Medshield Medical Aid provides comprehensive coverage for substance abuse treatment, including up to 21 days for drug and alcohol rehab treatment and a 3-day supervised detoxification. This extensive addiction treatment coverage is designed to ensure that members can access vital care for substance use disorders, providing a sense of security and peace of mind during their recovery journey.

At Changes Addiction Rehab, we’ve established a strong partnership with Medshield, a reputable healthcare provider. This partnership ensures that Medshield members receive the quality care they need for substance use disorders. Our multidisciplinary team, equipped with the skills and experience to treat these disorders, prioritises the safety and welfare of our patients, instilling confidence and reassurance in their members.

Overview Of Medshield Medical Aid For Alcoholics

Medshield Medical Aid is a reputable healthcare provider in South Africa. It offers a range of plans to its members with diverse needs and budgets.

What is Medshield Medical Aid?

Medshield Medical Aid is a leading medical aid scheme in South Africa dedicated to providing comprehensive medical coverage to its members. With a strong focus on quality healthcare services, Medshield ensures its members can access the best medical care available. The scheme is designed to promote healthy living and wellness, offering a range of plans that cater to different needs and budgets. By prioritising affordability and sustainability, Medshield Medical Aid allows members to receive essential healthcare services without financial strain.

Mission and Values of Medshield Medical Aid

At the heart of Medshield Medical Aid is a mission to provide members with access to top-notch healthcare services while fostering a culture of healthy living and wellness. The scheme is built on core values, including a steadfast commitment to excellence, integrity, and customer satisfaction. Medshield strives to develop long-term relationships with its members grounded in trust, respect, and open communication. This dedication to its values ensures that members receive the best medical care and a supportive and reliable healthcare partner.

History Of Medshield

Medshield has offered premium medical aid plans and services in South Africa for 50 years. The scheme started in 1968 as a small, workplace-based fund. Over time, it became one of the country’s larger open medical schemes. They have built a trustworthy reputation around solid financial stability. They maintain high reserves, which makes paying out claims possible. They have won multiple awards for their customer care and innovative products. In recent years, Medshield Medical Aid has advanced by adding digital services. Members can now conveniently access their plan information, benefits, and claims through a user-friendly mobile app, making the process more accessible and efficient.

Benefits of Medshield Medical Aid

Medshield Medical Aid offers many benefits designed to enhance the healthcare experience for its members. These benefits include:

Comprehensive Medical Cover: Members receive extensive coverage for hospitalisation, doctor’s visits, and other medical expenses, ensuring they are well-protected in times of need.
Access to Quality Healthcare Providers: Medshield has a network of reputable healthcare providers, giving members access to top-tier medical professionals and facilities.
Affordable Premiums and Flexible Payment Options: The scheme offers competitive premiums and various payment options, making it easier for members to manage their healthcare costs.
Personalised Customer Service and Support: Medshield is committed to providing exceptional customer service, offering personalised support to help members navigate their healthcare journey.
Wellness Programs and Health Education Initiatives: To promote healthy living, Medshield offers wellness programs and health education initiatives, empowering members to make informed decisions about their health.

Types of Medshield Medical Aid Plans

Medshield Medical Aid understands that healthcare needs vary, which is why it offers a range of plans to suit different requirements and budgets. These plans include:

Essential Plan: This basic plan provides essential cover for hospitalisation and other critical medical expenses, ensuring members have access to necessary care.
Classic Plan: A mid-range option, the Classic Plan covers hospitalisation, doctor’s visits, and additional medical expenses, offering a balanced approach to healthcare coverage.
Comprehensive Plan: For those seeking extensive coverage, the Comprehensive Plan includes all medical expenses, from hospitalisation to routine doctor’s visits, providing peace of mind and thorough protection.
Customized Plan: Recognising that each member’s needs are unique, Medshield offers a Customized Plan that can be tailored to meet an individual or family’s specific healthcare requirements and budget.

By offering these diverse plans, Medshield Medical Aid ensures that every member can find a suitable option that aligns with their healthcare needs and financial situation.

Substance Abuse and Alcohol Use Disorder Treatment Coverage Options

Medshield Medical Aid offers various options for substance abuse treatments, including those for alcohol abuse and alcohol addiction. Alcohol consumption can significantly impact treatment options, making it crucial to choose the right plan.

Each plan caters to the different needs and budgets of its members, covering a range of substance use disorders, including alcohol use and alcohol use disorder. Professional treatment is often necessary for alcohol use disorders to ensure effective recovery.

Detoxification processes are covered, including management of alcohol withdrawal and alcohol withdrawal symptoms. Rehab treatment for alcoholism is also available, providing comprehensive care.

Patterns of alcohol consumption, such as binge drinking, are considered, and the definition of alcoholism is addressed to help members understand their condition. Excessive alcohol and excessive drinking pose significant health risks, which are also covered under the plans.

The severity of alcohol use disorders, including heavy drinking and the increased risk of associated health issues, is taken into account. Mental health and mental health problems related to alcohol misuse are also addressed, ensuring holistic care.

