Note: The benefits mentioned below may vary depending on your specific plan. For accurate, personalised information, please contact MedXpert. We can help you compare plans and register for available programmes.
Mental health has become a vital part of overall well-being and, increasingly, a key feature of South African medical scheme offerings. With more schemes incorporating structured mental wellness support into their benefit designs, it’s never been more important to understand what your plan includes.
Medical aids now offer a variety of mental health benefits: structured programmes, virtual counselling, medication support, and app-based coaching. But not all benefits are created equal and what you have access to depends heavily on your specific scheme and option.
Let’s break it down by scheme to help you make informed choices.
Why mental health benefits should be on your radar
- Therapy is expensive: Out-of-pocket costs for psychologists or psychiatrists can be prohibitive.
- Stress and anxiety are rising: Modern life places serious mental strain on individuals and families alike.
- Support is now built into some plans: Medical schemes are beginning to respond with real, structured benefits, but they differ significantly by provider.
Snapshot of mental health benefits offered
Here’s a quick summary before we unpack the detail:
- Bonitas: Counsellors, app support, chronic medication benefits, and a dedicated Mental Health Programme.
- Discovery: Structured managed care programmes, including a 6-month care programme, digital CBT tools, virtual consults, and rewards through Vitality.
- Medshield: Strong in-hospital and out-of-hospital cover.
- Medihelp: Depression programme, out-of-hospital psychologist visits, podcasts and videos via HealthPrint.
- Momentum: In-hospital care only (unless self-funded), plus access to the Wysa app through Multiply.
Mental health support by scheme
Bonitas
Mental health programme
Bonitas offers a dedicated programme for members with depression, anxiety, PTSD, and alcohol abuse. Bonitas offers structured mental health support across all plans, including medication and consultation limits, with easy app access. Once registered, you’ll be paired with a dedicated counsellor who collaborates with your doctor and provides long-term support.
- Chronic medication for depression covered up to R160 per month (subject to DSP use and Chronic Programme registration).
- Educational content provided to help you manage your condition.
- Available across all plan types, including BonCap.
Digital support
Bonitas members have access to the October Health app (formerly Panda), a mental health platform offering anonymous audio-only sessions with peer supporters and mental health professionals.
Hospitalisation benefits
Mental health consultations are covered both in and out of hospital:
- Primary and Primary Select: Up to R10,920 per family per year.
Discovery Health
Mental health care programmes
Discovery offers two structured programmes. It has a specific Mental Health Care Programme, including but not limited to depression, and it has a 6-month Depression Risk Management Programme.
Here are some differences between the 2 programmes:
Depression Risk Management Programme:
- Access to face-to-face counselling.
- Includes GPs, psychiatrists, psychologists within the network.
- Available to members upon diagnosis and registration.
Mental Health Care Programme:
- Start with 3 virtual/face-to-face counselling with your GP and thereafter a yearly limit of R3479 per person for psychotherapy sessions.
- Includes GPs, and psychologists.
- Antidepressant medication funding.
Digital tools
Members can access:
- Mental wellbeing assessments. Virtual consultations.
- Guided digital CBT (Cognitive Behavioural Therapy) modules.
Vitality rewards
Vitality members earn points for completing mental health assessments and wellness activities, helping you stay consistent with your care.
Medshield
Taking care of your mental health is just as important as your physical wellbeing, and Medshield’s medical plans reflect this commitment. Here’s a clear breakdown of what you can expect when it comes to mental health cover:
- Hospitalisation for Mental Health: All Medshield plans cover mental health hospitalisation under the Prescribed Minimum Benefit (PMB) at the required level of care. This means essential mental health treatments in hospital are protected.
- Non-Network Hospital Admissions: If you are admitted to a mental health facility outside Medshield’s network, you’ll need to pay a 30% upfront co-payment on all plan options. This is important to keep in mind when choosing your treatment provider.
- Out-of-Hospital Mental Health Care: Consultations with psychiatrists, psychologists, and other mental health professionals outside of hospital are typically paid from your day-to-day or savings benefits, but this depends on the specific plan you’re on.
When it comes to limits on mental health benefits, Medshield offers different levels based on your plan tier:
- PremiumPlus (Top-tier): R68,750 per annum
- MediPlus (Middle tier): R38,550 per annum
- MediCurve (Entry-level): Coverage is subject to PMB regulations
Digital tools
Members can access Medshield Mind which offers:
- Expert-led workshops and interactive self-help tools for stress management and overall wellbeing.
- Features such as guided meditations and tailored content suggestions to suit your individual needs.
Medihelp
Medihelp’s Depression Management Programme offers essential support with day-to-day treatment, like monthly medication and mental health consultations. Further benefits are also offered, such as in-hospital care and guidance through a wellness app. This comprehensive approach makes managing depression more accessible and supportive.
Depression management programme
Includes:
- Monthly medication allowance.
- Annual limit for out-of-hospital mental health consults.
Example:
On MedVital:
- Hospitalisation and psychiatric services: R36,400/year.
- Out-of-hospital treatment: R3,000/year (with registration).
Digital support
Via the HealthPrint platform, members access the Healthy Mind programme: podcasts, videos, and mental wellness tips.
Momentum
Momentum’s cover is heavily weighted toward in-hospital care, unless you’ve opted into the HealthSaver offering. The Wysa app is a helpful digital tool, but isn’t integrated into rewards.
In-hospital support
Mental health care is covered only during hospital admission, subject to authorisation.
Out-of-hospital support
Generally not included unless members use their HealthSaver account, a voluntary self-funding option.
Digital coaching
Multiple members (any level) can access Wysa, a 24/7 AI-powered app that supports anxiety, sleep issues, and depression.
What about wellness and rewards?
Rewards platforms are making it easier to stay mentally well by turning self-care into everyday habits. Medical schemes are now integrating mental health into their incentive structures:
- Vitality (Discovery): Earn points by completing assessments and engaging with mental wellbeing content.
- Multiply (Momentum): Access Wysa on all levels. Though it doesn’t affect HealthReturns, it’s a valuable tool.
Your next step
It’s clear that mental health benefits differ vastly depending on the scheme and plan level. Whether you’re comparing options or trying to understand your current cover, having the right information can help you access the care you need.
Not sure what mental health benefits you currently have or if you’re missing out on something better?
Complete this quick MedXpert form and one of our experts will contact you directly to walk you through your mental health benefit options, programme eligibility, and how to register. This allows us to track your request and give you personalised advice based on your current scheme and plan.
Take the first step toward better mental wellbeing today, with the support you’re already paying for.