TRAUMA COUNSELLING BENEFIT
When dealing with a traumatic event and wanting to see a counsellor, our benefit can assist with the costs.
View the TRAUMA COUNSELLING BENEFIT guide below or click to download.
TRAUMA COUNSELLING BENEFIT
When dealing with a traumatic event and wanting to see a counsellor, our benefit can assist with the costs.
View the TRAUMA COUNSELLING BENEFIT guide below or click to download.
Our TRAUMA COUNSELLING BENEFIT is subject to the Overall Policy Limit (OPL) of R 210 580 per insured person per year.
WHAT IS TRAUMA?
It’s a state of severe fright or shock experienced when confronted with a sudden, unexpected, potentially life-threatening event over which you have no control and to which you’re unable to respond effectively.
HOW TRAUMA IS DIAGNOSED
There’s no specific diagnosis for trauma, and not all providers are allowed to make a diagnosis. Only providers registered with the Health Professions Council of South Africa (HPCSA) can formally make a diagnosis, while other providers will only treat the condition. This is why pastors, for example, won’t have an ICD-10 code on their invoices. Providers that use ICD-10 codes will diagnose a psychological condition, such as depression, and not the trauma itself.
HOW IT WORKS
We’ll cover the shortfalls when your medical aid pays part of your registered counsellor’s consultation fees from a risk, insured day-to-day or block benefit, or refund the total cost when paid from your medical savings account or pocket, subject to our benefit limits.
WHAT WE COVER
You’re covered when you:
- witness an accident or act of physical violence;
- are directly affected by an accident or act of physical violence, for example, suffering bodily injury resulting in total and permanent disability;
- receive news of a loved one’s or your own diagnosis of a critical illness; or
- mourn the death of a loved one.
Our benefit is offered on the following options:
ACTIVE OPTIONS | INACTIVE OPTIONS | ||
ELITE500 & CORPORATE ELITE500 | R 10 000 per policy | COMPACT200 & CORPORATE COMPACT200 | R 5 000 per policy |
MERIDIAN400 & CORPORATE MERIDIAN400 | 3 Consultations up to R 2 000 per consultation per policy | BASE500 | R 6 000 per policy |
COMPACT300 & CORPORATE COMPACT300 | R 5 000 per policy | CO-EVOLUTION500 & G-FORCE500 | R 7 000 per policy |
SENIOR500 | R 4 000 per policy |
GOOD TO KNOW
- Trauma affects everyone at different times. We provide cover even if the traumatic event occurred before your cover start date.
- Our benefit applies even if your medical aid doesn’t cover trauma counselling consultations.
- You’re covered from day one because this benefit isn’t subject to any waiting periods.
CLAIM PROCESS
A specific claim form is required when claiming from our benefit, as the counsellor has a particular section that must be completed, signed, or stamped. A fully completed claim form will ensure timely processing. If necessary, we may ask for additional supporting documentation.
Click below to download the TRAUMA COUNSELLING BENEFIT claim form. Once completed, email it to us at:
yourspecialisedclaim@stratumbenefits.co.za