Prescribed Minimum Benefits (PMBs) – Don’t ignore this vital sign

Don’t ignore this vital sign: Get up to speed with Prescribed Minimum Benefits (PMBs) and the workings of the Law

By law, Prescribed Minimum Benefits (PMBs) require medical aids to bear the costs of basic prosthetics

Prescribed Minimum Benefits (PMBs): A feature of the Medical Schemes Act

Prescribed Minimum Benefits (PMBs) are a feature of the Medical Schemes Act which means that in terms of South African law, medical aid schemes are required to bear the costs of basic prosthetics.

  • What this entails is that irrespective of the type of benefit option selected, Prescribed Minimum Benefits (PMBs) is a set of defined benefits that ensure that certain minimum health services are accessible to all medical scheme members where this applies to any emergency condition as defined within a certain limited set of such conditions.
  • The main purpose of this feature is to provide a more affordable form of healthcare and ensure continuous care to improve health and wellbeing.
  • To determine whether a condition falls within a PMB, a doctor should use a diagnosis-based approach which means that only the symptoms and not any other factors, such as cause of injury or how a condition was contracted, should be examined.

Amputations as a result of certain medical conditions fall within the scope of Prescribed Minimum Benefits (PMBs).

 

How does an amputation occur?

An amputation entails the surgical removal of all or part of a limb or extremity that could involve the leg, foot, toe, arm, hand or finger.

Studies suggest that there are 1.5 amputees per 1000 persons. Therefore, the current number of amputees in South Africa amounts to approximately 60 000.

What are the reasons for amputation?

An amputation may be required due to many reasons.

Vascular Conditions

  • Poor circulation due to damage or narrowing of the arteries, also known as peripheral arterial disease, is the most common cause since, without adequate blood flow, cells are unable to obtain the required amount of oxygen or nutrients. As a result, affected tissue begins to die which results in infection.
  • Poor circulation due to diabetes causes a limb to become gangrene due to loss of blood supply.

Other reasons for amputation may include:

  • Severe injury or trauma, for example, as a result of serious burns or a vehicle accident.
  • The presence of a cancerous tumour either in the bone or the muscle of the limb.
  • As a result of serious infection that does not respond to antibiotics or other treatments.
  • Frostbite
  • Neuroma (thickening of nerve tissue).

At Roger Wolfson and Associates doing whatever it takes means we never ignore the vital signs

At Roger Wolfson and Associates, we are passionate about doing whatever it takes in going the extra mile to ensure that our clients receive the funding needed for a basic prosthesis made available within the Prescribed Minimum Benefits (PMBs).

This means that we never ignore the vital signs. Our team of dedicated specialists at Roger Wolfson and Associates is available to answer your questions and help you take full advantage of the entitlements that fall within the Prescribed Minimum Benefits (PMBs). Don’t ignore this vital sign:

Call us  now on (011) 640 7198 to book your free first consultation and assessment.