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What medical conditions are covered under the Medical Schemes Act at MyRehab?

Date: 13 February 2024


Under the Medical Schemes Act 131 of 1998 and its regulations, certain treatments, including those for addiction, are classified as Prescribed Minimum Benefits (PMBs). This means that treatment for a range of substance use disorders and mental health conditions must be provided by medical aid schemes, ensuring a baseline level of care for individuals suffering from these conditions.

For patients at MyRehab Dual Diagnosis Addiction Centres, this legislative framework provides a layer of assurance that core aspects of their treatment for addiction and concurrent mental health issues will be supported under the PMBs mandated by the Act. By design, the PMBs cover essential health services across the spectrum of care, including emergency medical conditions, a set list of medical conditions, and a range of chronic conditions, ensuring that individuals have access to necessary treatments.

**Key Points for Patients:**

1. **Coverage Includes Substance Use Disorders and Mental Health Conditions:** By being classified under PMBs, treatments for addiction and concurrent mental health issues are recognized as necessary medical services that must be covered by medical schemes.

2. **Understanding Your Coverage:** Patients looking to receive treatment at MyRehab should carefully review their medical scheme’s policy to understand the specifics of what is covered under PMBs for dual diagnosis treatment. Coverage typically includes necessary inpatient and outpatient services, therapy sessions, and medication related to the treatment of substance use disorders and mental health conditions deemed essential under the PMBs.

3. **Advocating for Your Rights:** If you encounter challenges with your medical scheme concerning the coverage of mandated treatments, remember that the framework of the Medical Schemes Act is designed to support your right to essential health care services. It’s important to be informed and, if necessary, seek assistance in ensuring your treatment is covered according to the Act’s stipulations.

4. **Working With MyRehab:** MyRehab’s team is experienced in navigating the complexities of medical scheme coverage and can assist patients and their families in understanding and utilizing their available benefits for treatment. This collaborative approach between patients, MyRehab, and medical schemes contributes to a smoother admission process and ensures that patients can focus on their recovery journey without undue financial stress.

For individuals considering treatment at MyRehab Dual Diagnosis Addiction Centres, it’s encouraging to know that the Medical Schemes Act supports your journey to recovery by mandating coverage for essential treatments. MyRehab is committed to working within this framework to provide comprehensive, personalised care for dual diagnosis patients, ensuring that both their substance use and mental health conditions are addressed in a supportive, healing environment. If you have questions about how your medical scheme coverage applies to treatment at MyRehab, or if you need assistance with the admissions process, please don’t hesitate to contact us. Our team is here to support you in navigating these steps and to provide the care you need on your path to recovery.

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