Bonitas medical aid rehab cover at Houghton House

Bonitas covers inpatient treatment for substance abuse and related psychiatric conditions under Prescribed Minimum Benefits (PMBs). This means qualifying members are entitled to:

• 3 days of detoxification per year when medically necessary
• Up to 21 days of inpatient rehabilitation per year for alcohol, drug, or other substance dependence
• Psychiatric evaluation, diagnosis, and medication for PMB conditions
• 21 days of inpatient psychiatric or dual-diagnosis treatment if clinically indicated

Treatment is covered at the Bonitas scheme rate, provided it is pre-authorised and at a registered facility like Houghton House. If a longer stay is required, additional days may be considered on motivation, but these are subject to clinical review and scheme rules.

Houghton House is not currently a designated service provider (DSP) for Bonitas. However, we are a registered provider and a member of the National Hospital Network (NHN), which means all services are billed at Bonitas scheme rates.

You don’t need a referral from a GP or specialist to come to Houghton House. You can reach out to us directly. Our process begins with a confidential assessment by one of our registered mental health professionals. We handle the entire authorisation process with Bonita, including submitting the required clinical documents and coding. This means you and your family won’t need to worry about the paperwork or approvals; our team takes care of it all.

No. All treatment at Houghton House is provided at Bonitas scheme rates, and we waive any shortfalls or co-payments beyond the once-off admission fee and any copayments for medication. Everything else, including assessments, inpatient care, detox (if needed), and therapy, is included.

Bonitas requires pre-authorisation to confirm that treatment is medically necessary and eligible for cover. At Houghton House, this is handled entirely by our admissions and case management team.

The process looks like this:

1. Assessment: At Houghton House, a registered professional completes your confidential assessment.
2. Clinical motivation: We prepare and submit all required documents, ICD-10 codes, and a treatment plan to Bonitas.
3. Authorisation: Bonitas issues approval, including the number of days covered.
4. Treatment: Once authorised, your treatment can begin with no administrative burden on you or your family. Throughout your stay, we continue to submit progress reports to ensure uninterrupted cover.

If you’re a new member or recently upgraded your plan, waiting periods may apply before you can access rehabilitation benefits. These include:

• A 3-month general waiting period for new members or dependents, during which no claims are covered
• A 12-month condition-specific waiting period for pre-existing conditions

However, PMB-related care (including treatment for substance use and specific psychiatric conditions) may still be covered during waiting periods.

Houghton House will verify your benefit status and advise you upfront if any waiting periods affect your admission or cover.

With 30 years of experience, Houghton House is one of South Africa’s most trusted and established addiction treatment centres.

We are:

• An accredited Bonitas rehab partner and psychiatric hospital
• Licensed to treat dual-diagnosis cases (addiction with mental health conditions)
• Staffed by leading addiction psychiatrists, psychologists, and social workers
• Experts in navigating Bonitas authorisation and benefit structures

Our dedicated case management team works closely with Bonitas throughout your stay, ensuring all treatment is preauthorised, billed correctly, and reported as required. From your first call to the final day of care, we aim to make the process simple, supportive, and fully transparent.