Medical Aid Schemes That Cover Psychotherapy

Psychotherapy / Psychology IconPsychotherapy involves treating psychological problems through communication and understanding. It’s purpose is to equip people with the tools, knowledge and strategies to make positive behavioural changes.

Most often psychotherapy is considered a long-term treatment option, involving hourly sessions over a protracted period. This can make it an expensive option for patients. 

Typical Mental Health Benefit Structures

Leading medical aid schemes may offer cover for psychologist, psychiatrist and psychotherapist services, both in and out of hospital.

Each scheme has a specific benefit structure and may

  • specify a defined annual limit for psychotherapy
  • stipulate that all day-to-day or out-of-hospital treatments are covered only up to the amount in the member’s savings account, or
  • apply a combination, specifying that once a limit has been reached, cover is provided only from the member’s savings account

 

Chronic Conditions

Several common mental health disorders are categorised as chronic conditions, so all medical aids in South Africa are compelled by law to provide prescribed minimum benefits (PMBs) for them. Some of the conditions do not fall part of the normal chronic cover that schemes have to pay for and may only be covered on more Comprehensive plans.

Examples of these disorders are bipolar mood disorder, schizophrenia, anxiety disorder, neuropathies, obsessive compulsive disorder, post traumatic stress disorder, panic disorder and attention deficit disorder.

Medical Aid Comparison

The cover you’ll receive for treatments like psychotherapy will depend entirely on the type of medical aid plan you’ve signed up for. It’s imperative to conduct a medical aid comparison so that you secure the best available mental health cover.

Note that whatever medical aid scheme, plan or package you join, benefits will only apply for bona fide practitioners who are registered with the Health Professions Council of South Africa and the Board of Health Care Funders.

Medical aid schemes that offer mental health benefits

Discovery Health

Discovery Health offers in-hospital and day-to-day benefits that cover psychotherapy as part of its top-tier plans – Executive, Comprehensive, Priority and Saver.

Claims are paid from available funds in your medical savings account or from the hospital benefit for admissions. The Executive plan also provides an above threshold benefit that settles claims once you’ve exhausted your savings account and have reached an annual threshold. This is based on limits-etc.

On the Executive and Comprehensive plans, you can increase your cover via the allied, therapeutic and psychology extender benefit. It provides unlimited cover for a defined list of services and doesn’t affect the annual benefit limit. Only members with severe or complex conditions are eligible.

Bonitas

Bonitas offers sliding scale mental health benefits. Limits apply per family per annum, benefits are subject to pre-authorisation and there are sub-limits for consultations in and out of hospital. BonComprehensive, BonClassic and Standard plans offer premium mental health benefits, while BonCap provides cover for PMBs only.

Momentum Health

Momentum Health benefits cover psychiatry and psychology services, as well as drug and alcohol rehabilitation. Cover varies from plan to plan. In particular, the Summit option offers an attractive limit per beneficiary in hospital, as well as day-to-day benefits paid at 100% of the scheme rate, subject to an annual limit.

The Extender plan is another excellent option. A quarter of each member’s contribution goes into a medical savings account to enable more access to day-to-day cover. Once a threshold has been reached and the savings account is depleted, an extended cover benefit applies.

Explore Your Options

Fedhealth, Medshield, Resolution Health and Genesis, among others, also offer comprehensive cover for psychotherapy and other treatments associated with mental health.

Shop around by doing a fingertip medical aid comparison right here or contact us today for comparative quotes and up-to-date information on a benefit structure appropriate to your needs.