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Community Care
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Private nursing and hospices - in patient services at an approved facility
In lieu of hospitalisation only. Nursing services and sub-acute facilities.
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
Subject to submission and approval of a treatment plan.
27 days per family per annum (except for PMBs)
Subject to OAL100%
of Scheme rate
Psychiatric/Substance abuse
To treat abuse or dependence on psychoactive substances, including alcohol.
Benefit of 21 days per beneficiary per annum in SANCA-approved facility
Subject to OAL100%
of Scheme rate
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Blood transfusion and technologists
Bags, pouches and flanges.
Subject to pre-authorisation
Subject to OAL
100%
of Scheme rate
-
Alternative medical services
Subject to available MSA
Homeopaths and chiropractors, chiropodists, naturopaths and osteopaths. Including all services.
100%
of Scheme rate
-
Other medical services
Speech therapy
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Audiology
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Occupational therapy
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Podiatry
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Dieticians
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Social workers
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Educational and remedial counselling
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Marriage counselling
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Orthoptists
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate
Clinical psychologists
Subject to available MSA
No pre-authorisation required
100%
of Scheme rate