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Medical Aid

Mental Health Benefit

Medical aid cover for mental illness, included as a PMB but with practical limits to navigate.

Major Depressive Disorder, bipolar mood disorder and schizophrenia are CDL conditions covered on every plan. Other mental health conditions are covered as PMBs (typically 21 days of in-hospital treatment per year) plus through scheme-specific Mental Health Care Programmes. Specialist psychiatrist consultations and ongoing therapy may be paid from MSA on saver plans, or specialist benefits on comprehensive plans. Many schemes now include digital mental wellbeing programmes (CBT-based courses, telehealth coaching).

SA example: On Discovery, registering on the Mental Health Care Programme (via a Premier Plus GP) unlocks medication cover for SSRIs (R110 to R130/month) plus 2 mental wellbeing consultations regardless of plan tier.