Your Journey to a Healthier Life Starts Here
Comprehensive support, expert care, and a personalised path to long-term wellness through bariatric surgery.
Funding for Bariatric Surgery
Bariatric surgery is a medically recognised treatment for obesity and related health conditions. While its benefits are well established, navigating the funding process can be complex. At the Obesity Unit in Johannesburg, we’re committed to helping you understand your options, whether you’re applying for medical aid cover, exploring self-pay solutions, or seeking guidance through the pre-authorisation process.
Many medical aids in South Africa offer partial or full coverage for bariatric surgery, particularly on their comprehensive or executive plans. However, coverage is not automatic and is typically subject to strict criteria, including clinical necessity and multidisciplinary assessment.
Important points to note:
- Only certain plan types include cover for bariatric procedures
- Pre-authorisation is essential, and approval is not guaranteed
- A detailed clinical motivation must be submitted by the treating team
- Most schemes require documented failure of non-surgical weight loss methods
- Each application is reviewed individually and may be declined at the funder’s discretion
To begin this process, the entire multidisciplinary team, including the surgeon, physician, psychologist, and dietitian, must consult with you. An upfront payment is required for these assessments, and even with a strong motivation, medical aid approval is not guaranteed.
Our team has extensive experience working with major South African medical aids and will assist in preparing and submitting all necessary documentation to support your application
Co-Payments
Even when your procedure is approved by your medical aid, a co-payment is almost always required. This may include:
- A portion of the surgeon’s or anaesthetist’s fee
- A gap between the scheme tariff and actual charges
- Preoperative assessments or consultations not fully covered by the scheme
- Postoperative follow-up services or nutritional supplementation
These co-payments can vary widely depending on your scheme and plan type.
What if My Medical Aid Doesn’t Cover It?
If your scheme excludes bariatric surgery, or if you’re on a hospital or savings plan that does not offer cover, we offer self-pay packages for all procedures, including gastric sleeve, gastric bypass, and SADI. These packages include:
- Surgeon and anaesthetist fees
- Hospital and theatre costs
- Preoperative multidisciplinary assessment
- Standard postoperative follow-up
Medical Insurance Plans and Gap Cover
Many medical insurance products, such as hospital cash plans, do not cover bariatric surgery, even if hospitalisation is required. These plans are designed to pay fixed daily rates and do not meet the full cost of surgical care.
Additionally, if your medical aid does not authorise the procedure, your gap cover will not pay for it either. Gap cover only applies to shortfalls on approved procedures, not to services that are excluded from your policy. We encourage all patients to review their policies carefully and consult their broker or scheme advisor for clarification.
Our Commitment
We understand that funding your surgery can feel overwhelming, but you’re not alone. We’re here to
- Provide clear and transparent pricing
- Assist with medical aid motivation and documentation
- Offer structured, self-pay options
- Ensure you understand all possible costs before proceeding
Take the First Step
If you are considering bariatric surgery but unsure how to fund it, contact the Obesity Unit today. We’ll help you understand your options, verify your cover, and support you every step of the way, from consultation to authorisation and beyond.