The Admin Is Ours to Handle
So You Can Focus on Healing

Sorting out medical aid can feel like the hardest part. It doesn’t have to be. Our case managers arrange your authorisation and stay in contact with your medical aid throughout your stay, working to secure the maximum benefit available to you.

Step by Step

Important To Know

Medical Aid Authorisation
Our case managers arrange authorisation for your admission and stay in regular contact with your medical aid. If anything needs clarifying, they’ll liaise with your psychiatrist directly.
Additional Practitioner Accounts
You’ll receive separate accounts from the professionals involved in your care: psychiatrist, psychologist, occupational therapist, physiotherapist, and pathologist, depending on the services you receive.
What Optima Covers
Your account with Optima covers your ward fees, medication and ward stock. This is the account we manage directly with your medical aid.

Good to Check Beforehand

Co-payments on Some Plans

A few medical aid plans ask for an extra step or a co-payment before admission. We’ll always let you know in advance if anything applies to your plan. For example:

Discovery Keycare

A compulsory “GP to Specialist” authorisation is required before admission.

Momentum Custome

A co-payment of R1 920 applies on admission.
Kim Travel Consultants

Private Patients

Not on a medical aid?

You’re welcome as a private patient. Contact us for current private admission costs and payment arrangements — we’ll talk you through the options.

Physiotherapy Cover

You’ll receive separate accounts from the professionals involved in your care: psychiatrist, psychologist, occupational therapist, physiotherapist, and pathologist, depending on the services you receive.

Common Questions?

Clear answers to common questions about medical aid, and what to expect from Mcare Optima.

Do I need to arrange authorisation myself?

No, our case managers handle authorisation for you and stay in contact with your medical aid, and with your psychiatrist if anything needs to be confirmed.

Why have I received more than one account?

Optima bills for ward fees, medication and stock. The practitioners caring for you such as your psychiatrist and psychologist — bill separately for their own services.

Will my medical aid cover everything?

It depends on your plan and available benefits. Some plans need a co-payment or pre-authorisation. It’s worth checking you have benefits for extras such as physiotherapy, EEG and dietician services.

Can I be admitted without a medical aid?

Yes. You’re welcome as a private patient — contact us and we’ll share current costs and payment arrangements.

This is general information; your exact cover depends on your medical aid plan and available benefits. Our case managers will confirm the details that apply to you.

Have a Question About Your Cover?

Our case managers are happy to help you understand exactly what to expect.

Contact Us Today

If your question isn’t answered here, our team is only a call or message away without pressure or judgement.
Send us an email

admin@bloemoptima.co.za

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