Prescribed Minimum Benefit List of all Conditions

Prescribed Minimum Benefit List of all Conditions

Overveiw
The Prescribed Minimum Benefit (PMB) list of conditions lists all of the conditions which all medical schemes need to cover on all the health plans they offer to their members.
This cover includes funding for the diagnosis, treatment and ongoing care for the listed conditions. 

According to the Medical Schemes Act 131 of 1998 and its Regulations, all medical schemes have to cover the costs related to the diagnosis, treatment and care of: 
1. Any life-threatening emergency medical condition
2. A defined set of 271 diagnoses
3. 27 chronic conditions (Chronic Disease List (CDL) conditions). 

The 271 diagnoses and 27 chronic conditions (Chronic Disease List (CDL) conditions) that qualify for Prescribed Minimum Benefit (PMB) cover are diagnosis-specific and include a range of ailments that are divided into 15 broad categories below.
This information has been obtained directly from the Council for Medical Schemes (CMS) on www.medicalschemes.co.za.
This list may change from time to time, please refer to the CMS website for a full list of the 271 diagnostic treatment pairs.

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