Revelations Quest Psychology

PMB stands for Prescribed Minimum Benefits. Essentially, a PMB refers to a set of minimum health care services that all medical aid scheme members are entitled to, especially when meeting criteria for a particular condition/diagnosis. When an individual has been diagnosed with a condition that is part of the predefined conditions as according to the Medical Scheme Act, the medical aid scheme ought to cover the diagnosis, treatment, and/or care costs for the particular individual. This is because PMBs are intended to make healthcare more affordable, improve health, and ensure that the correct parties pay for healthcare. Thus, covering a range of conditions, including medical emergencies, cancers, and chronic diseases. 

Therefore, it is very important for clients to not apply for PMBs when they do not meet criteria for the predefined PMB conditions just because they would like to have additional consultations with the clinician.

More often than not, in psychotherapy, individuals want to apply for PMB with their respective medical aid schemes because they would like “additional” psychotherapeutic sessions with the psychologist, even though they might not have the condition. They are open to the idea because they do not want to make use of their Medical Savings Account (MSA). Not only is this fraud, but the individual then, mostly, waivers their in-patient treatment option for the rest of that particular year. Subsequently, when one becomes in need of admission or further treatment, that benefit might be exhausted.

This is why individuals need to be very careful about chasing PMBs when they do not need them, and want to just take advantage!