Rehab covered by international medical aid

Cigna is a US-based health insurer offering international medical cover for individuals, families, and organizations. It is particularly common among expatriates and international staff of global NGOs or multinational companies, particularly those operating in conflict areas and countries with limited healthcare infrastructure.

With more than 60 years of experience serving international organisations, Cigna has established an extensive global network of 2.4 million healthcare providers in more than 200 countries and jurisdictions worldwide.

Yes. Houghton House regularly treats Cigna members from various African countries, where local psychiatric or rehab services are limited. Cigna generally approves:

• Up to 21 days of inpatient rehabilitation
• Up to 3 days of hospital-based detox, where clinically indicated

Treatment approval is based on clinical need and motivated by supporting medical and psychiatric reports. There are no standard benefit limits like those found in South African schemes. Instead, Cigna evaluates cases on a quote-and-review basis.

Yes. Cigna covers inpatient psychiatric treatment and associated consultations, medication, and therapies, provided that:

• The patient has active international cover with psychiatric benefits
• Treatment takes place at an appropriately licensed facility
• The facility submits a full cost estimate along with supporting clinical documents 

Treatment is subject to pre-approval on a case-by-case basis and requires a detailed clinical motivation. Cigna members are free to use the healthcare provider of their choice, and Cigna typically pays providers directly for inpatient care.

With over 60,000 beneficiaries, Pula Medical Aid Fund (Pulamed) is Botswana’s second-largest open medical scheme. Established in 1991 by a group of mining companies and other private businesses, Pulamed operates on a not-for-profit basis.

Pulamed currently offers five different benefit options designed to cater to the needs and preferences of various demographics. Available plans include Executive, Deluxe, Galaxy, Standard, and Flexi.

Yes. Pulamed covers inpatient treatment for substance use disorders across most of its plans, provided the treatment is pre-authorised and clinically appropriate.

Members are entitled to:

• Up to 21 days of inpatient rehabilitation per beneficiary per year
• Up to 3 days of hospital-based detox from drugs or alcohol
• Treatment at a registered or recognised rehabilitation centre
• Care for both drug and alcohol dependency

Members are generally free to choose their provider, and coverage applies across Pulamed’s various plans. However, benefit limits and authorisation requirements may vary by option, so it’s best to confirm the specifics of your benefit before admission. Houghton House will assist with this process and typically waives any co-payments that might otherwise apply.

Yes. Inpatient psychiatric treatment is covered under Pulamed’s hospital benefits. While the scheme’s materials don’t define specific PMB allocations (as South African schemes do), we’ve found that Pulamed routinely covers:

• Up to 21 days of inpatient psychiatric care per beneficiary per year at a registered psychiatric hospital, such as Houghton House
• Cover for PMB-equivalent mental health conditions such as major depression, bipolar disorder, and other recognised psychiatric illnesses
• Cover for psychiatric medicines, subject to option limits

As with rehabilitation benefits, pre-authorisation is required. While Houghton House bills all services at National Hospital Network (NHN) rates, benefit availability and exact limits may vary by plan.

The Botswana Public Officers’ Medical Aid Scheme (BPOMAS) was established in 1990 through a Presidential Directive and registered with the Registrar of Societies. BPOMAS is a closed medical aid scheme, available exclusively to:

• Public service employees in Botswana
• Employees of former government departments that have since become parastatals (provided they choose to remain in the scheme)

The scheme is administered by Health Risk Management Botswana (HRMB) and is a member of the Board of Healthcare Funders of Southern Africa (BHF).

All government employees in Botswana are eligible to join BPOMAS and receive a 50% subsidy from the state toward their monthly contributions. Three benefit options are available: High Benefit, Medium Benefit, and Standard Benefit.

Yes. BPOMAS provides cover for inpatient treatment of substance use disorders, including detoxification and rehabilitation. In Houghton House’s experience with the scheme, members are generally covered for:

• Up to 3 days of hospital-based detoxification per beneficiary per year
• Up to 21 days of inpatient rehabilitation for drug or alcohol dependency

These benefits are available to all members regardless of plan type. While pre-authorisation is required, treatment at Houghton House is typically fully covered when submitted for approval.

Yes. BPOMAS offers consistent psychiatric coverage across all plan types. Members are entitled to:

• Up to 21 days of inpatient psychiatric care per beneficiary per year
• Treatment for a range of mental health conditions, including major depression, anxiety, bipolar disorder, and related diagnoses

Treatment is fully covered at National Hospital Network (NHN) rates, and there is no variation in benefits from one plan to another. Admissions must be clinically appropriate and pre-authorised.

Houghton House has extensive experience working with BPOMAS to secure funding for these admissions.

While neither of the schemes discussed above requires members to use DSPs, Houghton House can be considered a preferred service provider for all three.

As a dual-licensed facility and a registered member of the NHN and BHF, we bill all services at negotiated rates, and frequently receive referrals from both of the Botswana-based medical aids as well as Cigna.

We occasionally require referral letters from the patient’s treating psychiatrist or GP for BPOMAS and Pulamed. If this applies to you, we will let you know.

No. Aside from the once-off admission fee and possible copayment for certain medications, you won’t pay anything out of pocket as a member of either of these medical aids.

While it’s Pulamed’s policy to require a 10% co-payment for all services across all benefit options, Houghton House typically waives this co-payment.

At Houghton House, our admission team manages the entire pre-authorisation process on your behalf, liaising directly with the medical aid provider. We prepare and submit documentation in line with the scheme’s approval requirements, including clinical motivation, treatment plans and cost estimates.

We also confirm that your available benefits cover your treatment and check whether any exclusions apply prior to admission. We take care of the admin so you can focus on recovering.

Over the past 30 years, Houghton House has earned a reputation in South Africa — and beyond — for providing trusted, evidence-based care for addiction and mental health conditions.

We are:

• Dual-licensed as both a psychiatric hospital and a rehabilitation facility, and staffed by a multidisciplinary team of registered professionals
• Specialists in dual diagnosis treatment for psychiatric conditions and co-occurring addiction disorders
• Experienced in managing pre-authorisation and claims directly with international medical schemes for our international patients

Our close collaboration with your medical aid ensures you receive the treatment you need, without financial or administrative stress.

At Houghton House, we support you every step of the way with expert care and a clear path toward lasting recovery.