Discovery Health Medical Aid Comparison - 2017 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
Essential Smart Plan
Classic Smart Plan
Classic Core
Coastal Saver Essential Saver
Classic Delta Saver
Classic Saver
Classic Priority
Classic Delta Comprehensive
Classic Comprehensive
Keycare Plus Keycare Core
 
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 52,750  
  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 a Network Pharmacy  
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
               
               
               
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,317  
  Spouse/Adult dependant R 989  
  Per Child (Max 3) R 528  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 52,750  
  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 a Network Pharmacy  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,648  
  Spouse/Adult dependant R 1,234  
  Per Child (Max 3) R 661  
       
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 52,750  
  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 a Network Pharmacy  
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,496  
  Spouse/Adult dependant R 1,122  
  Per Child (Max 3) R 596  
       
.
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 52,750  
  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 a Network Pharmacy  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Unlimited GP Benefit with  
  R100 co-payment for face-to-face  
     consultations  
     
     Video call consultations paid in full  
     
   1 Dental check up with a R150  
    co-payment  
   1 eye test with R100    
    co-payment    
       
       
       
       
       
       
       
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,100  
  Spouse/Adult dependant R 1,100  
  Per Child (Max 3) R 1,100  
       
       
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 52,750  
  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 a Network Pharmacy  
               
               
  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 medication limited to:  
  12 prescriptions p/person per annum  
   with a R10 co-payment per item  
     
  2 Specialist Consultations for sports  
   related injuries only with a R100  
   co-payment  
       
    1 Dental check up with a R100   
     co-payment    
       
    1 eye test with R50  
     co-payment    
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,535  
  Spouse/Adult dependant R 1,209  
  Per Child (Max 3) R 612  
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 52,750  
  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 a Network Pharmacy  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
     
       
       
       
       
       
       
       
     
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,918  
  Spouse /Adult R 1,510  
  dependant    
  Per Child (Max 3) R 767  
       
. 
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 52,750  
  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 a Network Pharmacy  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 4,812  
  Member+Spouse R 8,424  
  Member+Spouse+Child1 R 10,356  
  Member+Spouse+Child2 R 12,288  
  Member+Spouse+Child3 R 14,220  
  Member+Child 1 R 6,744  
       
  Insured Network Benefit  
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,007  
  Spouse/Adult dependant R 1,506  
  Per Child (Max 3) R 808  
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 52,750  
  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 a Network Pharmacy  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 3,684  
  Member+Spouse R 6,444  
  Member+Spouse+Child1 R 7,908  
  Member+Spouse+Child2 R 9,372  
  Member+Spouse+Child3 R 10,836  
  Member+Child 1 R 5,148  
       
  Insured Network Benefit  
       
       
  ANNUAL THRESHOLD BENEFIT  
            Does not apply    
       
       
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,047  
  Spouse/Adult dependant R 1,536  
  Per Child (Max 3) R 819  
       
       
       
       
       
       
       
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 52,750  
  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 a Network Pharmacy   
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 6,168  
  Member+Spouse R 11,028  
  Member+Spouse+Child1 R 13,500  
  Member+Spouse+Child2 R 15,972  
  Member+Spouse+Child3 R 18,444  
  Member+Child 1 R 8,640  
       
   Insured Network Benefit  
       
       
  ANNUAL THRESHOLD BENEFIT  
            Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,058  
  Spouse/Adult dependant R 1,623  
  Per Child (Max 3) R 826  
       
       
       
       
       
       
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 52,750  
  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 a Network Pharmacy  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 7,728  
  Member+Spouse R 13,812  
  Member+Spouse+Child1 R 16,896  
  Member+Spouse+Child2 R 19,980  
  Member+Spouse+Child3 R 23,064  
  Member+Child 1 R 10,812  
       
   Insured Network Benefit  
       
       
  ANNUAL THRESHOLD BENEFIT  
       
   Does not apply    
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,577  
  Spouse/Adult dependant R 2,029  
  Per Child (Max 3) R 1,031  
       
