Houghton House
Fedhealth medical aid rehab cover at Houghton House
Fedhealth medical aid rehab cover ensures access to quality inpatient treatment at Houghton House, one of South Africa’s leading rehab centres. If you’re seeking rehabilitation through Fedhealth, Houghton House provides professional addiction treatment and inpatient psychiatric care. Keep reading to learn how your Fedhealth rehab benefits work for substance abuse and related psychiatric conditions.
About Fedhealth medical aid
Launched in 1936, Fedhealth Medical Scheme is an open medical scheme that operates on a not-for-profit basis, governed by the Medical Schemes Act.
Fedhealth is run by members for members, with an elected Board of Trustees. As a result, the scheme’s priorities are guided by the needs of its members rather than shareholders. It has 59,040 members and 107,964 beneficiaries, according to the most recent industry financial performance report published by the Council for Medical Schemes (CMS).
Fedhealth is known for giving members a high degree of control over their healthcare spend. Its plan options — which include the myFED, flexiFED, and maxima ranges — are designed to be flexible, enabling members to decide how to structure their day-to-day benefits
Does Fedhealth cover rehabilitation?
Yes. Fedhealth provides cover for inpatient substance abuse treatment as part of its Prescribed Minimum Benefits (PMBs). These are benefits set out in law under the Medical Schemes Act, which every medical scheme in South Africa must provide, regardless of the plan you belong to. For rehabilitation, Fedhealth’s PMBs include:
- Up to 21 days of inpatient rehabilitation per beneficiary per year
- Up to 3 days of in-hospital detoxification per year
- Cover for both drug and alcohol dependency treatment
These benefits apply across all Fedhealth plans, ensuring that members can access medically necessary treatment for substance use disorders. Additional cover may vary depending on your plan option, but the PMB minimum is always guaranteed.
Does Fedhealth cover psychiatric care?
Yes. Inpatient psychiatric treatment for specific mental health conditions is also covered under Fedhealth’s Prescribed Minimum Benefits, ensuring members have access to essential mental health care when hospitalisation is medically necessary.
As with Fedhealth’s rehabilitation cover, this applies across all benefit options, as long as the treatment is deemed clinically appropriate and pre-authorisation is granted. The PMB framework provides:
- Up to 21 days of hospital-based psychiatric treatment per year
- Cover for specific conditions, including:
- Major affective disorders (such as major depression and bipolar mood disorder)
- Schizophrenia and paranoid delusional disorders
- Brief reactive psychosis
- Hospital accommodation, procedures such as electroconvulsive therapy (ECT), consultations, and prescribed medication
Beyond the PMB minimum, Fedhealth offers additional mental health support depending on your plan. This includes access to the Mental Health Programme (for conditions like depression and bipolar disorder), chronic medication benefits, and the October Health app, which provides virtual counselling, group sessions, and mental health resources.
How Houghton House works with Fedhealth medical aid
Houghton House is dual-licensed as both a psychiatric hospital and as a rehabilitation facility. As a member of the National Hospital Network (NHN), all services are billed at Fedhealth scheme rates, ensuring your care is funded within your benefits.
Our team manages the entire pre-authorisation process directly with Fedhealth, including motivation letters and clinical coding, so there is no administrative burden on you or your family. All treatment is delivered by registered professionals in line with Fedhealth’s Prescribed Minimum Benefits.
- No upfront payments are required, except a once-off admission fee
- No co-payments or shortfalls, even if Fedhealth only covers a portion of the scheme rate
- Comprehensive care for both substance use and psychiatric conditions
- Seamless claims handling and direct coordination with Fedhealth
By working closely with Fedhealth, Houghton House ensures that treatment is fully funded within your plan’s limits. We guarantee there are no unexpected shortfalls or co-payments, and we waive any penalties that may otherwise apply for out-of-network care. At Houghton House, you get peace of mind and access to the care you need, without unexpected costs.
FAQs
Fedhealth covers essential care for both substance abuse rehabilitation and psychiatric treatment under the Prescribed Minimum Benefits (PMBs). This means that all members are guaranteed:
- Up to 3 days of in-hospital detoxification per year
- Up to 21 days of inpatient rehabilitation per year for alcohol or drug dependency
- Up to 21 days of inpatient psychiatric treatment per year for qualifying conditions
- Cover for consultations, hospital accommodation, certain prescribed medicines, and treatments such as electroconvulsive therapy (ECT) when clinically required
These benefits apply across all Fedhealth plans, provided treatment is pre-authorised and medically necessary. Additional benefits may vary between plan options, but PMB cover is protected by law.
While Houghton House is not currently listed as a designated service provider (DSP) for Fedhealth, we are a registered provider and a member of the National Hospital Network (NHN), which means all services are billed at Fedhealth scheme rates.
Moreover, Houghton House typically waives co-payments or penalties that might otherwise apply to out-of-network care.
No referral is required to access rehabilitation at Houghton House through Fedhealth. You can contact Houghton House directly, where admission begins with a confidential assessment by a registered mental health professional.
Once treatment is deemed clinically necessary, Houghton House handles the pre-authorisation process with Fedhealth, including all documentation, clinical coding, and motivation letters. This ensures members can focus on recovery without the administrative burden.
No, aside from a once-off admission fee. Fedhealth covers treatment for substance use and psychiatric conditions within PMB limits, provided pre-authorisation is obtained and treatment is clinically necessary.
At Houghton House:
- No upfront payments are required (except admission fee)
- All services are billed at Fedhealth scheme rates
- Co-payments and penalties for out-of-network care are typically waived
This ensures Fedhealth members are protected from unexpected costs while receiving care.
Fedhealth requires pre-authorisation before hospital admission for rehabilitation or psychiatric treatment. At Houghton House, this process is managed entirely by the clinical and administrative team, who:
- Conduct an initial assessment
- Submit the required documentation and motivation to Fedhealth
- Handle all communication and updates with the scheme during treatment
This guarantees a smooth admission process and ensures members have access to the benefits they are entitled to under their plan — without being burdened with administrative stress.
Waiting periods may apply if you are a new Fedhealth member or if you rejoined after a lapse in cover.
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 treatment — including substance abuse rehabilitation and inpatient psychiatric care — may still be covered during waiting periods. Houghton House verifies your benefits and advises you upfront if any waiting periods affect your admission.
At Houghton House, we make it simple for Fedhealth members to access high-quality, fully covered treatment for addiction and mental health conditions.
We are:
- Dual-licensed as a psychiatric hospital and rehabilitation facility
- Part of the National Hospital Network, billing at Fedhealth scheme rates
- Experienced in managing pre-authorisation and claims directly with Fedhealth
- Staffed by registered professionals delivering quality evidence-based care
- Specialists in dual diagnosis treatment for co-occurring addiction and psychiatric conditions
With 30 years of experience, Houghton House combines trusted clinical expertise with a patient-first approach. Fedhealth members can focus fully on recovery, knowing that care is clinically appropriate, financially secure, and professionally managed.
Proud member of
the National Hospital
Network
