Discovery Health Medical Aid Comparison - 2019 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:
Keycare Start
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  
  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 44,050  
  Oncology PMB  
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
   Only from a State Hospital  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% scheme rate  
   GP's:  No Limit from KeyCare  
     Network Providers  
     (2 out of network visits)  
  Specialists:  R 2,000 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 - R9,150  
  Principal Member R 839  
  Spouse /Adult R 839  
  dependant    
  Per Child (Max 3) R505  
       
  Income p/m: R9,151 - R13,050  
  Principal Member R 1,412  
  Spouse /Adult R 1,412  
  dependant    
  Per Child (Max 3) R 551  
       
  Income p/m: R13,051+  
  Principal Member R 2,198  
  Spouse /Adult R 2,198  
  dependant    
  Per Child (Max 3) R 596  
     
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  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 1,931  
  Spouse/Adult dependant R 1,448  
  Per Child (Max 3) R 776  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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 62,200  
  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 1,770  
  Spouse/Adult dependant R 1,330  
  Per Child (Max 3) R 704  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
.
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 62,200  
  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  
  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 1,285  
  Spouse/Adult dependant R 1,285  
  Per Child (Max 3) R 1,285  
       
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 62,200  
  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,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 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 1,794  
  Spouse/Adult dependant R 1,415  
  Per Child (Max 3) R 717  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  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 MedXpres  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
     
       
       
       
       
       
       
       
     
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,248  
  Spouse /Adult dependant R 1,772  
  Per Child (Max 3) R 900  
       
. 
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 62,200  
  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 5,688  
  Member+Spouse R 10,460  
  Member+Spouse+Child1 R 12,752  
  Member+Spouse+Child2 R 15,044  
  Member+Spouse+Child3 R 17,336  
  Member+Child 1 R 7,980  
  Member+Child 2 R 10,272  
  Member+Child 3 R 12,564  
       
  Day-to-Day Extender Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,373  
  Spouse/Adult dependant R 1,783  
  Per Child (Max 3) R 958  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  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 4,320  
  Member+Spouse R 7,560  
  Member+Spouse+Child1 R 9,288  
  Member+Spouse+Child2 R 11,016  
  Member+Spouse+Child3 R 12,744  
  Member+Child 1 R 6,048  
  Member+Child 2 R 7,776  
  Member+Child 3 R 9,504  
       
  Day-to-Day Extender Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
            Does not apply    
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,400  
  Spouse/Adult dependant R 1,800  
  Per Child (Max 3) R 962  
       
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 62,200  
  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 7,236  
  Member+Spouse R 12,948  
  Member+Spouse+Child1 R 15,852  
  Member+Spouse+Child2 R 18,756  
  Member+Spouse+Child3 R 21,660  
  Member+Child 1 R 10,140  
  Member+Child 2 R 13,044  
  Member+Child 3 R 15,948  
       
  Day-to-Day Extender Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
            Does not apply    
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,412  
  Spouse/Adult dependant R 1,906  
  Per Child (Max 3) R 969  
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  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 9,060  
  Member+Spouse R 16,200  
  Member+Spouse+Child1 R 19,824  
  Member+Spouse+Child2 R 23,448  
  Member+Spouse+Child3 R 27,072  
  Member+Child 1 R 12,684  
  Member+Child 2 R 16,308  
  Member+Child 3 R 19,932  
       
  Day-to-Day Extender Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
       
   Does not apply    
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,021  
  Spouse/Adult dependant R 2,382  
  Per Child (Max 3) R 1,209  
       
       
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 62,200  
  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 10,500  
  Member + Spouse R 18,780  
  Member + Spouse + Child1 R 22,980  
  Member+Spouse+Child2 R 27,180  
  Member+Spouse+Child3 R 31,380  
  Member+Child 1 R 14,700  
  Member+Child 2 R 18,900  
  Member+Child 3 R 23,100  
     
   Day-to-Day Extender Benefit  
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 15,510  
  Spouse/Adult independant R 11,620  
  Per Child (Max 3) R 5,080  
       
  MONTHLY CONTRIBUTIONS  
              
  Principal Member R 3,501  
  Spouse /Adult dependant R 2,761  
  Per Child (Max 3) R1,401  
       
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 62,200  
  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 R14,496  
  Member + Spouse R28,224  
  Member + Spouse + Child1 R31,104  
  Member+Spouse+Child2 R33,984  
  Member+Spouse+Child3 R36,864  
  Member+Child 1 R17,376  
  Member+Child 2 R20,256  
  Member+Child 3 R23,136  
       
  Day-to-Day Extender Benefit    
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member  R 18,800  
  Spouse/Adult independant R 18,800  
  Per Child (Max 3) R 3,600  
       
  MONTHLY CONTRIBUTIONS  
     
  Principal Member R 4,834  
  Spouse /Adult dependant R 4,577  
  Per Child (Max 3) R 962  
       
 
 
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  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  R16,140  
   Member+Spouse  R31,332  
   Member+Spouse+Child1  R34,536  
   Member+Spouse+Child2  R37,740  
   Member+Spouse+Child3  R40,944  
   Member+Child1  R19,308  
   Member+Child2  R22,512  
   Member+Child3  R25,716  
       
  ANNUAL THRESHOLD BENEFIT  
     
 
Principal Member                 R18,800
 
  Spouse /Adult dependant     R18,800  
  Per Child (Max 3)                R3,600  
     
  MONTHLY CONTRIBUTIONS  
     
  Principal Member R 5,368  
  Spouse /Adult R 5,077  
  dependant    
  Per Child (Max 3) R 1,070  
       
     
       
       
       
       
       
       
       
       
       
       
       
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 44,050  
  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  
     (4 out of network visits)  
  Specialists:  R 4,050 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 - R8,500  
  Principal Member R 1,088  
  Spouse /Adult R 1,088  
  dependant    
  Per Child (Max 3) R 396  
       
  Income p/m: R8,551 - R13,050  
  Principal Member R 1,532  
  Spouse /Adult R 1,532  
  dependant    
  Per Child (Max 3) R429  
       
  Income p/m: R13,051 +  
  Principal Member R 2,249  
  Spouse /Adult R 2,249  
  dependant    
  Per Child (Max 3) R 602  
       
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 44,050  
  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 R4,050  
    per person per annum. Must be  
     referred by GP    
     
     
       
       
       
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m:         R0 - R8,500  
   Principal Member R 871  
  Spouse /Adult R 871  
  dependant R225  
  Per Child (Max 3)    
       
  Income p/m: 
R8,551 - R13,050  
  Principal Member R 1,086  
  Spouse /Adult R 1,086  
   dependant    
  Per Child (Max 3) R 268  
     
  Income p/m:               R13,051 +  
  Principal Member R 1,661  
  Spouse /Adult R 1,661  
  dependant    
  Per Child (Max 3) R 376