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Contact usTel: 0800 226 5633 (0800 BANKMED) Private Bag X2, Rivonia, 2128 www.bankmed.co.zaHIV PMB application form Request for additional cover from the Prescribed Minimum Benefits Patient name and
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How to fill out request-for-additional-cover-for-pmb-chronic-disease-list

01
Obtain the request-for-additional-cover-for-pmb-chronic-disease-list form from your medical aid scheme.
02
Read and understand the instructions provided with the form.
03
Fill out your personal information such as name, ID number, and contact details in the designated fields.
04
Specify the chronic disease for which you are requesting additional cover.
05
Provide any relevant medical information or documentation that supports your request.
06
Double-check the form to ensure all sections are completed accurately and legibly.
07
Sign and date the form.
08
Submit the completed form to your medical aid scheme via fax, email, or in person as instructed.
09
Keep a copy of the form and any supporting documents for your records.
10
Follow up with your medical aid scheme to confirm the submission and inquire about the status of your request.

Who needs request-for-additional-cover-for-pmb-chronic-disease-list?

01
Anyone who has a chronic disease not already covered by their medical aid scheme may need to submit a request-for-additional-cover-for-pmb-chronic-disease-list. This form is beneficial for individuals seeking extended coverage for specific chronic conditions that may require ongoing medical treatment or medication.
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The request-for-additional-cover-for-pmb-chronic-disease-list is a formal application made to health authorities or insurers for additional coverage under the Prescribed Minimum Benefits (PMB) for specified chronic diseases.
Patients who have chronic diseases that require treatment beyond the standard covered benefits are required to file this request.
To fill out the request, patients should provide their personal and medical details, specify the chronic condition, outline the required treatment, and attach supporting medical documentation.
The purpose of this request is to ensure that individuals with chronic diseases receive adequate medical coverage for their required treatments and medications.
The form typically requires personal information, details of the chronic condition, treatment plans, and supporting medical evidence from healthcare providers.
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