Discovery Health Medical Scheme has a variety of hospital plans as part of the broader bouquet of insurance products offered by Discovery. Established a few decades ago, Discovery has become one of the giants in South Africa’s insurance landscape with a client base of more than five million. They pride themselves in a ‘shared value model’ in which they focus on the health of their clients, making for a healthier society in general.
Discovery Medical Scheme Options
One of the keys to Discovery’s success is the flexibility of their plans. Potential clients have 23 options to choose from for hospital plans. These plans are divided into three series; Core Series, Smart Series and Medical aid plans. Here is a brief overview of each of these and the benefits members can expect.
Core series:
The benefits under the series differ depending on which package in the series you choose. There are Classic, Classic Delta, Essential, Essential Delta and Coastal packages. Classic offers the most benefits while the Coastal package only offers unlimited cover in private hospitals in the coastal provinces.
- Complete cover for medication for chronic conditions as listed in the Prescribed Minimum Benefits (only from MedXpress pharmacy network). This is provided under all the five core series plans. Purchase of medicine for PMB conditions is also covered.
- Pre and post-natal care.
- Unlimited cover for treatment in private hospitals within the Discovery Health Medical Scheme network for the Core series.If you go for the Classic or Essential plan, you will be able to get treatment at any private hospital.
- All the plans under the core series provide full cover for treatment at specialists who Discovery Health has an agreement with.
- Treatment for medical emergencies that occur while travelling.
- Oncological treatment up to R200,000. If the beneficiary’s treatment exceeds this amount, the member will be required to pay a 20% co-payment.
Note that under the Core series you will not be eligible for day-to-day benefits.
Smart series:
This range of plans offers you two plans: Classic and Essential.
- Treatment by Discovery’s list of approved specialists in hospitals.
- You can get treatment outside of the Discovery specialist network at 200% of the Discovery Health Medical Scheme rate.
- Complete cover for pre and post-natal care, maternity care as well as early childhood care.
- Day-to-day benefits apply here, so consultations with your GP, dental and eye check-ups and purchases of over-the-counter medicine are covered in the Smart series. However, the extent to which you will be covered will depend on whether you’re on the Classic or Essential plan.
- With the Classic option you will also be covered for treatment for sports-related injuries. These include basic consultation with specialists (up to two visits), x-rays and up to four physiotherapy sessions.
- Cancer treatment is covered in the same way as in the Core series.
Contributions for Discovery Health Medical Scheme Hospital Plans
You won’t be able to get a list of premium requirements for different plans on the Discovery Health website. If you are interested in a particular kind of cover, you will need to send them a written request for a quote.