Houghton House
Medical aid cover for rehab & psychiatric treatment
Top-quality psychiatric and addiction treatment, fully covered by your medical aid.
Houghton House is dual-licensed as both a psychiatric hospital and a rehabilitation facility. This means your care is 100% covered under Prescribed Minimum Benefits (PMBs), no matter which medical aid plan you’re on.
Medical aid cover for rehabilitation: what you need to know
You are covered by law.
Under South Africa’s Medical Schemes Act of 1998, all registered medical aids are legally required to cover the diagnosis, treatment, and care for both:
- Substance use disorders (SUDs)
- Specific psychiatric conditions
This is part of your Prescribed Minimum Benefits (PMBs) guaranteed by the Medical Schemes Act. These prescribed Minimum Benefits apply to every plan, even hospital-only options. PMB coverage includes:
- 21 days inpatient psychiatric care per year (Code 902T)
- 3 days of hospital-based medical detox if needed (Code 910T)
- Additional rehab and transitional care depending on condition (e.g., Code 182T)
- Specific psychiatric treatment and therapy
No referral is needed. We handle all paperwork and pre-authorisation directly with your medical scheme on admission.
Why medical aid coverage is guaranteed at Houghton House
Houghton House is Johannesburg’s only facility licensed as both:
- A private psychiatric hospital
- A rehabilitation facility
We’re also a registered member of:
- The Board of Healthcare Funders (BHF)
- The National Hospital Network (NHN)
What this means for you:
- Full PMB cover guaranteed (we liaise directly with your medical aid)
- We bill at approved medical aid scheme rates
- No co-payments or hidden fees (aside from a once-off R1,850 admission fee)
- Extended care available (up to 42 days in total)
Even if you’ve used some PMB days earlier in the year, we work with your scheme to ensure you get the maximum days of care available. We guarantee we’ll never pass shortfalls on to you. This means Houghton House is essentially a fully covered rehabilitation centre, as long as you have active medical aid.
Which medical aids cover treatment at Houghton House?
We work with all medical schemes. Some of these include:
- Discovery Health Medical Scheme
- Government Employees Medical Scheme (GEMS)
- Bonitas Medical Fund
- SA Police Service Medical Scheme (POLMED)
- Momentum Medical Scheme
- Bestmed Medical Scheme
- Medihelp
- Fedhealth Medical Scheme
- Profmed
- Chartered Accountants (SA) Medical Aid Fund (CAMAF)
- International medical schemes: Cigna, Pulamed, BPOMAS
Not on this list? We can still help
Email us at info@houghtonhouse.co.za and we’ll work directly with your medical aid provider.
FAQs
No, you do not need a GP or psychiatrist referral. You can contact Houghton House directly. Our clinical team will conduct a free telephonic evaluation and assist with the admission and medical aid authorisation process.
Yes, if you are a member of any registered South African medical aid, you are entitled to treatment for substance use and specific mental health conditions under Prescribed Minimum Benefits (PMBs). These benefits apply to all plans, including hospital-only options. We bill according to scheme rates, and there are no out-of-pocket costs except for a once-off R1,850 admission fee.
Most South African medical aids cover up to:
- 21 days of inpatient psychiatric care per year
- 3 days of hospital-based medical detox
- 21 Days of in-hospital rehabilitation care per year
At Houghton House, we help you get the maximum care available. We also assist with medical coding to ensure the best possible medical aid rehabilitation coverage for your situation.
Yes. We work with all registered medical schemes in South Africa and many international ones. If your provider is not listed, our team will reach out to them directly to arrange cover. In most cases, full funding is still available through PMBs.
In some cases, waiting periods may apply if you recently joined a medical aid or upgraded your plan. However, emergency psychiatric care and substance use disorder treatment are often covered during waiting periods under PMBs. Contact us and we will confirm your eligibility with your scheme.
If you are on a closed corporate scheme these waiting periods may be waived.
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