The Allied Health Professions Council of South Africa
Reimbursement is typically subject to your specific plan’s limits and is often deducted from your Medical Savings Account (MSA).
Medical Aids Covering Acupuncture
The following schemes are known to provide cover for acupuncture, often categorised under “alternative” or “complementary” medicine:
- Discovery Health: Coverage is available on several plans (e.g., Classic Saver). Claims are generally paid from your MSA.
- Government Employees Medical Scheme (GEMS): GEMS has a specific tariff for acupuncture and Chinese medicine.
- Momentum Medical Scheme: Plans like the Incentive Option and Summit Option include cover for acupuncture, subject to day-to-day limits or savings.
- Bonitas Medical Fund: While often focused on physiotherapy and chiropractic care, certain plans cover complementary medicines like acupuncture.
- SABMAS: Covers various allied health services, which may include acupuncture depending on the benefit guide for the year.
Key Limitations & Requirements
- Registration: The acupuncturist must have a valid practice number and be registered with the AHPCSA.
- Plan Dependency: Hospital-only plans usually do not cover acupuncture as it is considered an out-of-hospital (day-to-day) expense.
- Payment Method: Most practices require you to pay upfront and claim back from your medical aid.
- Tariff Rates: Schemes reimburse according to their own set Scheme Rate; if the practitioner charges more, you will need to pay the difference out of pocket.