Challenges in controlling drinking habits, such as the need to stop drinking, are recognised, and the treatment of alcoholism is supported through various options. Withdrawal symptoms and the importance of medical supervision during this phase are emphasised to ensure safe and effective treatment.

Inpatient vs Outpatient Rehab Programs for Alcoholism Treatment

Medshield Medical Aid covers residential rehab programs for up to 21 days, including a 3-day medically supervised detoxification from alcohol and drugs to manage withdrawal symptoms. Patients reside in the facility for a set period in a secure and safe environment that is conducive to recovery and free of distractions; this program is suitable for individuals with severe substance use disorders seeking urgent care. Alcohol withdrawal symptoms can be severe and require medical supervision to mitigate risks such as seizures and delirium tremens.

The outpatient rehab program allows individuals to attend to daily responsibilities such as work, relationships and school while still receiving treatment for their addiction. Usually, outpatient serves as a transitionary program after completing the entire inpatient rehab program; individuals who seek to attend the outpatient program without completing inpatient will have to undergo a thorough evaluation from our clinical team at Changes Addiction Rehab to determine if they are suitable. Both programs offer individual counselling and group therapy, which can be claimed through Medshield Medical Aid. It is important to note that Medshield does not cover the complete outpatient program, and members may be liable for a co-payment upon admission into our inpatient rehab facility.

Therapy And Counselling Benefits for Alcohol Withdrawal Symptoms

Therapy and counselling are cornerstones of inpatient rehab treatment facilities. Individuals will unpack their maladaptive behaviours around their addiction and learn healthy coping mechanisms and tools that are conducive to recovery. These sessions are crucial for addressing the impact of addiction on mental health and helping individuals manage anxiety and depression. Mental health problems often co-occur with addiction, leading to various psychiatric disturbances and social ramifications. Medshield Medical Aid offers its members individual counselling and group therapy benefits; the number of sessions will depend on the plan chosen by the member.

Pre-Authorisation Procedure

Members must obtain a pre-authorisation for approval before being admitted into an inpatient treatment facility. This ensures that the treatment is medically necessary and covered by the plan, especially for conditions like alcohol use disorders. At Changes Addiction Rehab, members can phone our admissions department, and we will conduct the pre-authorisation process for you to obtain approval. We will phone Medshield on your behalf and provide them with your details, which will include:

Your ICD-10 codes for your specific addiction
Any other relevant information
Our facilities practice numbers

Lastly, no referral letter from a medical health professional is needed to be admitted.

The Claims Process For Medshield

Filing claims for Medshield Medical Aid involves following specific steps and submitting supporting documentation. Proper preparation can ensure a smooth and hassle-free process.

Supporting Documents

To submit a claim for substance abuse treatment, members will need the following:

A detailed invoice from the chosen inpatient rehab facility
Treatment plans, including those addressing alcohol use and alcohol use disorder
Invoices and receipts
Any other relevant documents

Keeping the original receipts and documents when submitting a claim is essential.

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Submitting A Claim

Medshield offers its members various ways to submit claims:

Online: Members can log onto their profile and submit their claims.
Email: Members can send their supporting documents to the claims department, including any documentation related to alcohol misuse.
Mobile App: Members can use the app to submit their claims on the go.

For claims related to the treatment of alcoholism, it is essential to include all necessary medical documentation, such as reviews and studies evaluating pharmacological options like topiramate, baclofen, and psilocybin-assisted psychotherapy.

Lastly, members must include their membership numbers in all correspondence cases, double-check that all their forms are filled out correctly, and ensure that everything is signed to prevent delay.

Conclusion

Medshield Medical Aid is a trusted healthcare provider offering its members comprehensive substance abuse treatment coverage, including for alcohol dependence. Inpatient rehab treatment is covered for up to 21 days, including a 3-day medically supervised detoxification. Additionally, members can claim individual counselling and group therapy sessions. At Changes Addiction Rehab, we understand that coming into treatment for addiction can be an overwhelming experience, which is why we do pre-authorisation procedures, making the admission process into our facility a smooth and stress-free experience. Call us today!

FAQs

Are Rehabilitation Programs for Alcohol Dependence Covered By Medical Aids In South Africa?

Yes, all medical aid schemes are legally required to cover addiction treatments, including those for alcohol addiction, as they fall under the prescribed minimum benefits (PMBs).

Do I Need A Referral Letter To Be Approved For Substance Abuse Treatment By Medshield?

No, you do not need a referral letter. You can call us at Changes Addiction Rehab, and we will proceed with the pre-authorisation process on your behalf with Medshield Medical Aid. This includes assessments for alcohol use disorders, ensuring that you receive the necessary professional treatment and support.

Does Medshield Cover Outpatient?

Medshield only covers specific services offered at the outpatient program, including those aimed at addressing alcohol misuse.

Does Medshield Cover Substance Abuse Treatment?