Alcohol Rehab Covered For Up To 21 Days With Medically Supervised Detox

Alcohol Rehab Covered For Up To 21 Days With Medically Supervised Detox

Would access to up to 21 days of inpatient alcohol rehabilitation including a medically supervised detox give you the safe start to lasting recovery?


La Health members are covered for their alcohol abuse disorder for up to 21 days in an inpatient rehab facility, including a 3-day medically supervised detoxification administered by a registered healthcare professional.

Substance use disorders are complex and multifaceted and need to be treated with an integrated approach to ensure long-term recovery. LA Health recognises the severity of addiction and offers comprehensive coverage to its members with varying plans and prices to suit different income brackets.

Medical Aid Plans, their coverage, benefits, limitations and exclusions may seem overwhelming, which is why the team at Changes Addiction Rehab have compiled this article to explain what the LA Health Medical Aid Scheme has to offer its members in terms of addiction rehab treatment coverage.

Alcohol Rehabilitation Benefits

Members who struggle with alcohol abuse disorder can receive up to 21 days of inpatient treatment coverage; this includes a 3-day medically supervised detoxification.

Alcohol Detoxification

The detox from alcohol is an integral part of the treatment process for alcohol abuse. However, it should be noted a detox does not equal recovery and should instead be viewed as a stepping-stone to the next phase of treatment.

Detoxification is implemented to help individuals remove substances from the body while simultaneously treating the psychological symptoms and aftermath.

We offer an individualised approach at Changes Addiction Rehab as each patient’s needs and situation are considered; they will undergo a medical assessment to determine the severity of their condition and be administered a personalised detox.

During detoxification, patients may experience uncomfortable withdrawal symptoms; our round-the-clock medical health professionals will be there to monitor and offer support through the process.

Residential Inpatient Rehabilitation

LA Health Medical Aid Scheme covers up to 21 days of inpatient treatment for substance abuse. However, members may be liable to a co-payment upon admission, as LA Health only pays a portion of residential rehabilitation.

Counselling And Therapy

Members can receive therapy session benefits for their alcohol abuse disorder.

LA Health offers a range of differing plans, from essential to comprehensive. Comprehensive plans provide more extensive benefits and may include more annual sessions and specialist visits.

Changes Addiction Rehab employs different therapeutic modalities to combat alcoholism and drug addiction, which manifests as a multifaceted, chronic brain disease.

These modalities include:

  • Cognitive-Behavioural therapy (CBT)
  • Dialectical Behavioural Therapy (DBT)
  • Motivational Enhancement Therapy
  • Family Therapy
  • Group Therapy

Members can claim for these individual sessions through LA Health.

Outpatient Treatment Services

The outpatient treatment program is a transitionary phase of treatment after inpatient rehab. The ideal candidate for the outpatient program would have completed residential treatment and is ready to return to their responsibilities.

LA Health only covers specific services in the outpatient program, such as individual counselling.

How To Qualify For Coverage Through LA Health Medical Aid

For members to reap the full benefits from their claims, they should seek treatment at one of the designated service providers on the list offered by LA Health; if a member chooses a facility that is not on this list, they will be liable to a larger co-payment.

Lastly, a pre-authorisation process must be followed meticulously to receive coverage in an inpatient treatment facility. If the pre-authorisation is not approved, members will not receive coverage.

Claims Submission

Claims can be submitted to LA Health for reimbursement; supporting documentation such as relevant invoices, treatment plans, and medical reports need to be submitted alongside the claim forms, which can be found on the LA Health website.

Limitations And Exclusions

The plans offered by LA Health are subject to limitations and exclusions.

These include the following:

  • The number of days a member will receive coverage is limited.
  • LA Health does not cover secondary and halfway house phases of treatment, and members will be liable to pay privately.
  • LA Health does not cover non-registered facilities
  • Treatments that are not deemed medically necessary.
  • Alternative forms of treatment.

The Pre-Authorisation Process

The pre-authorisation process to receive coverage from LA Health into a primary care facility for alcohol abuse is straightforward.

At Changes Addiction Rehab, we can do this procedure on your behalf. Once you call our facility, we will forward you to our admissions department. They will call LA Health and provide them with your ICD-10 codes and our facility’s practice numbers. The good news is that you won’t need a letter of motivation from a healthcare professional to be admitted.

Conclusion

LA Health Medical Aid offers extensive coverage to ensure that members get the care that they need for their substance use disorders.

Additionally, their plans range in comprehensiveness and pricing to accommodate their member’s diverse individual needs and budgets, making them accessible.  

At Changes Addiction Rehab, we have a multidisciplinary clinical team to provide our patients with quality treatment for their addictions, making sure they have a fighting chance at long-term sustainable recovery.

Call us today at 081-444-7000 to start your pre-authorisation process.

FAQS

Does LA Health Offer Basic Plans?

The LA Health KeyPlus Plan is affordable, and members can receive addiction treatment coverage.

Can I Recieve Coverage For Alcohol Detoxification Through LA Health Medical Aid?

LA Health is legally obligated to cover 21 days of inpatient rehab treatment, including a 3-day medically supervised detoxification per year as it falls under the prescribed minimum benefits (PMBs).

Does LA Health Medical Aid Cover More Than One Inpatient Stay Per Year?

