Can a lack of knowledge regarding Prescribed Minimum Benefits (PMBs) mean that you, instead of your medical scheme, end up paying for the treatment of conditions, diagnosis and care?
PMB's: Episode 4
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In this episode... |
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- Deb and Suzie’s chat
- Emergency Services
- PMBs - Hospitalisation & Emergency Rooms
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Suzie arrived at Jay and Deborah’s house after having called ahead to confirm lunch plans they had made the day before. To Suzie, Deborah is the type of person who always seems to lighten the mood when you’re in her presence. This particular afternoon was no different and the humour, good food and wine flowed spontaneously. After lunch Suzie and Debs went to sit outside on the stoop whilst Jay took Cheslyn (their outrageously beautiful three year old son) for a walk on the beach.
“So Debs, with the accident last year... how has it affected you financially?” Suzie enquired. Deborah turned to face Suzie with an uncharacteristically serious look on her face and replied “One is not supposed to live with regrets, but I can tell you this now, I will never go without medical aid cover again!”
Jay and Deborah had been in a terrible car accident just short of a year ago in which young Cheslyn was thankfully not involved, but both Jay and Deborah sustained serious injuries. What ended up with two fatalities and many seriously injured people in a five car pileup at high speeds, started with one young driver skipping a red robot.
“Speaking to our medical aid brokers after the incident, the answers seem so obvious,” said Debs, “we realise now that with the most basic medical aid cover ‘Prescribed Minimum Benefits’ would have saved us almost the entire financial struggle we have to endure now!”
Suzie looked over to Debs and then noticed Jay and Cheslyn coming back from the beach. “Debs, you guys are all still alive and for that I’m extremely grateful, but I understand what you’re saying. The human resource guy at my new company wants me to choose my medical aid cover and a task that seemed daunting at first has turned out to be far simpler because of ‘Prescribed Minimum Benefits’. Just knowing that each Medical Aid company must provide a minimum set of benefits, with certain rules of course, makes the choice more about the extra great benefits you get or that you want.” Suzie and Debs continued to talk about this subject for a while and Jay also jumped in to add his views, but all agreed in the end that PMBs are a fantastic service to people since it guarantees those basic benefits that we don’t want to be worrying about.
Although Suzie had no doubt that Jay and Debs were in the midst of a terrible financial struggle she was glad to see her friends in good health and even more relieved that she would be able to avoid these financial difficulties by simply choosing a medical aid.
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Most medical schemes cover Hospitalisation and Emergency Rooms but only in certain situations through prescribed minimum benefits.
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