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C.1 GENERAL EXCLUSIONS APPLICABLE TO ALL …

P a g e | 1 1.1 The Scheme will pay in full, without co-payment or use of deductibles, the diagnosis, treatment and care costs of the prescribed minimum benefits as …

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  General, Treatment, Applicable, Exclusion, General exclusions applicable to all

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Prescribed Minimum Benets (PMB) Application Form 2020-11-30 BMF-2001 2.00 3 of 3 SECTION E: MOTIVATION SECTION F: DETAILS OF DOCTOR APPLYING FOR BENEFITS Please attach copies of blood test results and / or any other relevant diagnostic reports. Is the treatment in accordance with treatment as practised in the state sector?

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  Artificial, Disc, Artificial disc

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• Artificial disc - no benefit • Drug-eluting stents - PMBs and DSP products only • Mesh R11 044 • Gynaecology/Urology R9 025 • Lens implants R6 887 a lens per eye Prosthesis – External No benefit (PMBs only). Exclusions Limits and co-payments applicable. Preferred provider network available. Joint replacement surgery (except for PMBs).

  Replacement, Artificial, Disc, Artificial disc

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formularies, funding guidelines and the Mediscor Reference Price (MRP) may apply. • Should a member voluntarily choose not to make use of a hospital forming part of a hospital network for the Beat network benefit option a maximum co-payment of R12 373 shall apply.

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