Where a medical scheme does not ordinarily make provision for organ donation, and it is specifically stated as an exclusion in the scheme rules, there will be no benefit. 

When the medical aid does not cover a specific procedure or is a specifically excluded by the medical scheme, Sirago cannot provide cover as the scheme has not processed / paid this procedure. 



Jamie has decided to donate part of his kidney to someone that requires a kidney transplant, however his medical scheme does not provide benefit for the procedure to be able to donate his kidney. Due to this, Jamie will not be covered for the procedure by his Gap cover with Sirago.


Things to consider when receiving this repudiation reason:

  • Any procedure and / or procedure code not covered by your medical aid will not be covered by Sirago.