Quick Answer: medical Weight loss consultation cost Medical Aid & Fees Equilibrium Health submits medical aid claims directly to your scheme on your behalf. Most schemes cover a portion of the consultation…
medical
Weight loss consultation cost
Medical Aid & Fees
Equilibrium Health submits medical aid claims directly to your scheme on your behalf. Most schemes cover a portion of the consultation fee, with a shortfall payable by you. For Discovery members this is typically from R250. GLP-1 weight-loss medication may be covered by your medical aid, but typically will come off the saving account.
How Billing Works
Equilibrium Health submits claims directly to your medical aid scheme. You don’t need to pay upfront and claim back yourself, and there’s no paperwork on your side. At your first visit, we’ll ask for your medical aid details (scheme name, plan, membership and dependant number) so your claim can be submitted correctly.
Consultation Fees & Medical Aid Shortfalls
Scenario | What You Pay |
Discovery Health Medical Scheme | Shortfall of approximately R250-R500 per consultation |
Other medical aid schemes | Shortfall varies by scheme tariff, up to approximately R250-R500 per consultation |
Hospital plan (no day-to-day benefit) | Full consultation fee. Hospital plans do not cover outpatient consultations |
Follow-up consultations | R1000, with shortfall from R74 |
Private / self-pay | Initial consultation from R1,500. Follow consultations R1000 |
Weight-Loss Medication & Medical Aid Funding
GLP-1 receptor agonist medications such as semaglutide and tirzepatide are generally not funded by medical aid schemes, through their Chronic Benefit Funds, when prescribed for weight management, as most schemes classify obesity treatment as an exclusion under day-to-day or chronic benefits.
If you have a diagnosed diabetic condition, your GLP-1 prescription may be covered under your scheme’s chronic medication benefit or Prescribed Minimum Benefits (PMBs), subject to your specific plan rules. Some higher-tier medical aid plans allow these medications to be paid from your available medical savings account, even without a diabetic diagnosis.
We recommend confirming your specific benefit and any pre-authorisation requirements with your scheme directly before starting treatment.
What Determines Your Programme Cost
Every patient’s metabolic health programme is structured differently, and total cost depends on several factors discussed at your initial consultation, including:
- Medication, either weekly injectables or pill form medication
- Medical Consultation with bio-impedence monitoring
- Blood Tests
Because of this, we don’t publish a single fixed programme price. Your specific cost range is discussed transparently at your first visit, once your baseline assessment and treatment plan are established.
Payment Methods Accepted
We accept cash, credit card, EFT and medical aid. Medical aid claims are submitted directly to your scheme on your behalf; any shortfall or non-covered cost is payable by card, cash, or EFT at the time of your consultation.
Frequently asked questions
Does Equilibrium Health accept medical aid?
Yes. We submit claims directly to your medical aid scheme on your behalf. Most schemes cover a portion of the consultation fee, with a shortfall, typically around R250-R500 for Discovery members (payable by you).
How much does an initial consultation cost?
Initial consultations start from R1,500 for private (self-pay) patients. If you have medical aid, your scheme's tariff applies and you're only responsible for the shortfall.
Is weight-loss medication like semaglutide or tirzepatide covered by medical aid?
Generally not, unless you have a diagnosed diabetic condition, in which case GLP-1 medication may be covered under your scheme's chronic benefit. Some medical aid plans allow these medications to be paid from your available savings account even without a diabetic diagnosis. We recommend confirming your specific benefit with your scheme.
Do I need to pay upfront and claim back from my medical aid myself?
No. Equilibrium Health submits your claim directly to majority of Medical Aids. You're only responsible for any shortfall your scheme doesn't cover.
Why don't you publish a fixed price for the full weight-loss programme?
Every patient's treatment plan is different, from the medication that may be prescribed, bloods and the consultation frequency you decide on; so your total programme cost is discussed transparently once your baseline assessment is complete at your first visit.