Preventative Procedures

  • Paid from Insured benefits at 100% of Scheme rate.

Benefits Description
Flu vaccine injection
1 per beneficiary per year
Preventative Health Screenings, limited to:
  • Blood Pressure Measurements
  • Blood Glucose Screening (finger prick test)
  • Cholesterol Screening (finger prick test)
  • Body Mass Index (BMI)
These screening tests are to be undertaken at any Pharmacy Network Providers,
are subject to Scheme Protocols and limited to R380 per beneficiary per year.
Limited to R362 per beneficiary per year
Cholesterol tests One of the following tariff codes will be allowed:
  • 4025
  • 4026
  • 4027
  • 4028
  • 4170
1 per beneficiary per year
Pap smears The following tariff codes will be allowed: 4566 and 4599 1 per beneficiary per year
Prostate-specific antigen (PSA) testing The following tariff code will be allowed: 4519 1 per beneficiary per year
Colorectal cancer screening:
Fecal occult blood test/Faecal immunochemical test
50 years and older or family history
Faecal Occult blood annually
  • 4351
  • 4352
1 per beneficiary per year
HIV Finger-prick Screening Test Tariff code
  • 4614
1 per beneficiary per year
(if this test shows a positive reading, then all subsequent tests will be paid for from the PMB HIV benefit)
Mammogram Beneficiary 40 years and older
or clinically indicated (high risk members).
Once every 2 years.
  • 3605
  • 34100
  • 34101
1 per beneficiary per year