Discovery Health Medical Aid Comparison - 2015 Plans

Discovery Health is by far the biggest medical aid scheme in South Africa and tends to dominate the industry. Their Global Credit Rating is the highest available (AA) and total membership is in excess of 2 million lives. They are an extremely innovative company and introduced a number of new concepts to the industry, including introducing the new generation savings plan schemes.

 
Discovery
Health:
Coastal Core Essential Delta Core Classic Core
Coastal Saver Essential Saver Classic Delta Saver
Classic Saver Classic Priority Classic Delta Comprehensive
Classic Comprehensive
Keycare Core Keycare Plus
Keycare Access    
 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
       
  Designed for members in coastal  
  provinces using a Network of  
  Coastal Hospitals  
     
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions   
  Subject to scheme formulary  
   Only from MedXpress  
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
               
               
               
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,195  
  Spouse/Adult dependant R 896  
  Per Child (Max 3) R 477  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
               
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from MedXpress  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,110  
  Spouse/Adult dependant R 833  
  Per Child (Max 3) R 445  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27  PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from MedXpress  
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,617  
  Spouse/Adult dependant R 1,272  
  Per Child (Max 3) R 646  
       
.
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
       
  Designed for memebers in coastal  
  provinces    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27  PMB Chronic Disease Conditions  
  Subject to scheme formulary  
              
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 5,124  
  Member+Spouse R 8,964  
  Member+Spouse+Child1 R 11,082  
  Member+Spouse+Child2 R 13,092  
  Member+Spouse+Child3 R 15,156  
  Member+Child 1 R 7,188  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,710  
  Spouse/Adult dependant R 1,282  
  Per Child (Max 3) R 688  
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
               
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 MB Chronic Disease Conditions  
  Subject to scheme formulary  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 3,096  
  Member+Spouse R 5,424  
  Member+Spouse+Child1 R 6,660  
  Member+Spouse+Child2 R 7.896  
  Member+Spouse+Child3 R 9,132  
  Member+Child 1 R 4,332  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,725  
  Spouse/Adult dependant R 1,294  
  Per Child (Max 3) R 690  
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit    
  schedule    
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from MedXpress  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 5,196  
  Member+Spouse R 9,300  
  Member+Spouse+Child1 R 11,388  
  Member+Spouse+Child2 R 13,476  
  Member+Spouse+Child3 R 15,564  
  Member+Child 1 R 7,284  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,734  
  Spouse /Adult R 1,368  
  dependant    
  Per Child (Max 3) R 697  
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 MB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 6,516  
  Member+Spouse R 11,640  
  Member+Spouse+Child1 R 14,244  
  Member+Spouse+Child2 R 18.848  
  Member+Spouse+Child3 R 19,452  
  Member+Child 1 R 9,120  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,172  
  Spouse/Adult dependant R 1,710  
  Per Child (Max 3) R 869  
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 MB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 7,428  
  Member+Spouse R 13,272  
  Member+Spouse+Child1 R 16,248  
  Member+Spouse+Child2 R 19.224  
  Member+Spouse+Child3 R 22,200  
  Member+Child 1 R 10,404  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 10,980  
  Spouse/Adult dependant R 8,250  
  Per Child (Max 3) R 3,590  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,478  
  Spouse/Adult dependant R 1,950  
  Per Child (Max 3) R 992  
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R400 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
  Specialised medicine & technology  
   benefit R200,000  
     
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  (Add. 23 Chronic Disease Conditions)  
  Only from MedXpress  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 9,984  
  Member+Spouse R 19,428  
  Member+Spouse+Child1 R 21,408  
  Member+Spouse+Child2 R 23,388  
  Member+Spouse+Child3 R 25,368  
  Member+Child 1 R 11,964  
       
   Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 12,590  
  Spouse/Adult independant R 12,590  
  Per Child (Max 3) R 2,380  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,329  
  Spouse/Adult dependant R 3,149  
  Per Child (Max 3) R 662  
       
       
       
       
       
