Reimbursement
At OP Active we pride ourselves in making claiming for your assistive device as easy as possible. Whether it’s a Medical aid claim or third party claim (Road Accident fund / Workmen’s compensation fund), We will assist wherever possible.
As we all know there a huge number of Private Medical aids in South Africa, each with its own set of rules and regulations. What is not know to all is a lot of the medical aids have External Appliance benefits, Theses may Range from R4 000 – R70 000 depending on the scheme. Together with south africa’s PMB regulations. Claiming and Paying for an assistive device may not be as difficult as you think.
What is a PMB?
The 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.
This includes:
- any emergency medical condition
- a limited set of ±270 medical conditions (which includes amputation)
- 25 chronic conditions
To apply for PMB, you contact your medical aid and ask for the necessary documentation. This documentation must then be completed and submitted by both you and your healthcare practitioner – in the case of prosthetic treatment, your prosthetist. The medical aid will then provide you with feedback within 60 days.
More information
Do we claim from the Road accident Fund
Yes, Yes and Yes. Feel free to contact us for more information as this is handeld per patient and undertaking/ Interim undertaking.
More information
