When it comes to treating substance use disorders, medical aid plays a vital role in accessing addiction treatment therapies. Bonitas Medical Aid covers 21 days of inpatient rehab treatment, including a 3-day medically supervised detoxification, ensuring its members get sufficient high-quality care.

Bonitas members will experience the benefits of its comprehensive coverage. By partnering with a network of registered drug and alcohol rehabilitation facilities, Bonitas ensures its members receive the best possible care, focusing on improving their health and emotional well-being.

At We Do Recover, we have partnered with Bonitas to ensure that patients who enter our facility will be covered for their treatment. This informative article provides everything you need to know about Bonitas medical aid plans.

Overview Of Bonitas Medical Aid

Bonitas is a leading medical aid service provider in South Africa. It offers various plans to suit its diverse members’ needs and budgets, making it accessible to all. Bonitas is recognised as having comprehensive plans, including extensive, appealing benefits for substance use disorders.

History And Background

Bonitas Medical Aid was established to provide quality and affordable healthcare insurance to individuals and rapidly became one of the leading medical aid systems in South Africa. Its history of providing stable and quality healthcare has allowed it to grow exponentially.

The organisation prioritises making healthcare accessible and affordable. This goal is exemplified by its affordable plans, which cater to various income brackets. 

Substance Abuse Treatments Covered By Bonitas

Bonitas Medical Aid offers extensive coverage for the treatment of addiction to drugs and alcohol. This comprehensive coverage ensures that their members receive quality care to ensure long-term sustainable recovery.

The following subsections will discuss the different types of addiction therapies Bonitas Medical Aid covers.

Inpatient Treatment

Residential inpatient treatment is covered for up to 21 days, including a 3-day medically supervised detoxification administered by a medical health professional. 

Members may be liable to a co-payment upon admission as Bonitas might only cover a portion of the inpatient rehabilitation stay. 

Outpatient Program Services

The outpatient program is ideal for the individual who has to attend to daily responsibilities while still needing to receive therapy and care for their substance use disorder.

Members can claim individual sessions through Bonitas for the outpatient program.

It is vital to understand that the outpatient program is only suitable for people whose substance use disorders are not severe. The program is usually a transitionary phase of treatment after individuals have received intensive care during an inpatient rehabilitation program. 

On a case-by-case basis, an individual is referred to the outpatient program and undergoes a thorough evaluation.

Therapy And Counselling

Bonitas Medical Aid Covers individual counselling and a portion of group therapy sessions. 

The extent of coverage will vary from plan to plan. The more comprehensive the plan, the more benefits a member will receive. Members must review their plans to fully understand their coverage.

Pre-Authorisation Requirements

Members must adhere to a pre-authorisation procedure before being admitted into an inpatient treatment facility. Failure to follow the procedure guidelines will result in coverage being denied.

At We Do Recover, we understand that the process behind pre-authorisation can be confusing, so we will do it on your behalf. 

 We will call Bonitas and provide them with We Do Recover’s practice numbers and the ICD-10 codes for your specific addiction. Luckily, you will not need a referral letter from a doctor to be admitted into an addiction rehab facility.

Exclusions And Limitations

Bonitas Medical Aid offers its members comprehensive coverage for addiction treatment; however, all plans are subject to exclusions and limitations.

Exclusions

• Bonitas will not cover alternative therapies, such as homoeopathic approaches.
• Bonitas will not cover therapies that are not deemed medically necessary. 
• Bonitas will not cover any inpatient treatment that has not been approved through a pre-authorisation process.

Limitations

Plans offered by Bonitas Medical Aid are subject to benefit limit caps. For example, basic plans may only receive the essential benefits, while comprehensive plans may access more benefits, like specialist visits and more therapy sessions per year.

Claims Process

Claiming treatment for substance use disorders through Bonitas Medical Aid requires understanding both the submission and documentation procedure. In addition, knowing the turnaround time can help manage the member’s expectations.

Essential Documentation And Submissions

When submitting a claim, a member must provide all the necessary supporting documentation, which can include all of the following:

• Detailed Medical Reports
• Relevant Invoiced
• Proof Of Payment
• Treatment Plan From The Facility

Conclusions

Bonitas Medical Aid prioritises its members’ well-being by providing coverage for substance use disorders at inpatient treatment facilities for up to 21 days per year, which includes a 3-day medically supervised medical detoxification.

Bonitas is legally obligated to pay for addiction treatment as it falls under the prescribed minimum benefits (PMBs). Regardless of the plan a member is enrolled in, they will be covered to a certain extent. Members must know they may be liable for a co-payment upon admission into an inpatient treatment facility, as Bonitas only provides partial coverage for residential inpatient facilities.  

At We Do Recover, we strive to provide our clients with a safe and secure environment when being treated for their substance use disorder. Call us today at 081-444-7000, and we will start your admissions process through Bonitas Medical Aid on your behalf.

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