Can I claim biokinetics from my medical aid?

The short answer is: yes — biokinetics is claimable from most major South African medical aid schemes. But how much you can claim, from which benefit pool, and what to check before you book is worth understanding upfront. It saves nasty surprises at the end of the month.

Why is biokinetics claimable?

Biokineticists are registered with the Health Professions Council of South Africa (HPCSA), which means we are a recognised allied health profession. Medical aid schemes are required by South African regulation to recognise claims from HPCSA-registered practitioners across most of their plans.

Which schemes cover biokinetics?

Effectively all major South African schemes:

• Discovery Health
• Momentum Health
• Bonitas
• Fedhealth
• Medihelp
• Bestmed
• Profmed, KeyHealth, Medshield and most others

The question is never "is biokinetics covered?" — it's "how much benefit do I have, and from which pool?"

Which benefit pool does biokinetics come from?

On most medical aid plans, biokinetics is paid from one of two places:

1. Day-to-day or savings benefits

The most common scenario. Your biokinetics sessions are billed against your day-to-day or savings account, depending on the plan structure. The amount remaining in that pool determines how many sessions are covered.

2. Allied health / chronic / rehabilitation benefits

Some plans — particularly higher-tier options — have a separate benefit specifically for allied health practitioners, or for rehabilitation after surgery. If you're on one of these, you may have substantial cover even after day-to-day savings run out.

3. Prescribed Minimum Benefits (PMBs)

If your condition qualifies as a Prescribed Minimum Benefit — for example, certain post-surgery rehabilitation requirements — biokinetics may be covered from a separate, ring-fenced pool. Your scheme can confirm whether your condition qualifies.

What to check before your first session

Before booking, take 5 minutes to do the following:

1. Log into your medical aid app or call the scheme's number
2. Ask: "How much of my day-to-day / allied health / savings benefit do I have remaining this year?"
3. Ask: "Is biokinetics covered on my current plan, and from which benefit pool?"
4. If you've recently had surgery or have a chronic condition, ask whether it qualifies as a PMB for rehabilitation purposes

How does the claim actually work?

There are two ways biokinetics claims are typically handled in South Africa:

Option A — Pay yourself, claim back

You pay the full session fee at the time. The practice gives you a detailed invoice with the relevant practice number, ICD-10 code and procedure code. You submit this to your medical aid (via app or email) and they reimburse you according to your plan rules.

Option B — Direct submission to medical aid

The practice submits the claim directly to your medical aid on your behalf. The scheme pays the practice directly, and you only owe any shortfall or co-payment. This is the most common arrangement.

Gabbio Biokinetics can do either — let us know your preference at your first session.

The most common confusion

People often think their day-to-day savings has run out and assume biokinetics isn't covered. But many plans have an allied health benefit that kicks in after savings is depleted, or a chronic / PMB benefit that's entirely separate. Always ask specifically. Don't assume.

If you're not on a medical aid

Biokinetics is still affordable as a private-pay option, particularly when you consider the alternative: chronic medication, repeat surgeries, lost work days. A short course of focused biokinetic rehabilitation often pays for itself in avoided downstream costs.

If you'd like help understanding your specific medical aid benefit before booking, WhatsApp Gabi on 078 471 8959 — we're happy to help you decode it.