       
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 44,000  
  Oncology R400 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
  Specialised medicine & technology  
   benefit R200,00  
     
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Add. 23 Chronic Disease Conditions  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 11,088  
  Member+Spouse R 21,576  
  Member+Spouse+Child1 R 23,784  
  Member+Spouse+Child2 R 25,992  
  Member+Spouse+Child3 R 28,200  
  Member+Child 1 R 13,296  
       
   Insured Network Benefit  
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 12,590  
  Spouse/Adult independant R 12,590  
  Per Child (Max 3) R 2,380  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,696  
  Spouse/Adult dependant R 3,496  
  Per Child (Max 3) R 737  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Certain procedures only covered at  
  Network Day Clinics  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 33,300  
  Oncology PMB  
       
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from DSP  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Does not apply  
       
       
  Specialist benefit limited to R3,000  
   per person per annum. Must be  
   referred by GP  
     
     
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m: R0 - R7,050  
  Principal Member R 611  
  Spouse /Adult R 611  
  dependant    
  Per Child (Max 3) R158  
       
  Income p/m: R7,051 - R10,000  
  Principal Member R 762  
  Spouse /Adult R 762  
  dependant    
  Per Child (Max 3) R 187  
       
  Income p/m: R10,000+  
  Principal Member R 1,176  
  Spouse /Adult R 1,176  
  dependant    
  Per Child (Max 3) R 265  
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Certain procedures only covered at  
  Network Day Clinics  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 31,300  
  Oncology PMB  
       
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from DSP   
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% scheme rate  
  GP's: No Limit from KeyCare  
    Network Providers  
  Specialists: R 3,000 per person  
    from Network Providers  
   (must be referred by network GP)  
  Conservative Dentistry:  
    No Limit from KeyCare  
    Network Providers.  
       
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m:            R0 - R7,050  
  Principal Member R 695  
  Spouse /Adult R 695  
  dependant    
  Per Child (Max 3) R 251  
       
  Income p/m:     R7,051 - R10,000  
  Principal Member R 973  
  Spouse /Adult R 973  
  dependant    
  Per Child (Max 3) R 272  
       
  Income p/m:                 R10,000+  
  Principal Member R 1,448  
  Spouse /Adult R 1,448  
  dependant    
  Per Child (Max 3) R 388  
       
       
       
       
       
 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  State Hospitals to be used  
  Access Network hospitals to be used  
  for emergencies, trauma & childbirth  
     
  Certain procedures only covered at  
  Network Day Clinics  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 31,300  
  Oncology PMB  
       
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from DSP   
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme rate  
  GP's: No Limit from KeyCare  
    Network Providers  
  Specialists: R 3,000 per person  
    from Network Providers  
   (must be referred by network GP)  
  Conservative Dentistry:  
    No Limit from KeyCare  
    Network Providers.  
       
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m:            R0 - R4,400  
  Principal Member                    R538    
  Spouse /Adult                         R538  
  dependant  
  Per Child (Max 3)                    R235  
     
  Income p/m:      R4,401 - R7,050  
  Principal Member R 718  
  Spouse /Adult R 718  
  dependant    
  Per Child (Max 3) R 258  
       
  Income p/m:    R7,051 - R10,000  
  Principal Member R 1,036  
  Spouse /Adult R 1,036  
  dependant    
  Per Child (Max 3) R 292  
       
  Income p/m:                R10,001 +  
  Principal Member R 1,556  
  Spouse /Adult R 1,556  
  dependant    
  Per Child (Max 3) R 420  
       
 

For more detailed information on any of the above Discovery Health plans, just click on the name of the relevant plan in the tables above. If you already know what you want, why not make use of our site to download the relevant Medical Aid Application form and then fax it back to us on 0866 200 320. Alternatively, if you would like us to confirm some of the finer details and/or pricing, just fill in our Medical Aid Quote Request form and we will get back to you promptly.

Finally, we invite you to contact us on +27 21 712-8866 at any point in your decision making process for further information on the Discovery Health Medical Aids.