Anaphylaxis – one of the prescribed PMB’s
Did you know that anaphylaxis is one of the medical conditions listed for prescribed minimum benefits or “PMB’s”?
The Medical Schemes Act states that medical schemes must cover the full cost related to the diagnosis, treatment and care of certain listed medical conditions, one of which is Anaphylaxis.
This ensures that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected.
If you have been diagnosed with anaphylaxis, and have been prescribed an epipen, ask your doctor to complete a PMB application.
Your medical scheme might require additional supporting documentation from you or your doctor before they approve the application.
If you do qualify, your medical aid will be obliged to cover the cost of your diagnosis, treatment and medication for this condition in full, with no co-payments or deductibles.
The costs must be covered from the PMB benefit and cannot be deducted from your medical savings account. This applies to all individuals who are members of a medical scheme, even if they are on a hospital plan only.
See our AFSA video on Faces of Anaphylaxis
Hi there,
I see that Anaphylaxis is listed on Discovery as a PMB. What is the process of applying for cover for the meds for this as I don’t see it listed as a chronic illness, and neither is Angioedema? I currently pay for my meds out of my savings account. Thanks.
Your doctor will apply for the PMB on your behalf. Each medical scheme will have a slightly different application process, but most will require your doctor to complete a PMB application form. This form can usually be downloaded from your medical aid website. Alternatively, call your medical aid and ask them to send you the correct form. The doctor may also have to write a short motivation letter to accompany this form. This motivation letter should describe any previous episodes of anaphylaxis, including the date of the incident and the treatment received. Your doctor is permitted to claim a fee for completing this application. Regards Dr Sarah Karabus