Discovery Executive Plan

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.

Discovery Executive Plan for the Whole Family

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