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 OAL


    100%
    of Scheme rate
    Psychiatric/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 OAL


    100%
    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 rate
    Audiology

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Occupational therapy

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Podiatry

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Dieticians

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Social workers

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Educational and remedial counselling

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Marriage counselling

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Orthoptists

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate
    Clinical psychologists

    warning Subject to available MSA

    No pre-authorisation required


    100%
    of Scheme rate