Your medical scheme is not required to provide cover for treatment options that do not appear on what is called the Prescribed Minimum Benefits (PMB) list. This means you may not be eligible to receive the treatments your medical specialist may recommend – such as biological drugs for the treatment of cancer.
Including a cancer cover benefit on your gap plan, provides you with access to continued innovative cancer treatments, to assist you when your medical scheme limits have been reached.
What is PMB treatment?
Prescribed Minimum Benefit (PMB) refers to a set of essential healthcare services and treatments that must be provided by medical schemes (health insurance providers) to their members, regardless of the specific plan they have. The purpose of Prescribed Minimum Benefits is to ensure that all members have access to a basic level of healthcare services, regardless of their financial means.