Discovery Priority Series Explained
The Discovery medical aid scheme has a full range of plans to choose from. It has different baskets or sub-types which then filter out to over 22 options. The discovery priority series is a median sub-type with cost effective cover and premiums. It has two options in its basket namely the Classic and Essential plans. On all their plans, Discovery has made arrangements with healthcare professionals. The scheme then pays the member. Who then has to settle the full bill with the healthcare provider
Discovery Priority Series
The main advantages of the discovery priority series are unlimited hospital cover regardless of which private hospital you use. Full specialist cover for procedures in hospital at percentage rates according to your plan option; total insurance for medicines for the treatment of chronic conditions that are on Discovery’s Chronic Disease list. Savings for day to day health care needs as well as a capped benefit above a threshold. Bonus cover for essential health services such as GP visits. Specialised maternity benefit of DNA sequencing and none- invasive in utero testing and medical insurance for emergencies while travelling.
For all in-hospital claims, specialists on the Discovery arrangement are paid in full. Experts not on the agreement, with the Classic Priority option, covers specialist procedures at 200% of the discovery rate. The Essential Priority option includes these same procedures at 100% of the Discovery rate. Both options include any MRI and CT scans at 100% of the Discovery rate. This claim is paid out of your hospital benefit for the year. If on the other hand, the scans do not relate to a hospital admission a co-payment starting at R2750 does apply. Any scopes also carry a co-payment for both plan options.
Claims out of a hospital for both plans pay out of the savings account if it is healthcare provider on the Discovery arrangement. All other specialist claims pay up to 100% of the Discovery health scheme rate out of the medical savings account.
While both plan options cover GP consultations (in their insured network) after the savings are depleted, the ideal priority option also pays for children’s visits to Casualty and paediatrician video call consultations, blood tests and consultations relating to pregnancy including 2D scans, all of which the essential plan does not cover.
Classic Priority plan allocates 25% of the premium to savings while only 15% of the original priority plan does. Premiums currently start at R2700 for a single adult member on the classic priority while the figure is R2321 for the Essential priority.
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