SAMWUMED covers its members for mental health and substance dependency (drug abuse), including hospitalisation. The benefits apply to consultations or visits as well as procedures.
OPTION A
Paid from Risk
- Mental Health Out of Hospital
Limited to R3160 per family per year. It is unlimited for PMB level of care or when registered on the Mental Health Programme. - Mental Health In-Hospital
PMB protocols apply. Subject to clinical motivation and authorisation.
Conditions:
- PMB protocols apply.
- Benefits are subject to clinical motivation and authorisation.
- Limited to PMB level of care and a maximum of 21 days or 15 outpatient contacts per year.
OPTION B
Paid from Risk
- Mental Health Out of Hospital
Limited to R5260 per family per year. It is unlimited for PMB level of care or when registered on the Mental Health Programme. - Mental Health In-Hospital
PMB protocols apply. Subject to clinical motivation and authorisation.
Conditions:
- PMB protocols apply.
- Benefits are subject to clinical motivation and authorisation.
- Limited to PMB level of care and a maximum of 21 days or 15 outpatient contacts per year.
