Discovery Health Medical Aid Comparison - 2016 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.

Get Discovery Life Insurance
 
Discovery
Health:
Essential Delta Core Essential Core Coastal Core
Smart Plan
Classic Core
Essential Saver
Coastal Saver Classic Delta Saver
Classic Saver
Classic Priority
Classic Delta Comprehensive
Classic Comprehensive
Keycare Plus Keycare Core Keycare Access
 
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 48,000  
  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 1,198  
  Spouse/Adult dependant R 900  
  Per Child (Max 3) R 480  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 48,000  
  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 1,499  
  Spouse/Adult dependant R 1,123  
  Per Child (Max 3) R 601  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 48,000  
  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 1,302  
  Spouse/Adult dependant R 976  
  Per Child (Max 3) R 519  
       
.
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 48,000  
  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, Clicks  
  or Dischem  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Unlimited GP Benefit with  
  R50 co-payment for face-to-face  
     consultations  
     
     Video call consultations paid in full  
     
     Prescribed medications limited to  
     12 prescriptions per person per  
     annum with a R10    
     co-payment per item  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,397  
  Spouse/Adult dependant R 1,099  
  Per Child (Max 3) R 557  
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 48,000  
  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  
  Only from MedXpress  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
     
  Does not apply  
       
       
       
       
       
       
       
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,745  
  Spouse/Adult dependant R 1,373  
  Per Child (Max 3) R 698  
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 48,000  
  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  
     
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 3,348  
  Member+Spouse R 5,856  
  Member+Spouse+Child1 R 7,188  
  Member+Spouse+Child2 R 8,520  
  Member+Spouse+Child3 R 9,852  
  Member+Child 1 R 4,680  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,862  
  Spouse /Adult R 1,397  
  dependant    
  Per Child (Max 3) R 745  
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 48,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
       
   Designed for members    
   in Coastal Provinces    
               
  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 5,580  
  Member+Spouse R 9,768  
  Member+Spouse+Child1 R 12,012  
  Member+Spouse+Child2 R 14.256  
  Member+Spouse+Child3 R 16,500  
  Member+Child 1 R 7,824  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,862  
  Spouse/Adult dependant R 1,397  
  Per Child (Max 3) R 750  
       
       
       
       
       
       
       
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 48,000  
  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  
  Only from MedXpress  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 5,616  
  Member+Spouse R 10,044  
  Member+Spouse+Child1 R 12,300  
  Member+Spouse+Child2 R 14.556  
  Member+Spouse+Child3 R 16,812  
  Member+Child 1 R 7,872  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
            Does not apply    
       
       
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,872  
  Spouse/Adult dependant R 1,476  
  Per Child (Max 3) R 752  
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 48,000  
  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  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 7,032  
  Member+Spouse R 12,564  
  Member+Spouse+Child1 R 15,372  
  Member+Spouse+Child2 R 18,180  
  Member+Spouse+Child3 R 20,988  
  Member+Child 1 R 9,840  
       
   Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
            Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,344  
  Spouse/Adult dependant R 1,846  
  Per Child (Max 3) R 938  
       
       
       
       
       
       
       
. 
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 48,000  
  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  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 8,100  
  Member+Spouse R 14,472  
  Member+Spouse+Child1 R 17,712  
  Member+Spouse+Child2 R 20,952  
  Member+Spouse+Child3 R 24,192  
  Member+Child 1 R 11,340  
       
   Insured Network Benefit  
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 11,960  
  Spouse/Adult independant R 8,990  
  Per Child (Max 3) R 3,910  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,700  
  Spouse/Adult dependant R 2,125  
  Per Child (Max 3) R 1,080  
       
       
       
       
       
       
       
       
       
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 48,000  
  Oncology R400,000 thereafter 20%  
   co-payment  
  Specialised Medicine & Technology      
   benefit: R200,000  
  Internal Prostheses: See detailed  
   benefit schedule  
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from MedXpress  
   (Add. 23 Chronic Disease Conditions)  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
    Limits per annum:  
  Member R 10,872  
  Member + Spouse R 21,168  
  Member + Spouse + Child1 R 23,328  
  Member+Spouse+Child2 R 25,488  
  Member+Spouse+Child3 R 27,648  
  Member+Child 1 R 13,032  
       
   Insured Network Benefit    
     
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 13,840  
  Spouse/Adult independant R 13,840  
  Per Child (Max 3) R 2 ,260  
       
  MONTHLY CONTRIBUTIONS  
              
  Principal Member R 3,626  
  Spouse /Adult R 3,432  
  dependant    
  Per Child (Max 3) R721  
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 48,000  
  Oncology R400,000 thereafter 20%  
    co-payment  
   Specialised Medicine & Technology      
    benefit: R200,000  
   Internal Prostheses: See detailed  
    benefit schedule  
               
  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 R12,072  
  Member + Spouse R23,496  
  Member + Spouse + Child1 R25,896  
  Member+Spouse+Child2 R28,296  
  Member+Spouse+Child3 R30,696  
  Member+Child 1 14,472  
       
   Insured Network Benefit    
     
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member  R 13,840  
  Spouse/Adult independant R 13,840  
  Per Child (Max 3) R 2 ,620  
       
  MONTHLY CONTRIBUTIONS  
     
  Principal Member R4,026  
  Spouse /Adult R 3,809  
  dependant    
  Per Child (Max 3) R 802  
       
     
       
       
       
       
       
 
 
  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 34,000  
  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 3,250 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 - R7,550  
  Principal Member R 832  
  Spouse /Adult R 832  
  dependant    
  Per Child (Max 3) R 301  
       
  Income p/m:    R7,551 - R10,750  
  Principal Member R 1165  
  Spouse /Adult R 1165  
  dependant    
  Per Child (Max 3) R 326  
       
  Income p/m:                 R10,751+  
  Principal Member R 1,734  
  Spouse /Adult R 1,734  
  dependant    
  Per Child (Max 3) R 464  
       
       
       
       
       
       
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 34,000  
  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 R3,250  
   per person per annum. Must be  
   referred by GP  
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Income p/m: R0 - R7,550  
  Principal Member R 665  
  Spouse /Adult R 665  
  dependant    
  Per Child (Max 3) R173  
       
  Income p/m: R7,551 - R10,750  
  Principal Member R 830  
  Spouse /Adult R 830  
  dependant    
  Per Child (Max 3) R 204  
       
  Income p/m: R10,751+  
  Principal Member R 1,281  
  Spouse /Adult R 1,281  
  dependant    
  Per Child (Max 3) R 289  
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  State Hospitals to be used  
  Acces 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 34,000  
  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 3,250 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 - R4,700  
  Principal Member R 586  
  Spouse /Adult R 586  
   dependant    
  Per Child (Max 3) R 256  
     
  Income p/m:        R4,701 - R7,550  
  Principal Member R 782  
  Spouse /Adult R 782  
  dependant    
  Per Child (Max 3) R 281  
       
  Income p/m:     R7,551 - R10,750  
  Principal Member R 1129  
  Spouse /Adult R 1129  
  dependant    
  Per Child (Max 3) R 317  
       
  Income p/m:                 R10,751+  
  Principal Member R 1,695  
  Spouse /Adult R 1,695  
  dependant    
  Per Child (Max 3) R 458  
 

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.

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