A legally mandated minimum level of cover every scheme must provide.
By law, every South African medical scheme must cover a defined list of conditions and emergencies in full, regardless of which plan you're on — these are the Prescribed Minimum Benefits (PMBs). PMBs exist so that serious or life-threatening conditions aren't left uncovered because of plan limits or exclusions.
More jargon
Open scheme · Restricted scheme · CDL (Chronic Disease List) · DTP (Diagnosis Treatment Pair) · Co-payment · Designated Service Provider (DSP) · Waiting period · Late-joiner penalty · Savings account / above-threshold benefit
Sentrix Digital, Melbourne · ABN 29 203 554 753. Not medical, legal, or financial advice. Organisation and drafting only. Verify with treating practitioners, the PDS, and the trustee/insurer. Australian complaints: insurer/trustee IDR, then AFCA. · info@sentrixdigital.com · +61 (03) 9088 1341 · Admin login