Bestmed medical aid rehab cover at Houghton House

Bestmed covers both addiction rehabilitation and inpatient psychiatric treatment in line with the Prescribed Minimum Benefits (PMBs) required by law. This means members are entitled to:

• 3 days of hospitalisation for detoxification per year
• Up to 21 days of inpatient rehabilitation per year
• Up to 21 days of hospitalisation for psychiatric conditions per year

These entitlements apply to all Bestmed members as part of PMBs, although the way they are authorised and managed can vary slightly from plan to plan.

At Houghton House, we ensure these benefits are fully accessible. Our case management team secures pre-authorisation on your behalf, submits the required clinical motivations, and liaises directly with Bestmed so that your treatment is covered and billed correctly.

Houghton House is not currently a designated service provider (DSP) for Bestmed. However, we are a registered provider and a member of the National Hospital Network (NHN), which contracts directly with Bestmed. This means all services provided at Houghton House are billed at Bestmed’s scheme rates.

While DSP arrangements can differ depending on the benefit option, patients admitted to Houghton House for rehabilitation or psychiatric care will not face additional penalties. If a co-payment would normally apply, Houghton House typically waives the balance, ensuring your treatment is fully covered.

No referral is required. You can contact Houghton House directly to begin the admission process.

We start with a confidential assessment by one of our registered professionals. Our team submits the necessary documentation and motivation to Bestmed for pre-authorisation. We manage all the clinical coding, paperwork, and communication with the scheme so you and your family can focus fully on treatment and recovery.

No. Treatment at Houghton House is billed at Bestmed scheme rates. While some medical aids may cover only a percentage of these rates, Houghton House waives any shortfalls or co-payments so you are not left with unexpected costs. The only payment you will make is the once-off admission fee, which applies to all patients.

Bestmed requires pre-authorisation for both rehabilitation and psychiatric admissions. At Houghton House, our case management team handles this process for you. We prepare and submit the clinical motivations, treatment plans, and progress reports directly to Bestmed, ensuring your care is authorised without unnecessary delays.

Bestmed may apply a three-month general waiting period or a 12-month condition-specific waiting period for new members. During this time, hospital admissions for rehabilitation or psychiatric treatment are usually not covered except in emergencies.

Once waiting periods have passed, you are entitled to your Prescribed Minimum Benefits (PMBs), which include cover for detox, inpatient rehabilitation, and psychiatric care. The admissions team at Houghton House will confirm whether any waiting periods apply to you before treatment begins.

At Houghton House, we make it simple for Bestmed members to access high-quality, fully covered treatment for addiction and mental health conditions.

We are:

• Dual-licensed as a psychiatric hospital and a rehab facility
• Part of the National Hospital Network, billing at Bestmed scheme rates
• Experienced in securing pre-authorisation and managing claims directly with Bestmed
• Staffed by registered professionals providing evidence-based care
• Specialists in dual diagnosis treatment for co-occurring addiction and psychiatric conditions

With 30 years of experience in addiction treatment Houghton House combines trusted clinical expertise with a patient-first approach, ensuring Bestmed members can focus on recovery without financial worries.