       
       
       
       
       
       
       
       
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 52,750  
  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 a Network Pharmacy  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
    Limits per annum:  
  Member R 8,904  
  Member + Spouse R 15,912  
  Member + Spouse + Child1 R 19,464  
  Member+Spouse+Child2 R 23,016  
  Member+Spouse+Child3 R 26,568  
  Member+Child 1 R 12,456  
       
   Insured Network Benefit    
     
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 13,150  
  Spouse/Adult independant R 9,850  
  Per Child (Max 3) R 4,300  
       
  MONTHLY CONTRIBUTIONS  
              
  Principal Member R 2,968  
  Spouse /Adult R 2,337  
  dependant    
  Per Child (Max 3) R1,187  
       
       
       
       
       
       
       
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 52,750  
  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 a Network Pharmacy  
   (Add. 23 Chronic Disease Conditions)  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% scheme rate  
    Limits per annum:  
  Member R12,168  
  Member + Spouse R23,688  
  Member + Spouse + Child1 R26,100  
  Member+Spouse+Child2 R28,512  
  Member+Spouse+Child3 R30,924  
  Member+Child 1 R14,580  
       
   Insured Network Benefit    
     
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member  R 15,500  
  Spouse/Adult independant R 15,500  
  Per Child (Max 3) R 2 ,950  
       
  MONTHLY CONTRIBUTIONS  
     
  Principal Member R 4,059  
  Spouse /Adult R 3,842  
  dependant    
  Per Child (Max 3) R 807  
       
     
       
       
       
       
       
 
 
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 52,750  
  Oncology R400,000 thereafter 20%  
   co-payment    
   Specialised Medicine & Technology       
    benefit R200,000  
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
   Only from a Network Pharmacy  
   (Add. 23 Chronic Disease Conditions)  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
     
   Member  R13,512  
   Member+Spouse  R26,304  
   Member+Spouse+Child1  R28,992  
   Member+Spouse+Child2  R31,680  
   Member+Spouse+Child3  R34,368  
   Member+Child1  R16,200  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
     
 
Principal Member                R15,500
 
  Spouse /Adult dependant  R15,500  
  Per Child (Max 3)                R2,950  
     
  MONTHLY CONTRIBUTIONS  
     
  Principal Member R 4,506  
  Spouse /Adult R 4,264  
  dependant    
  Per Child (Max 3) R 898  
       
     
       
       
       
       
       
     
       
       
       
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Full Cover Network Hosp to be used  
  Certain procedures only covered at  
  Network Day Clinics  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 37,350  
  Oncology PMB  
       
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
   Only from a Network Pharmacy or  
   chosen GP  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% scheme rate  
   GP's:  No Limit from KeyCare  
     Network Providers  
  Specialists:  R 3,570 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 - R8,100  
  Principal Member R 914  
  Spouse /Adult R 914  
  dependant    
  Per Child (Max 3) R331  
       
  Income p/m: R8,101 - R11,550  
  Principal Member R 1,280  
  Spouse /Adult R 1,280  
  dependant    
  Per Child (Max 3) R 358  
       
  Income p/m: R11,551+  
  Principal Member R 1,906  
  Spouse /Adult R 1,906  
  dependant    
  Per Child (Max 3) R 510  
       
       
       
       
       
       
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)
 
  Does not Apply  
       
    Specialist benefit limited to R3,570  
    per person per annum. Must be  
     referred by GP    
     
     
       
       
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m:                R0 - R8,100  
  Principal Member R 731  
  Spouse /Adult R 731  
   dependant    
  Per Child (Max 3) R 190  
     
  Income p/m:        R8,101 - R11,550  
  Principal Member R 912  
  Spouse /Adult R 912  
  dependant    
  Per Child (Max 3) R 224  
       
  Income p/m:                    R11,551+  
  Principal Member R 1,408  
  Spouse /Adult R 1,408  
  dependant    
  Per Child (Max 3) R 318  
       
     
       
       
       
       
 

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.

e