Houghton House
CAMAF medical aid rehab cover at Houghton House
CAMAF medical aid rehab cover ensures access to quality inpatient treatment at Houghton House, one of South Africa’s leading rehabilitation centres. If you’re seeking rehabilitation through CAMAF, Houghton House provides professional addiction treatment and inpatient psychiatric care. Keep reading to learn how your CAMAF rehab benefits work for substance abuse and related psychiatric conditions.
About Chartered Accountants Medical Aid Fund
The Chartered Accountants (SA) Medical Aid Fund (CAMAF) is a restricted medical scheme, which means membership is limited to professionals in the accounting sector and their dependents.
Established in 1951, CAMAF is administered on a not-for-profit basis and operates in terms of the Medical Schemes Act, with oversight from the Council for Medical Schemes (CMS).
The scheme has 26,329 members and 48,000 beneficiaries, according to the most recent industry financial performance report published by the Council for Medical Schemes (CMS).
Over time, CAMAF has developed a strong focus on providing benefits that align with the needs of professionals in private practice and corporate roles, while offering a choice of plans that balance comprehensive cover with affordability.
Does CAMAF cover rehabilitation?
Yes. CAMAF covers inpatient rehab for substance use disorders in line with the Prescribed Minimum Benefits (PMBs) mandated by the Medical Schemes Act 131 of 1998. This means all members are covered for:
- Up to 3 days of hospitalisation for detoxification per year
- Up to 21 days of inpatient rehabilitation per year
- Treatment for both drug and alcohol dependency
These benefits apply across all CAMAF plans and are guaranteed under South African law. Additional days may be considered on motivation if clinically motivated, especially in dual-diagnosis cases (e.g., addiction and depression). Cover for rehabilitation is subject to pre-authorisation.`
Does CAMAF cover psychiatric care?
Yes. Inpatient psychiatric treatment for specific mental health conditions is also covered as a Prescribed Minimum Benefit, as long as the treatment is deemed clinically appropriate and pre-authorisation is granted.
- Up to 21 days of inpatient psychiatric care per beneficiary per year
- Treatment for PMB psychiatric conditions such as major depression, bipolar disorder, schizophrenia, and related conditions
As with CAMAFs rehabilitation cover, psychiatric benefits apply across all CAMAF options. Additional psychiatric benefits may be available depending on the plan, but PMB minimums are guaranteed for all members. Coverage may differ depending on your plan’s hospital network. For example, Alliance Network members usually face a 20% co-payment for admissions to out-of-network hospitals.
How Houghton House works with CAMAF medical aid
Houghton House is dual-licensed as both a psychiatric hospital and as a rehabilitation facility. We are a member of the National Hospital Network (NHN), which means all services are billed at CAMAF scheme rates.
Our admissions team manages the entire pre-authorisation process directly with CAMAF, ensuring that all clinical documentation and coding requirements are handled on your behalf.
- No upfront payments are required (other than a once-off admission fee)
- No co-payments or shortfalls, as services are billed at scheme rates
- Treatment is always provided by registered professionals within the PMB framework
We work closely with CAMAF to ensure that all treatment is fully funded within your benefit limits. Even in cases where care might be considered out-of-network, Houghton House typically waives penalties or co-payments, so you can focus on recovery with financial peace of mind.
FAQs
CAMAF covers substance abuse rehabilitation and inpatient psychiatric treatment as part of its Prescribed Minimum Benefits (PMBs). This means members are entitled to:
- Up to 21 days of inpatient rehabilitation per year for alcohol or drug dependency
- Hospital-based detoxification when clinically indicated
- Psychiatric evaluation, diagnosis, and medication for PMB conditions
- Inpatient psychiatric admissions for PMB conditions at 100% of cost, subject to pre-authorisation
- In-hospital psychiatric care, including consultations and psychotherapy, paid at scheme rates, with an additional out-of-hospital psychotherapy benefit of 100% of CBT up to R17,088 per beneficiary on many options
- PMB medication and out-of-hospital treatment in line with PMB regulations
Treatment is covered at the CAMAF 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 CAMAF. However, we are a registered provider and a member of the National Hospital Network (NHN), which means all services are billed at CAMAF scheme rates.
Additionally, we typically waive any penalties or co-payments that might otherwise apply when care is received outside of CAMAF’s contracted networks. This ensures members can access treatment at Houghton House without unexpected financial burdens.
No referral is required. You can contact Houghton House directly to arrange an admission assessment. Our clinical team will evaluate your needs, and handle the pre-authorisation process with CAMAF on your behalf. This means you don’t have to go through a GP or specialist first – we take care of all clinical motivation and paperwork.
No. Houghton House bills at CAMAF scheme rates and, as part of the NHN, does not charge above-tariff fees. Members do not need to make upfront payments (aside from a once-off admission fee), and we waive co-payments that could otherwise apply for out-of-network treatment. Provided your care is pre-authorised and falls within CAMAF’s benefit rules, you should not face out-of-pocket costs for inpatient rehabilitation or psychiatric care.
CAMAF requires that all hospital admissions are pre-authorised 48–72 hours in advance (or within 72 hours of admission in emergencies). This involves submitting documentation detailing your medical diagnosis and treatment plan, including the correct ICD-10 codes.
At Houghton House, CAMAF members can access the treatment they need without financial stress or administrative hurdles. Our admissions team manages this entire process on your behalf. We provide the clinical motivation, diagnosis, and supporting documentation to CAMAF, and we keep them updated with progress reports throughout your stay.
All inpatient rehabilitation and psychiatric admissions require pre-authorisation. At Houghton House, our team manages this process for you. We submit the necessary clinical motivation, diagnosis codes, and treatment plans directly to CAMAF, liaising with case managers throughout your stay.
We help you make the most of your available benefits and ensure administrative or financial hurdles don’t get in the way of you getting the help you need.
CAMAF may apply general waiting periods or condition-specific waiting periods if you recently joined CAMAF or rejoined after a gap in membership. These include:
- A 3-month general waiting period for new members or dependents
- A 12-month condition-specific waiting period for pre-existing conditions
During this time, planned admissions for rehabilitation or psychiatric care may not be covered. However, PMB-related care (including treatment for substance use and psychiatric conditions) may still be covered during waiting periods. Houghton House will confirm your benefit status with CAMAF before admission and advise you upfront if any waiting periods affect your cover.
At Houghton House, CAMAF members have access to trusted, evidence-based care for addiction and mental health conditions, without unexpected financial burdens. Our close collaboration with CAMAF ensures that members receive the benefits they are entitled to, while we handle the administrative process to make admission as seamless as possible.
We are:
- Dual-licensed as both a psychiatric hospital and a rehabilitation facility
- A National Hospital Network member, billing at CAMAF scheme rates
- Specialists in dual diagnosis treatment for psychiatric conditions and co-occurring addiction disorders.
- Experienced in managing pre-authorisation and claims directly with CAMAF
- Staffed by a multidisciplinary team of registered professionals
With 30 years of experience in addition treatment, Houghton House combines clinical expertise with a patient-first approach. We support you every step of the way with expert care and a clear path toward lasting recovery.
Proud member of
the National Hospital
Network
