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References in periodicals archive ?
[3] Prescribed Minimum Benefits (PMBs) in SA are a set of benefits the purpose of which is to ensure that all members of medical aid schemes have access to certain minimum health services, regardless of their benefit options.
The prescribed minimum benefits: Prescribed minimum beneficence
Sacrificed on the altar of cost-efficiency are prescribed minimum benefits (PMBs), an extensive set of medical conditions, chronic diseases and emergency care that the Medical Schemes Act says must otherwise be provided by all medical schemes.
"The growth drivers include global generic growth, legislation in South Africa encouraging generic substitution, the implementation of prescribed minimum benefits by medical schemes and the dire need for ARVs in South Africa and the rest of sub-Saharan Africa," according to Collins.
The act, which is governed by the Council for Medical Schemes, stipulates prescribed minimum benefits for psychiatric care, HIV/AIDS, attempted suicide and sexually transmitted diseases--conditions that were previously often excluded from private benefit packages.
Hammering home now-persistent private sector pleas, Raath singled out the 25% solvency rate medical schemes must adhere to, the hugely expensive current Prescribed Minimum Benefits (PMBs), and the self-sustaining requirement that makes it illegal for schemes to implement risk and income cross-subsidies across options.
such as those described in the Prescribed Minimum Benefits (PMB) and Essential Drugs List (EDL)'.
The correct code will ensure that patients receive the correct benefit, especially with regard to prescribed minimum benefits (PMBs).
The most likely explanation for this movement of the cost burden is the payment of costs related to Prescribed Minimum Benefits (PMB) conditions, which now have to be paid in full by schemes.
Since osteoporosis does not feature on the so-called Prescribed Minimum Benefits (PMB) list, medical aid schemes either refuse to pay or draw up their own arbitrary funding criteria and financially cap the reimbursement of osteoporosis treatment.
Making medical scheme member contributions mandatory is less important than properly regulating prescribed minimum benefits (PMBs) which pose the biggest, most imminent threat to medical schemes' viability, Board of Healthcare Funders (BHF) CEO Dr Humphrey Zokufa claims.
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