Discovery Health Hospital Plans
Discovery Health offers a range of 6 different Hospital plans under their Core series
These plans are:
- Classic Core
- Classic Delta Core network option
- Essential Core
- Essential Delta Core network option
- Coastal Core
- KeyCare Core network option
The hospital benefit will cover all the services offered in hospital including the anaesthetist and the surgeon (related accounts) provided that you are admitted to hospital and Discovery Health has confirmed your admission and treatment plan prior to your admittance. Outpatients and trauma units are generally not considered a hospital event unless you are admitted.
Important Discovery Hospital Plan Information
Please note that surgeons and anaesthetists charge separately and have the choice of charging anywhere between the Discovery Scheme rate and Private rates which can be as much as 4 times higher than the scheme rate. Discovery Health does however have an agreement with certain specialists and if this is the case your hospitalisation and related costs will be paid in full. If not you will personally be liable for the difference unless you purchase a gap cover product.
You also have cover for the 27 Prescribed Minimum Benefit chronic conditions plus cancer, HIV and AIDS as well as cover for certain medical expenses while travelling overseas (the KeyCare Core plan does not include overseas cover)
All 6 of the plans have unlimited hospital benefits but cover claims at different rates - KeyCare Core, Coastal Core, Essential Delta Core and Essential Core cover you at the Discovery scheme rate while Classic Delta Core and Classic Core cover you at 2 X the Discovery scheme rate. Your hospital bill would be paid in full because of tariff agreements that Discovery Health has with the Hospital groups but as previously stated you could have a shortfall with regard to the surgeons and anaesthetists unless you use a specialist who is contracted to charge the Discovery Health rate or have gap cover.
Discovery Health Upgrade or Downgrades
Discovery Health will allow you to downgrade your plan on a monthly basis (eg from Classic Core to Coastal Core) but if you are on a lower benefit plan and wish to upgrade you may only do this with effect from 01 January of the following year.
The Coastal Core plan is aimed at members who reside in the Coastal regions of South Africa and if you were to go on to this plan as an inland dweller it would only pay out at 70% of the Discovery Health rate for planned procedures (emergencies would be covered in full anywhere in the country however) Thus members on the Coastal Core plan who are moving to Gauteng from Cape Town would be well advised to speak to their I.H.S. advisor about changing to the Essential or Classic Core plan.
For more detail on the benefits of each individual plan please go to Hospital Plan comparisons page on this site or contact us at I.H.S. where one of our consultants will be able to help and advise you