How to get Covid screenings paid from PMB

Qualifying Covid-19 screening tests are paid from the Scheme’s Prescribed Minimum Benefits (PMB), which means that they will not reduce your available Everyday Services Benefits. It therefore makes sense to make sure that your tests qualify for cover and that the process will ensure the quickest and most accurate processing of your claim.

GET A REFERRAL

The Scheme will only pay for these screening tests if you are referred by a healthcare practitioner. This could be a nurse at a clinic or at work or your general practitioner, if it seems as if you have symptoms of Covid-19.

USE A PATHOLOGY LAB

Visit a registered pathology lab for your test. They will send the claim directly to the Scheme, which means no out-of-pocket expenses for you.

THE SCHEME WILL NOT COVER THE FOLLOWING FROM PMB

In the following instances your claim will not be paid from PMB, but from available Everyday Services Benefits:

  • If you need a procedure done at a hospital and you are required to be screened beforehand to ensure that you are not likely to infect other with Covid-19 (if you are an asymptomatic patient, for example, and not even aware that you have Covid-19).
  • If you have a Covid-19 screening test done at a facility other than a registered pathology lab, such as at a pharmacy.
  • If you refer yourself for a Covid-19 test.