Business Jumpstart with DJ Fresh, featuring The PMB Coach
Loading player...
Guest : Roger Wolfson (medical orthotist and prosthetist)
Background
Johannesburg based orthotist and prosthetist Roger Wolfson argues that many
medical aid members are unaware of their legal entitlement to Prescribed
Minimum Benefits (PMBs), often only discovering them after financial strain. His
2025 eBook, The PMB Coach, aims to simplify the system and equip patients
with tools to challenge funding decisions.
PMBs are designed to cover essential treatment for emergency, chronic, and
specific conditions, regardless of a member’s plan. However, Wolfson claims
gaps in awareness and communication lead to disputes, particularly around
follow-up care and devices, leaving patients liable for costs that should be
covered.
Medical schemes dispute these claims, maintaining that PMBs are paid in line
with regulations, though they acknowledge that members can appeal decisions
through formal channels.
Background
Johannesburg based orthotist and prosthetist Roger Wolfson argues that many
medical aid members are unaware of their legal entitlement to Prescribed
Minimum Benefits (PMBs), often only discovering them after financial strain. His
2025 eBook, The PMB Coach, aims to simplify the system and equip patients
with tools to challenge funding decisions.
PMBs are designed to cover essential treatment for emergency, chronic, and
specific conditions, regardless of a member’s plan. However, Wolfson claims
gaps in awareness and communication lead to disputes, particularly around
follow-up care and devices, leaving patients liable for costs that should be
covered.
Medical schemes dispute these claims, maintaining that PMBs are paid in line
with regulations, though they acknowledge that members can appeal decisions
through formal channels.
