Glaucoma and PMB Rights
Glaucoma is one of the chronic diseases listed as a Prescribed Minimum Benefit (PMB) in Section 29 (1)(0) of the Medical Scheme’s Act 131 of 1998.1,2
About glaucoma
Glaucoma is a group of eye disorders that affects the optic nerve,3 leading to vision loss and blindness.3
The exact cause of glaucoma is unknown;3 it cannot be prevented and, if left untreated, it can cause irreversible vision loss or blindness.3-5
Glaucoma can’t be cured, but it can be kept under control with treatment.3,5 Early detection is essential, which is why it’s important to have regular eye exams.3,5
About PMBs
The PMBs are a set of defined benefits which ensure that all medical-scheme members have access to certain minimum health services, regardless of the benefit option they have selected.2,6
Are you registered for chronic benefits? All medical schemes have to provide PMB cover for a defined list of chronic conditions.2,6 Glaucoma is one of these PMB conditions.1 Please contact your medical scheme for chronic registration.
What can you do if the product suggested by your medical scheme on the preferred medicines list is not ideal for you? Most medical schemes will consider a medical motivation if the scheme’s preferred medicine does not work for you. If, however, you cannot resolve the matter directly with your medical scheme, you may seek resolution via the Council for Medical Schemes (CMS) in any of the following ways:7
- Customer Care: 0861 123 267
- Complaints (fax): 086 673 2466
- Complaints (email): complaints@medicalschemes.co.za