Community care
- Private nursing and hospices - in patient services at an approved facility
info In lieu of hospitalisation only. Nursing services and sub-acute facilities.
warning Subject to submission of healthcare provider's comprehensive treatment plan and Scheme approval. Frail care services are not included.
Subject to OAL
100%
of cost - Rehabilitation
Physical rehabilitation
warning Subject to submission and approval of a treatment plan.
do_not_disturb_on 27 days per family per annum (except for PMBs)
Subject to OAL100%
of Scheme ratePsychiatric/Substance abuse
To treat abuse or dependence on psycho-active substances, including alcohol.
do_not_disturb_on Benefit of 21 days per beneficiary per annum in SANCA-approved facility
Subject to OAL100%
of Scheme rate - Blood transfusion and technologists
info Bags, pouches and flanges.
warning Subject to pre-authorisation
Subject to OAL
100%
of Scheme rate - Alternative medical services
warning Subject to available MSA
All services from homeopaths and chiropractors, chiropodists, naturopaths and osteopaths.
100%
of Scheme rate - Other medical services
Speech therapy
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateAudiology
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateOccupational therapy
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme ratePodiatry
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateDieticians
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateSocial workers
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateEducational and remedial counselling
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateMarriage counselling
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateOrthoptists
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rateClinical psychologists
warning Subject to available MSA
No pre-authorisation required
100%
of Scheme rate