Does Insurance Cover Mental Illness in South Africa?

Table of Contents

2020 noticed an increase in instances of melancholy and anxiousness amongst South Africans triggered by the Covid-19 pandemic. Based on, melancholy is a standard and critical medical sickness that negatively impacts all areas of your life. And whereas the situation is predicted to rise globally with melancholy anticipated to turn into the second largest reason for incapacity, between 76% and 85% of individuals in low- and middle-income nations obtain no therapy for his or her dysfunction.

Incapacity Insurance coverage

Disability Insurance pays out a lump sum within the occasion of bodily harm or sickness the place you’re now not capable of work. 

It doesn’t cowl:

  1. Compensation – that is lined by a employee’s compensation coverage
  2. Medical care payments – that is lined by medical support insurance or dread illness coverage.
  3. Psychological sickness – whereas there may be nonetheless a number of confusion round what medical support schemes will cowl on this realm, sure continual psychological well being circumstances like schizophrenia and bipolar temper dysfunction require ongoing therapy and medical administration and have Prescribed Minimal Advantages (PMBs) hooked up.  

Medical Support Schemes PMBs

Prescribed Medical Advantages are a set of outlined well being service advantages that each one members of a medical scheme have entry to, whatever the plan they opted for. 

There are eleven types of mental illnesses, every with its personal PMB. Every psychological prognosis is assigned a therapy over a given time interval. Therapies fluctuate from hospital-based administration to psychotherapy and counselling. 

Regardless of being legislated, not all medical support schemes will honour the PMBs. The most effective medical schemes that cater for psychological well being are those that present probably the most handy entry to care. As Allan Sweidan, CEO Akeso Clinics & Psychologist places it,Know Thine PMB Rights!”

Record of Psychological Sicknesses and their Prescribed Remedy

This listing consists of all the psychological sickness circumstances which all medical schemes should cowl, no matter which plan a member is on. 

mental illness benefits pdf


  • Medical schemes should pay in full, and not using a co-payment or using deductibles, for the prognosis, therapy and care prices of the Prescribed Minimal Profit circumstances. 
  • The medical scheme can not use your medical financial savings account to pay for Prescribed Minimal Advantages. 
  • Every possibility provided by a medical scheme should make provision for the Prescribed Minimal Advantages, together with hospital plan choices.

You’ll find extra info on this wonderful complete PMB consumer booklet.

Disclaimer: This content material is for informational, instructional, or leisure functions solely. We don’t make any warranties concerning the completeness, reliability, and accuracy of the content material.