Medical Aids

What is a PMB Disease?

A Prescribed Minimum Benefit (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. Therefore the payment for a PMB should occur whether you have a hospital plan or a top level full plan.

Infertility & PMBs

The Medical Schemes Act, No. 131 of 1998, recognizes infertility as a PMB disease under the category Female Reproductive System and treatment guidelines are classified as:

  1. Code: 902M
  2. Diagnosis: Infertility
  3. Treatment: Medical and surgical management

How Do You Claim?

It is best to first phone your Medical Aid Scheme before your procedure or test to ensure that you adhere to their guidelines. Medical Schemes have a right to stipulate who their Designated Service Providers are.

An Open Letter to Discovery Health

Infertility & Medical Aid Schemes

Discovery Health Medical Scheme (DHMS) claims process for Infertility

An Open Letter to Discovery Health

Dear Discovery Health

IFAASA is a Non-Profit Company focusing on advocacy, empowerment and information for the population group diagnosed with infertility. Advocating with medical schemes to afford patients the treatment they deserve for their diagnosis is a key focus of our organisation.

Infertility & Medical Aid Schemes

A Prescribed Minimum Benefit (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. Therefore the payment for a PMB should occur whether you have a hospital plan or a top level full plan.

Discovery Health Medical Scheme (DHMS) claims process for Infertility

By now you are probably aware that IFAASA has been in discussions with Discovery Health Medical Scheme (DHMS) regarding the coverage offered for the diagnosis and treatment of infertility. In a recent meeting with DHMS, it was agreed that a claims process needs to be documented and communicated to members.

Dear Discovery Health

IFAASA is a Non-Profit Company focusing on advocacy, empowerment and information for the population group diagnosed with infertility. Advocating with medical schemes to afford patients the treatment they deserve for their diagnosis is a key focus of our organisation.

A Prescribed Minimum Benefit (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. Therefore the payment for a PMB should occur whether you have a hospital plan or a top level full plan.

By now you are probably aware that IFAASA has been in discussions with Discovery Health Medical Scheme (DHMS) regarding the coverage offered for the diagnosis and treatment of infertility. In a recent meeting with DHMS, it was agreed that a claims process needs to be documented and communicated to members.

Take part in a video campaign to petition the medical aids for cover

Would you be willing to do a short video clip, answering a few questions about your journey with Infertility and explaining why you feel that the medical aids should cover treatment, for a recognised disease ie: Infertility? If yes, please email saskia@ifaasa.co.za for more information.

UPDATE: We are currently in the process of getting funding, so we can make this video a professionally edited/shot one, which will reach even more people. We have a celebrity couple on board too. Keep an eye on our FB page for more developments!