Medical aid
Medical aid and weight loss
The short answer: most schemes do not yet fund structured weight-management programmes as a standard benefit. The longer answer has useful exceptions, starting with your blood tests.
Why cover is limited
Obesity isn't on most schemes' chronic list
Schemes fund a defined list of conditions and benefits. Obesity is not yet classified as a chronic condition under most scheme rules, so structured weight-management care usually falls outside the funded benefits. Some schemes are reviewing this; confirm with yours before assuming either way.
What you can usually claim
Your blood tests
Pathology before and during the programme is typically claimable from your medical savings account, so many patients pay little or nothing out of pocket for bloods. If your doctor asks for tests, we send the lab form; you do your bloods at Lancet, Ampath, PathCare or your preferred lab.
Paperwork
Itemised invoices, on request
Every charge can be issued as an itemised invoice with the codes schemes ask for, so you can submit to your scheme for consideration. Whether it pays is your scheme's call, but the paperwork will never be the obstacle.
Either way
The programme price stays flat
Membership is R299/month whatever your scheme decides: screening, doctor consultations, a personalised plan where clinically appropriate, ongoing reviews and coaching. If your doctor recommends medicine or blood tests, those are billed separately by the pharmacy or lab.
Five minutes
Check your own scheme
One phone call or a few taps in your member app answers it for your plan specifically.
-
1 · Ask about cover
Call your scheme or open the member app and ask what your plan covers for weight-management care and online doctor consultations.
-
2 · Ask about pathology
Ask whether blood tests are payable from your medical savings account.
-
3 · Ask for exclusions
Ask for the specific exclusions on your plan, so there are no surprises later.
-
4 · Ask about invoices
Ask whether you can submit an itemised invoice for consideration. We provide one whenever you need it.
-
5 · Keep a note
Write down who you spoke to and what they said. It helps if a claim is queried later.
Costs known upfront.
The free check comes first. There is no charge until your assessment is reviewed and you choose to start.
Start the free check →