POLMED Medical Aid Coverage Overview
Does your medical scheme cover up to 21 days of inpatient rehabilitation and a medically supervised detox for addiction?
POLMED covers addiction rehabilitation. Inpatient rehab and medically supervised detox are Prescribed Minimum Benefits, so every POLMED plan is required by law to fund them, usually up to 21 days of inpatient treatment a year once your policy is active and up to date. That cover extends to the main member and registered dependents, including a spouse and children.
POLMED funds the treatment, but you need pre-authorisation first. What gets approved depends on your plan and your clinical motivation. Call Changes on 081-444-7000 and we handle that authorisation with POLMED directly.
Does POLMED Cover Rehab?
Yes. Because addiction is a chronic condition, South African law classes substance use disorder as a Prescribed Minimum Benefit, and POLMED must cover it on every plan, from entry-level options to full hospital plans. The one condition is that your membership is current. Members who have just joined, or whose policy has lapsed, are unlikely to have a rehab admission paid for, so it helps to confirm your standing before you book.
What POLMED Medical Aid Rehab Cover Includes
Cover centres on inpatient treatment, with detox included as part of the admission. The table below shows what comes standard as a Prescribed Minimum Benefit and what depends on your specific plan.
| Funded as a PMB | Depends on Your Plan |
|---|---|
| Inpatient rehabilitation, up to 21 days a year | Outpatient therapy and counselling |
| Medically supervised detox | Aftercare and support-group sessions |
| Psychiatric and dual-diagnosis care | Day limits beyond the PMB minimum |
| Treatment for the member and dependants | Co-payments on certain plans |
Most POLMED plans also reach beyond the basic entitlement. Some include outpatient therapy or support-group participation after discharge, and certain plans add medication management. These extras vary, which is why the figure that matters is the one POLMED confirms for your membership rather than a general promise.
Getting Treatment Pre-Authorised
Pre-authorisation is mandatory, and it is the step that trips people up. POLMED needs the patient’s medical aid details and ID. It also needs the treating clinician’s practice numbers and the ICD-10 codes that confirm medical necessity. You do not need to see your GP or a specialist first to prove the case.
Changes handles this for you. Our admin team is on the phone with medical schemes for much of the working day, and we call POLMED with the correct information so you get a clear answer, often within minutes, on what is covered and what your co-payment will be.
What Is Not Automatically Covered
No medical aid cover is unlimited. Outpatient therapy, counselling and outpatient detox usually sit outside the PMB entitlement unless your plan specifically adds them. Annual day limits and co-payments can also apply, even on treatment that is covered. The practical question is usually how much POLMED pays and for how long, rather than whether it pays at all.
Support for SAPS Members and Their Families
Changes treats 8 to 10 POLMED members from the police service through our primary care centre in a typical month, so we know the pressures the job carries. Policing in South Africa brings exposure to trauma that few other careers match, and many officers worry that going to rehab will mark their record or threaten their position.
It does not work that way. POLMED members receive a sick note covering their time away that does not state the reason, so clinical details stay private. Your station sees only what it needs for leave and deployment, and you decide how much more to share. Our aim is to return officers to full functioning at home and work, because a treatable brain disease should not end a career.
Other Medical Aids We Work With
Changes handles pre-authorisation across most South African schemes. If your cover sits elsewhere, these pages explain how each one treats addiction rehab:
- LA Health
- Remedi
- Bestmed
- Medscheme
- Momentum
- Discovery
- Compcare
- Genesis
- Medshield
- Gems
- Fedhealth
- SABC
Confidential • Licenced • Support Changes Rehab admissions for personal advice on treatment, medical aid or the next steps.Need help for yourself or a loved one?
If you or a family member is a POLMED member weighing up rehab, the fastest first step is to let us confirm your cover. Call Changes on 081-444-7000 or book an assessment, and we will deal with POLMED’s pre-authorisation while you focus on getting well.