No, LA Health only covers one residential inpatient treatment stay per year.

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Related Questions

If my medical scheme says "up to 21 days" are covered, does that mean everything is paid for?

No. "Up to 21 days" is a headline — not a cheque. In South Africa medical schemes, employer funds and private insurers handle rehab coverage differently: some authorise inpatient detox days but exclude certain professional fees, aftercare sessions, lab work or specialist consultations; others insist on a designated service provider or a co‑payment. Always get written pre‑authorisation that itemises which services are included (detox meds, nursing, psychiatry, group therapy, blood tests, psychiatrist/GP fees, aftercare referrals) and how many days are authorised for detox versus rehabilitation. Ask specifically about shortfalls, co‑payments and whether emergency admissions or repeat admissions in a year will be treated differently. If the scheme balks, request a formal motivation from the treating doctor — that document often changes the outcome. Don’t assume "covered" means you won’t get a surprise account; plan for possible shortfalls and get an itemised estimate before admission.

Will 21 days of inpatient treatment actually stabilise someone with severe alcohol dependence and trauma?

Twenty‑one days can be lifesaving for stabilising acute withdrawal: it’s usually enough time to manage detox safely, start medical treatment, and begin psychotherapy. But severe dependence plus untreated trauma, ongoing suicidal ideation, or major psychiatric illness rarely resolve in three weeks. Clinically, detox is about removing physiological danger and starting the psychiatric work — not finishing it. Expect the team to: stabilise withdrawal, treat nutritional deficiencies, begin medication where indicated, and open trauma or mood work. For many patients the inpatient phase is the medical reset; meaningful trauma processing, relapse prevention and rebuilding daily functioning require structured follow‑up, longer therapy blocks or step‑down care. If there’s heavy liver disease, frequent seizures, active psychosis or ongoing domestic safety risks, 21 days may be insufficient and escalation or longer admission should be negotiated up front.

What exactly does "medically supervised detox" involve — what should family members be watching for?

Medically supervised detox means continuous clinical assessment and treatment of withdrawal — not a quiet bed and watchful relatives. Expect regular withdrawal scoring, vital‑sign monitoring, medication protocols to prevent or treat seizures and delirium tremens, thiamine and vitamin support, basic lab monitoring (liver function, electrolytes), and psychiatric assessment for suicide risk or psychosis. Families should watch for escalation signs: severe confusion, hallucinations, unremitting vomiting, high fever, tremor that worsens, seizures or sudden behavioural changes — those are signals for immediate escalation to higher care. Also confirm who will manage medication adjustments and how information is communicated to family; confidentiality rules apply, but safety issues and consent capacity must be handled transparently. Ask the unit to explain their emergency transfer plan and what happens if intensive care is needed.

If inpatient beds are full or unaffordable, can detox be done safely at home in Johannesburg?

Sometimes, yes — but only for the right person under strict conditions. Home detox can be considered for those with mild dependence, reliable daily medical supervision, no prior seizures or delirium tremens, stable housing and no access to alcohol or violent home dynamics. In Johannesburg that "stable" environment is not a given for many families: overcrowding, cohabiting intoxicated partners, or lack of transport to emergency services change the risk profile. If you’re considering home detox, insist on a documented clinical plan from a medical provider, daily or twice‑daily monitoring, emergency contact procedures, and an ambulance plan. For anyone with prior seizures, active suicidal ideation, major medical comorbidities, pregnancy, or severe liver disease, inpatient care is the safe, evidence‑based option — do not attempt home detox in those cases.

I'm on chronic medication (ART, TB treatment, antidepressants) — will detox medications interfere with my other drugs?

Yes, they can. Alcohol withdrawal medications and supportive drugs interact with antiretrovirals, TB regimens, mood stabilisers and some antipsychotics; liver impairment changes how drugs are metabolised. Clinically, the inpatient team needs a full and accurate medication list, the dates of your current treatments, and any recent blood results. That lets doctors choose safer benzodiazepines or alternative regimens, adjust doses and monitor liver enzymes and drug levels where necessary. If you’re pregnant, breastfeeding, on methadone or on complex psychiatric meds, detox should be managed by a service experienced in those interactions — not a generic bed. Tell the admissions team about HIV/TB care or psychiatric clinics so they can coordinate care and avoid dangerous interactions or withdrawal complications.

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Content on this website is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Always speak to a qualified health professional about any medical concerns.
Changes Addiction Rehab PTY LTD (‎2013/152102/07) is licensed by the South African Department of Social Development (Practice No. 0470000537861) and the Department of Health, and is a registered detox facility and practice with the Board of Healthcare Funders. Our treatment programme is led by counsellors registered with the HPCSA, working alongside a multidisciplinary team of medical professionals under a unified practice. We are proud, standing members of the International Certification & Reciprocity Consortium (IC&RC), the Occupational Therapy Association of South Africa, the South African Council for Social Service Professions, the South African Medical Association, the South African Nursing Council and the South African Society of Psychiatrists. Changes Addiction Rehab has been in continuous professional operation since 2007, when it was founded by Sheryl Rahme, who has worked in the addiction treatment field since 1984. Our core clinical team brings over 100 years of combined professional addiction recovery experience.