Does health insurance cover mental illness?
Medical Aid and Medical Insurance have many similarities when it comes to the type of cover they offer, but one of the many differences between the two types of health benefits is that when you have medical insurance, it probably doesn’t cover a mental health practitioner’s fees.
An article on Health24 says that depression is one of the most commonly diagnosed psychiatric disorders. According to Department of Health statistics, one in four South Africans has or is affected by mental health issues, but only 10%-15% of them get help. Research also shows that depression is expected to become the second biggest cause of disability worldwide and the leading cause in high-income nations.
Psychologist and Psychiatrist visits are seen as specialist expenses and could possibly be covered, depending on the plan you choose at your health insurance provider.
The Affinity Health Day-to-Day plan has been designed to help you cover the everyday costs of staying healthy, such as going to the doctor or dentist, obtaining prescribed acute medication or receiving a pair of reading glasses. You also receive service from any Medical Society Centre for primary healthcare and medical treatment.
Basic radiology and pathology are also covered when recommended by your GP.
The South African Depression and Anxiety Group (Sadag) reports that there are 22 psychiatric hospitals in South Africa and 36 psychiatric wards in general hospitals. Many middle-class South Africans spend up to R2 700 a night to stay in private institutions. This excludes the cost of seeing a psychologist or psychiatrist.
A recent mental health survey conducted by the Sadag advocacy group included 604 respondents.
“Mental health is not in a good situation in South Africa,” said Sadag founder, Zane Wilson. “Almost 25% of respondents said their condition had worsened due to stress and anxiety.”
More than half (55%) of the respondents said they were using their own money to fund the gaps in their medical scheme cover and 13% said they had turned to family and friends for help.