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Discovery Health Medical Aid

Discovery is South Africa's largest medical scheme and provides cover for approximately 2.8 million lives. It offers a choice of 23 medical aid options. The Classic options cover in-hospital specialist bills at 200% whilst these are paid at 100% on the Essential options. Members have the choice of using a hospital of choice or a plan that uses a network of hospitals (the Delta options). The Coastal options are targeted specifically for people living at the coast. Premiums for a single member range from R968 to R7 688 and the Classic Saver is the most popular option. All options offer maternity and preventative care benefits. A defined list of procedures, on all options, needs to be done in a Network Day Hospital to avoid a co-payment. Annual contribution increases will be effective from 1st May 2022.

Discovery Health offers various medical aid plans with different contribution levels and medical savings. The table below shows the contribution ranges and savings available
for each plan.

PlanContributions Range (Main) ZARContributions Range (+ Adult) ZARContributions Range (+ Child) ZARMedical Savings (Up to)
Executive Plan 10,303 10,303 1,969 R30,900 (Main) R30,900 (+1 Adult) R5,904 (+1 Child)
Comprehensive Series 7,163 – 8,381 6,611 – 7,927 1,674 R25,104 (Main) R23,748 (+1 Adult) R5,004 (+1 Child)
Priority Series 4,531 – 5,272 3,562 – 4,158 1,809 – 2,108 R15,792 (Main) R12,456 (+1 Adult) R6,312 (+1 Child)
Saver Series 2,673 – 4,182 2,017 – 3,299 1,072 – 1,676 R10,020 (Main) R7,908 (+1 Adult) R4,020 (+1 Child)
Core Series 2,281 – 3,322 1,716 – 2,621 915 – 1,329 No MSA
Smart Series 1,565 – 2,627 1,565 – 2,073 1,049 – 1,881 No MSA
Keycare Series 1,102 – 3,354 1,102 – 3,354 336 – 897 No MSA

*Contribution ranges are estimates and may vary. For accurate details, consult Discovery Health or a healthcare advisor.

Executive plan

Executive Plan

The Executive Plan is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 300%. Co-payments are applied to specialized radiology and/or scopes and a few other procedures. Day-to-day claims are paid from savings with additional benefits applying after savings are exhausted. Unlimited cover for GP & specialist consults, pathology, radiology, specific scopes, and MRI/CT scans.

Comprehensive

Comprehensive Series

The Comprehensive series offers unlimited hospital cover and is suited for families requiring extensive medical cover. Co-payments are applied to specialized radiology and/or scopes and dentistry. Day-to-day claims are paid from savings, followed by a self-payment gap, and then from additional benefits. Unlimited cover is provided for GP & specialist consults, pathology, radiology, basic dental check-ups, and MRI/CT scans. The Classic Smart Comprehensive plan uses a network of hospitals and offers limited day-to-day benefits. Once the threshold is reached, day-to-day claims are paid from the scheme's risk pool.

Priority series

Priority Series

The Priority series offers unlimited hospital cover and is suited for families requiring additional medical cover. Co-payments are applied to an extensive list of in-hospital procedures. Day-to-day claims are paid from savings, followed by a self-payment gap, and then from a limited above-threshold benefit.

Saver Series

Saver Series

The Saver series offers unlimited hospital cover and is suitable for young families. Co-payments are applied to specialized radiology and/or scopes and dentistry. Day-to-day claims are paid from savings.

Discovery Health Smart series

Smart Plans

These are mainly hospital plans with day-to-day benefits limited to network GP consults, acute and over-the-counter medicines, dental check-ups, eye tests, plus some preventative care and maternity benefits. Both options apply co-payments to certain in-hospital procedures, and the Essential option has a comprehensive list of in-hospital exclusions. The Classic option also provides cover for some sports-related injuries. All treatments are subject to provider networks and co-payments.

<p>The Core series offer unlimited hospital cover and are ideal for young, health individuals. Co-payments are applied to specialized radiology and / or scopes and dentistry. This is a hospital plan and does not provide cover for day to day claims.</p>

Core series

The Core series offer unlimited hospital cover and are ideal for young, health individuals. Co-payments are applied to specialized radiology and / or scopes and dentistry. This is a hospital plan and does not provide cover for day to day claims.

Keycare Series

Keycare Series

These are entry-level capitated network products that are affordable and ideal for low-earning individuals. A comprehensive list of in-hospital exclusions applies, and all treatments are subject to network providers and network protocols.

Lifestyle Programme - Discovery Health | Hippo.co.za

Lifestyle Programme

Vitality is a health programme that rewards members for living well. You can earn Vitality Health points by getting active, eating well, and completing all your health checks. Members will enjoy a variety of rewards at each Vitality status level and can increase their status as they get healthier.

Discovery Health Medical Aid Insurance Company Ltd is an authorised financial services provider (FSP licence number: 16354).