or that person could die.
Examples of life threatening conditions are:
MVA ( Motor Vehicle Accident )
These are only a few examples of PMB conditions.
What do you need to do to get a claim paid as a PMB condition?
- Firstly you need to qualify for PMB cover. This means you will be a category B or C client.
- You need a detailed account from your doctor or hospital.
- Your claim will be submitted as a normal claim for payment to your medical aid.
- Should there be a short payment on the account, find out what category client you are and if you do qualify for PMB cover.
- If you do qualify and your claim was short paid, confirm this from your medical aid.
- The medical aid will confirm if the case do qualify as a PMB or not.