Medical aid (Funds)
- Most medical aid funds cover all clinical costs and accommodation in a psychiatric hospital (for all psychiatry related therapy) for up to 21 days per annum.
- Patients remain responsible for any shortfall of claims not paid by the medical aid (amounts their medical aids do not cover).
- Patients have to obtain an authorisation- or reference number from their medical aid funds before they can be admitted to Bloemcare.
- Some medical aid funds do not pay for treatment by physiotherapists while in a psychiatric hospital.
- All medical procedures that the psychiatrist refers the patient to undergo, e.g. gastroscopies, colonoscopies, X-rays, etc are not covered under “psychiatry-related”. This will be paid as per the patient’s specific option (plan) of his/her medical aid scheme.
- Before a patient is admitted to Bloemcare, they should contact their medical aid fund to make sure which services will be covered by their plan.
- Accommodation fees are charged according to negotiated rates between the facility/service provider and the patient’s medical aid scheme.
- Case Managers (medical aid fund queries) and Debtors (private queries) personnel are available Monday to Friday, during office hours, for any queries.
Fees (Subject to change)
- Accommodation for most medical aids – as per the medical aid (fund) tariff. Private patients must pay an up-front deposit of R7 700.00 when admitted.
- Discovery Health Coastal Network : 30% of account is patient’s liability.
- Medication is charged per item and is part of the hospital bill.
- Psychiatrists charge separately and their account is not part of the hospital bill.
- Psychologists charge separately and their account is not part of the hospital bill.
- Physiotherapists charge separately and their account is not part of the hospital bill.
- Occupational therapy: as per the medical aid fund tariff, but forms part of the Bloemcare group therapy program, which is psychiatry related.
- Blood tests are charged separately by the pathologist.
- Sleep study does not form part of the hospital bill.