Medical aids do not have similar policies regarding financial assistance for bariatric surgery. It remains the responsibility of the patient to obtain the correct information regarding his/her medical aid’s funding and reimbursement stipulations.
The medical aid member needs to be registered for chronic medication prior to a bariatric surgery motivation being submitted if the BMI is between 35 and 40.
Motivations need to be submitted preferably 4 weeks, but at least 3 weeks prior to surgery, and Discovery Health has a 7 day working day policy regarding the handling of the document. If the motivation is not approved, 14 days remain to make alternative financial arrangements for the surgery. The BCE should be informed if this is not within reach of the patient.
The DISCOVERY plan options which allow for bariatric surgery motivation are:
- Classic Comprehensive
The benefit year runs from 01 January to 31 December. If the medical aid member belongs to a different option, please note that the plan option can only be changed in December or early January – so that it can be effective for the new calendar year.
The BONITAS plan options which allow for bariatric surgery motivation are:
- Bon Comprehensive
The motivation should be submitted at least 3 weeks prior to surgery. BONITAS has a 5 day working day policy regarding the handling of the document.
The only BANKMED plan option which allow for bariatric surgery motivation is:
All other options are evaluated according to comorbidities (illnesses the patient has). The motivation should be submitted at leat 3 weeks prior to surgery.