Discovery Executive Plan
January 8, 2017
South African medical aid giant, Discovery, offer a top of the range plan called the Discovery Executive Plan. It offers extensive in and out of hospital cover. The plan provides unlimited private hospital care, including private ward cover and up to 300% Discovery Health Rate for other specialists.
A few additional benefits:
Ongoing cover after Medical Savings Account is depleted. Can be used for blood tests, GP consultation fees, preferred medicine, maternity costs, etc
Complete cover for chronic medication applicable to all conditions on Chronic Disease List as well as other conditions. Access to an exclusive list of brand name medicines.
A high savings account providing unlimited Above Threshold Benefit for out of hospital day-to-day costs.
Monthly contributions for Discovery Executive Plan:
Main member – R 5544
Additional Adult – R 5544
Per child – R 1055
Annual savings:
Main member – R 16 632
Additional Adult – R 16 632
Per child – R 3156
Annual threshold amount:
Main member – R 16 600
Additional Adult – R 16 600
Per child – R 3150
Hospitalisation
Hospitalisation – private hospitals – unlimited
Hospitalisation – provincial hospitals – unlimited
Benefits paid at 300% of Discovery Health Rate
Prescribed hospital networks – any hospital
ICU and high care – Unlimited
Private ward cover R 1 750/approved admissions
MRI/cat scans – 100% of Discovery Health Rates (DHR). Paid from day-to-day benefits
Partner specialists – 100% Cover
Non-Partner specialist – 300% DHR. Paid from day-to-day benefits
Other Discovery Executive Plan Benefits
Ambulance– Unlimited
Preferred provider for ambulance – Discovery 911
Psychiatric hospitalisation – 21 days per member annual limit
HIV/aids benefit – Obtain medication from a DSP otherwise subject to 20% co-payment
Renal dialysis – Unlimited
Chemotherapy and radiotherapy – R400 000 of approved cancer treatment per 12 month cycle. Thereafter, 20% co-payment of all additional costs
Organ transplants – Unlimited
Rehabilitation for alcohol or drug abuse – 21 days per person
Compassionate care benefit – R 48 000 in member lifetime
Cochlear implants, auditory brain implants and processors – R207 000 per member per benefit
Internal nerve stimulators – R142 200 per member
Shoulder joint prostheses – No overall limit provided a preferred suppliers is used
Non-preferred suppliers limited to R40 000 per prosthesis
Major joints surgery – 100%. Pre-approval and Discovery partner network to be used.
Alternative providers, Discovery will pay 80% of DHR for in-hospital account.
Limit of R 38 200 per prosthesis per admission
Prosthetics required for spinal surgery – Unlimited if Discovery partner network used
Alternative providers, limited to R 25 500 for level one and R 51 000 for 2 levels or more, Limit of one procedure per person per year
Dentistry – Total limit of R48 350 per member.
Medicine Cover with Discovery Executive Plan
Prescription medication, schedule 3 and above:
Single member – R33 000
Plus 1 dependant – R38 700
2 dependants – R44 300
3 or more dependants – R49 950
Over-the-counter medicine, immunisations and vaccines
Paid out of Medical Savings Account (MSA).
Payments no included towards Annual Threshold and will not be funded by the Above Threshold Benefit (ATB)
Appliances and equipment
Optical – includes lenses, frames, contact lenses as well as operations or any healthcare procedure to correct refractive errors of the eye
Limit – R6 800 for each person
External medical items – R58 800 per family
Hearing aids – R22 900 per family
To get your free hospital plan quote, please complete and submit the form on this page
All info was correct at time of publishing