Insurance & Billing

Understanding your coverage and payment options at Royal Hospital

Medical Aid Accepted

We Accept All Medical Aids

Subject to pre-approval

Royal Hospital works with all major medical aid schemes to ensure you receive the care you need.

Questions About Coverage or Billing?

Our billing department is here to help you understand your financial options

Medical Aid Coverage

We work with all major South African medical aid schemes

We Accept All Major Medical Aids

Royal Hospital is registered with the Council for Medical Schemes and accepts all major medical aids including:

Discovery Health
Bonitas
Momentum Health
Medshield
Bestmed
Fedhealth
Profmed
Sizwe Hosmed
GEMS
POLMED
And many others...
Note: Your medical aid plan determines your coverage level and benefits.

Authorization Process

Most medical aids require pre-authorization for rehabilitation services. Here's what you need to know:

  • We Handle Authorization Our admissions team submits authorization requests on your behalf
  • Required Documentation Medical reports, diagnosis, and treatment plan from your doctor
  • Processing Time Usually 24-48 hours, emergency cases processed faster
  • Regular Updates We keep you informed of authorization status

What's Typically Covered

Coverage varies by medical aid plan, but typically includes:

Accommodation & Nursing Care
  • Room and board
  • 24/7 nursing care
  • Meals and dietary services
  • Medical supplies and consumables
  • Basic nursing procedures
Therapy Services
  • Physiotherapy sessions
  • Occupational therapy
  • Speech and language therapy
  • Hydrotherapy treatments
  • Group therapy activities
Medical Care
  • Daily medical rounds by physician
  • Medication management
  • Diagnostic tests (as needed)
  • Specialist consultations (when required)
  • Emergency medical response
Support Services
  • Nutritional counseling
  • Social worker services
  • Discharge planning
  • Family education and training
  • Equipment recommendations

Payment Options for Self-Paying Patients

Flexible payment solutions for patients without medical aid coverage

For patients who don't have medical aid or whose plans don't cover rehabilitation, we offer transparent pricing and flexible payment arrangements.

Detailed Quotation

We provide a comprehensive cost estimate before admission, so you know exactly what to expect.

Payment Plans

Flexible payment arrangements available - discuss options with our billing department.

Payment Methods

We accept cash, electronic transfers, debit and credit cards for your convenience.

Package Rates Available: We offer package rates for certain rehabilitation programs. Contact our billing department for more information.

Understanding Your Bill

How billing works during and after your stay

1
Daily Charges

Services are charged daily during your stay, including accommodation, nursing, meals, and therapy.

2
Weekly Updates

We provide weekly billing statements so you can track costs throughout your stay.

3
Direct Billing

We bill your medical aid directly, you're responsible for any shortfalls or co-payments.

4
Final Statement

Upon discharge, you'll receive a final statement showing all charges and payments received.

Co-Payments & Shortfalls

Understanding your out-of-pocket expenses when using medical aid:

Co-Payments

Some medical aid plans require a co-payment (e.g., 20% of the daily rate). We'll inform you of any co-payment requirements before admission.

Shortfalls

If our rates exceed your medical aid's reimbursement rates, you may be responsible for the difference. We'll communicate this clearly upfront.

Tip: Contact your medical aid before admission to understand your specific coverage, limits, and out-of-pocket costs.

Billing FAQs

For medical aid patients, we bill your medical aid directly and you'll receive statements for any co-payments or shortfalls. Self-paying patients are typically required to make payment arrangements before or upon admission.

If your medical aid doesn't authorize treatment, we'll discuss alternative options including self-payment arrangements or appealing the decision. Our admissions team will work with you to find a solution.

Yes, absolutely. We provide detailed, itemized statements showing all services, treatments, and charges. You can request an itemized bill at any time during or after your stay.

We accept electronic funds transfer (EFT), debit cards, credit cards (Visa, Mastercard), and cash. Payment arrangements can be made with our billing department.

Need Help Understanding Your Coverage?

Our billing specialists are here to assist you with insurance and payment questions.