The Council for Medical Schemes (CMS) has announced that all cases of COVID 19 will be regarded as a Prescribed Minimum Benefits (PMB) condition, and should be funded in full in line with the current NICD guidelines as published.
The CMS Circular describes that in line with clinical protocols and benefit guidelines, this should cover:
|●||All clinically appropriate diagnostic tests including Viral PCR;|
|●||All clinically appropriate medication; and|
|●||Costs of hospitalisation including all complications and rehabilitation.|
Furthermore, the CMS requested that, in the spirit of social solidarity, schemes investigate all disruptions to member contributions on a case by case basis and determine the merits thereof, prior to termination.
Click here to download the Circular which also outlines functions that will be viewed as support to essential services as well as the operations of the CMS during the lockdown period.