Does Discovery pay for addiction rehab in 2026?

If you’re wondering whether Discovery pays for addiction rehab, the short answer is: Yes, in‑hospital treatment for alcohol dependence and substance use disorder is covered by Discovery’s medical aid plans — but there are important conditions, limits, and processes to understand. In this article, we’ll explain how rehab coverage works under Discovery, what Patients need to do, and what to watch out for in 2026 when seeking addiction rehab through your medical aid.

How Discovery covers addiction rehab

Coverage under Prescribed Minimum Benefits (PMBs)

Discovery Health Medical Scheme (DHMS) classifies in‑hospital detoxification and rehabilitation for alcohol, substance and drug abuse as part of its Prescribed Minimum Benefits (PMBs). Discovery+1

The Scheme states that while “alcohol, substance and drug abuse” is a general exclusion, the in‑hospital management (detox + rehab) is included as a PMB.
Out‑of‑hospital (i.e., outpatient) treatment for alcohol, drugs or solvent abuse is not covered under the PMB benefit.

What benefits you can expect

According to the most recent benefit guides:

Cover for in‑hospital detoxification at a designated service provider (DSP) for up to 3 days per approved admission.
Cover for in‑hospital rehabilitation at a DSP for up to 21 days per year for each person.
The cover includes accommodation at the facility, therapy sessions, consultations with psychologist/psychiatrist, withdrawal‑medication, etc.

Conditions & co‑payments

Treatment must be at a Designated Service Provider (DSP) listed by Discovery. If you choose a non‑DSP facility, you may get only 80% of the Discovery Health Rate (DHR) and you’ll pay the shortfall.
Pre‑authorisation is required. Without prior authorisation the Scheme may cover only up to 70% of DHR for that admission.
Co‑payments may apply if the facility charges more than the DHR, or if you use a non‑DSP provider.
Out‑of‑hospital rehab (outpatient sessions, day‑programmes) is excluded under the PMB benefit for substance/solvent/ alcohol abuse unless your specific plan includes extra benefits beyond the PMB.

What this means for Patients in 2026

Key steps for Patients seeking drug rehab or alcohol dependence treatment

Check your plan — Not all Discovery plans are identical. Some benefits vary by plan (Classic, Essential, KeyCare, etc). The limits (21 days) apply across plans for PMB cover but other additional benefits may differ. ARC Addiction Recovery Centre+1

Obtain a formal diagnosis — Your condition (alcohol dependence, substance use disorder) must be medically necessary (often via a doctor/psychiatrist).

Select a recognized DSP facility — To get full cover, you must admit into a facility on Discovery’s DSP list for detox and rehab.

Request pre‑authorization before admission — Contact Discovery, submit the required documentation and get approval. Failure to get pre‑authorisation may drastically reduce how much is covered.

Understand the limits — You are generally entitled to up to 21 inpatient days per year (plus 3 detox days) under PMB. After this limit is exhausted in that calendar year, further admissions may not be covered. Discovery Health Medical Scheme+1

Discuss co‑payments or shortfalls — Even with authorization, some of the facility cost may be above the rate Discovery pays; you may need to contribute.

Aftercare & outpatient programmes — While the inpatient stay is covered under PMB, outpatient rehab/therapy might not be unless your plan includes additional benefits. Budget accordingly.

Plan ahead — Because you have limited days of coverage, and because the process takes time, early engagement is vital. Delaying treatment can lead to higher cost and risk of longer stays beyond your cover.

What Patients should watch out for

If the facility is not on Discovery’s DSP list → partial cover (80% of DHR) or more out‑of‑pocket cost.
Out‑of‑hospital rehab excluded under PMB benefit → you may have to self‑fund or rely on other benefits.
Using benefits without pre‑authorisation → risk of substantial personal cost.
Staying beyond your covered days (21 days) in a year → additional cost to you.
Non‑registered or unaccredited facilities → risk of no or limited cover.
Clarify how your specific plan defines “in‑hospital” vs “out‑patient” rehab for your case of alcohol dependence or substance use.

Why this matters for MyRehab Addiction Rehab Centre

At MyRehab Addiction Rehab Centre, we specialise in addiction rehab in Johannesburg’s affluent areas, and we understand how medical aid works. We assist Patients in navigating their Discovery benefits, ensuring a smoother admission process and clearer cost expectations. If you or a loved one are exploring rehab options and wondering “Does Discovery pay for addiction rehab in 2026?”, we can help you understand your cover, get pre‑authorised, and choose the right facility.

If you’re ready to take the next step.

Contact us via WhatsApp or phone or email at admissions@myrehab.co.za.
We’ll check your Discovery plan benefits, help with pre‑authorisation, and guide you through the admission process.