Medshield Medical Aid provides comprehensive coverage for substance abuse treatment, including up to 21 days for inpatient treatment and a 3-day supervised detoxification. This extensive addiction treatment coverage is designed to ensure that members can access vital care for substance use disorders, providing a sense of security and peace of mind during their recovery journey.
At Changes Addiction Rehab, we’ve established a strong partnership with Medshield, a reputable healthcare provider. This partnership ensures that Medshield members receive the quality care they need for substance use disorders. Our multidisciplinary team, equipped with the skills and experience to treat these disorders, prioritises the safety and welfare of our patients, instilling confidence and reassurance in their members.
Overview Of Medshield Medical Aid
Medshield Medical Aid is a reputable healthcare provider in South Africa. It offers a range of plans to its members with diverse needs and budgets.
History Of Medshield
Medshield has offered premium medical aid plans and services in South Africa for 50 years. The scheme started in 1968 as a small, workplace-based fund. Over time, it became one of the country’s larger open medical schemes.
They have built a trustworthy reputation around solid financial stability. They maintain high reserves, which makes paying out claims possible. They have won multiple awards for their customer care and innovative products.
In recent years, Medshield Medical Aid has advanced by adding digital services. Members can now conveniently access their plan information, benefits, and claims through a user-friendly mobile app, making the process more accessible and efficient.
Substance Abuse Treatment Coverage Options
Medshield Medical Aid offers various options for substance abuse treatments. The extent of coverage will depend on the plan chosen by the member. Each plan caters to the different needs and budgets of its members.
Inpatient vs Outpatient Rehab Programs
Medshield Medical Aid covers residential rehab programs for up to 21 days, including a 3-day medically supervised detoxification. Patients reside in the facility for a set period in a secure and safe environment that is conducive to recovery and free of distractions; this program is suitable for individuals with severe substance use disorders seeking urgent care.
The outpatient program allows individuals to attend to daily responsibilities such as work, relationships and school while still receiving treatment for their addiction. Usually, outpatient serves as a transitionary program after completing the entire inpatient rehab program; individuals who seek to attend the outpatient program without completing inpatient will have to undergo a thorough evaluation from our clinical team at Changes Addiction Rehab to determine if they are suitable.
Both programs offer individual counselling and group therapy, which can be claimed through Medshield Medical Aid.
It is important to note that Medshield does not cover the complete outpatient program, and members may be liable for a co-payment upon admission into our inpatient rehab facility.
Therapy And Counselling Benefits
Therapy and counselling are cornerstones of inpatient rehab treatment facilities. Individuals will unpack their maladaptive behaviours around their addiction and learn healthy coping mechanisms and tools that are conducive to recovery.
Medshield Medical Aid offers its members individual counselling and group therapy benefits; the number of sessions will depend on the plan chosen by the member.
Pre-Authorisation Procedure
Members must obtain a pre-authorisation for approval before being admitted into an inpatient treatment facility. This ensures that the treatment is medically necessary and covered by the plan.
At Changes Addiction Rehab, members can phone our admissions department, and we will conduct the pre-authorisation process for you to obtain approval. We will phone Medshield on your behalf and provide them with your details, which will include:
- Your ICD-10 codes for your specific addiction
- Any other relevant information
- Our facilities practice numbers
Lastly, no referral letter from a medical health professional is needed to be admitted.
The Claims Process For Medshield
Filing claims for Medshield Medical Aid involves following specific steps and submitting supporting documentation. Proper preparation can ensure a smooth and hassle-free process.
Supporting Documents
To submit a claim for substance abuse treatment, members will need the following:
- A detailed invoice from the chosen inpatient rehab facility
- Treatment plans
- Invoices and receipts
- Any other relevant documents
Keeping the original receipts and documents when submitting a claim is essential.
Submitting A Claim
Medshield offers its members various ways to submit claims:
- Online: Members can log onto their profile and submit their claims.
- Email: Members can send their supporting documents to the claims department.
- Mobile App: Members can use the app to submit their claims on the go.
Lastly, members must include their membership numbers on all cases of correspondence and double-check that all their forms are filled out correctly and that everything is signed to prevent delay.
Conclusion
Medshield Medical Aid is a trusted healthcare provider offering its members comprehensive substance abuse treatment coverage. Inpatient rehab treatment is covered for up to 21 days, including a 3-day medically supervised detoxification. Additionally, members can claim individual counselling and group therapy sessions.
At Changes Addiction Rehab, we understand that coming into treatment for addiction can be an overwhelming experience, which is why we do pre-authorisation procedures, making the admission process into our facility a smooth and stress-free experience. Call us today!
FAQs
Are Rehabilitation Programs Covered By Medical Aids In South Africa?
Yes, all medical aid schemes are legally required to cover addiction treatments as they fall under the prescribed minimum benefits (PMBs).
Do I Need A Referral Letter To Be Approved For Substance Abuse Treatment By Medshield?
No, you do not need a referral letter. You can call us at Changes Addiction Rehab, and we will proceed with the pre-authorisation process on your behalf with Medshield Medical Aid.
Does Medshield Cover Outpatient?
Medshield only covers specific services offered at the outpatient program.