Prescribed Minimum Benefits: what every SA medical aid must cover

Prescribed Minimum Benefits are the floor of cover that every registered South African medical scheme must provide, on every plan, with no annual limit. Understanding them is the single most useful piece of medical-aid knowledge a member can have.

Frequently asked questions

Are PMBs the same on every medical aid plan?

Yes — every registered scheme on every plan must cover the same list of PMBs. Schemes can offer more, but never less.

Can a scheme refuse to pay a PMB claim?

Only if the condition is not on the PMB list, or you used a non-DSP voluntarily for a non-emergency. Otherwise the scheme must pay in full.