Why we don’t claim from medical aid (and why that might be good news for you)
“Do you take medical aid?”
It’s one of the first questions people ask us, usually in a hopeful voice. And I understand why. You’ve been paying your contributions for years. If there was ever a time to use it, surely it’s now.
So when I say no, I can almost hear the disappointment. But stay with me for a few minutes, because for a lot of the people we work with, this turns out to be one of the main reasons they choose us. Once you understand what a claim actually means, you might feel the same way.
Reason one: medical aid won’t cover what actually helps
Most medical aid addiction benefits in South Africa are built around two things: detox and short inpatient stays. Your scheme might cover a few weeks in a facility. That has its place.
But it won’t cover eight months of outpatient recovery work. It won’t cover the weekly sessions where you learn to handle a craving on a Friday night, or rebuild trust with your partner, or work out what you’re going to do with all the hours that used to go to drinking or betting.
And that’s where the real change happens. Not in the first 28 days, but in the months after, when you’re back in normal life and the pressure is real.
So even if we did claim, you’d run into the limit long before the work was done. You’d be left with the expensive bit covered and the important bit unfunded.
Reason two: your medical record follows you
This is the part people don’t think about until it’s too late, and it’s the one I really want you to hear.
When you claim from medical aid for addiction treatment, a diagnosis goes onto your medical record. It sits there. And it can come up again at moments you’d never expect:
- when you apply for life cover, so your family is looked after if something happens to you
- when you apply for disability cover or income protection
- when you switch to a different medical scheme
- when an underwriter, years from now, asks about your history
Think about that for a moment. You do the hard work. You get well. You rebuild your life. And then, five years later, when you’re trying to protect your family with a life policy, an old claim comes back to follow you around.
That doesn’t seem fair to me. You deserve to put this chapter behind you.
Many of the people who walk through our doors tell us they’d rather keep their recovery between them and us. Their spouse might know. Their closest friend might know. But their employer, their insurer and their medical scheme? No. Paying privately makes that possible. What happens in your recovery stays in your recovery.
What it actually costs
I don’t like hidden fees and I don’t like surprises, so here it is, plainly:
| Service | Cost |
|---|---|
| Monday Recovery Groups | Free |
| Biopsychosocial Assessment (about 45 minutes) | R750 once-off |
| Recovery Coaching | R850 per session (4–6 sessions recommended) |
| REBUILD Programme (8 months) | R3 850 per month, or R25 500 once-off |
We offer the monthly option on purpose. You shouldn’t need a lump sum sitting in the bank before you’re allowed to get better.
And I’ll say something gently here, because I think it needs saying. Take a moment and add up what your drinking, using, betting or habit is costing you right now. Not just the bottles, the bets or the bags. The takeaways because you were too wrecked to cook. The Ubers. The sick days. The things you bought to make up for the things you did. For many people, R3 850 a month is less than what the addiction is already taking from them. The difference is that this money is buying your life back.
Why we don’t do refunds
This is the bit people sometimes push back on, so let me explain the thinking.
All our fees are paid upfront, before sessions start, and they’re not refundable. That’s not us being difficult. It’s deliberate, and it’s part of the treatment.
Here’s what I’ve learned, both from my own recovery and from years of walking with other people through theirs. At some point, recovery gets hard. Properly hard. And it usually happens right around the time that real change is starting to happen. The old way of coping is gone, the new one isn’t solid yet, and everything in you wants to run.
That’s exactly the moment people want to quit. And if there’s money on the table, it becomes very easy to tell yourself “this isn’t working, I want my money back.”
Paying in advance is a promise you make to yourself on a clear-headed day. It’s the version of you that’s ready, looking after the version of you that’s going to want to give up. It keeps you showing up on the bad days. And the bad days are the ones that count the most.
Not sure yet?
That’s completely fair. You don’t have to commit to eight months today.
Start with the R750 assessment. Or don’t spend anything at all, and come to a free Monday group first, 19:00 to 21:00, in Centurion or on Zoom. Sit, listen, and see how it feels.
Book an assessment or WhatsApp Steven on +27 76 402 7083. Your recovery stays between you and us.
