Discovery Health Medical Aid
Medical Aid Plans
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.
Table of Content
- Executive Plan
- Comprehensive Series
- Priority Series
- Saver Series
- Core Series
- Smart Series
- Keycare Series
- Lifestyle Programme
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.
| Plan | Contributions Range (Main) ZAR | Contributions Range (+ Adult) ZAR | Contributions Range (+ Child) ZAR | Medical 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
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 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
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
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.
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.
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
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
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.
