Discovery Health Medical Aid Comparison - 2014 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 Classic Core Coastal Saver
Classic Saver Classic Priority Classic Delta Comprehensive
KeyCare Core Keycare Plus Classic Comprehensive
 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 40,000  
  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  
     
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
               
               
               
               
               
               
               
               
               
               
               
               
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1087  
  Spouse/Adult dependant R 815  
  Per Child (Max 3) R 434  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 40,000  
  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)
 
  No Benefit  
               
               
               
               
               
               
               
               
               
               
               
               
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1 471  
  Spouse/Adult dependant R 1 157  
  Per Child (Max 3) R 587  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 40,000  
  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 4,668  
  Member+Spouse R 8,160  
  Member+Spouse+Child1 R 10,032  
  Member+Spouse+Child2 R 11,904  
  Member+Spouse+Child3 R 13,776  
  Member+Child 1 R 6,549  
       
  Insured Network Benefit  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,556  
  Spouse/Adult dependant R 1,166  
  Per Child (Max 3) R 625  
       
.
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 40,000  
  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 5,928  
  Member+Spouse R 10,596  
  Member+Spouse+Child1 R 12,960  
  Member+Spouse+Child2 R 15.324  
  Member+Spouse+Child3 R 17,688  
  Member+Child 1 R 8,292  
       
  Insured Network Benefit  
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
     
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,976  
  Spouse/Adult dependant R 1,556  
  Per Child (Max 3) R 790  
       
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 40,000  
  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 6,756  
  Member+Spouse R 12,072  
  Member+Spouse+Child1 R 14,727  
  Member+Spouse+Child2 R 17,427  
  Member+Spouse+Child3 R 20,127  
  Member+Child 1 R 9,456  
       
  Insured Network Benefit  
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 9,990  
  Spouse/Adult dependant R 7,510  
  Per Child (Max 3) R 3,270  
       
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,254  
  Spouse/Adult dependant R 1,774  
  Per Child (Max 3) R 902  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric benefit 21 days  
  Hospice care R 40,000  
  Oncology: R400, thereafter 20%  
   20% co-payment  
  Specialised Medicine &  R200,000  
    Technology Benefit        
  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 R 9,084  
  Member+Spouse R 17,676  
  Member+Spouse+Child1 R 19,476  
  Member+Spouse+Child2 R 21,276  
  Member+Spouse+Child3 R 23,076  
  Member+Child 1 R 10,884  
       
   Insured Network Benefit  
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 11,350  
  Spouse/Adult independant R 11,350  
  Per Child (Max 3) R 2,150  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,028  
  Spouse/Adult dependant R 2,864  
  Per Child (Max 3) R 602  
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Certain procedure only covered  
  at Network Day Clinics  
  Annual Sub-limits per person:  
     
     
  Psychiatric Treatment 21 days  
  Hospice Care R 28,500  
  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)
 
     
       
   Specialist Benefit limited to  
   R2 750 per person per annum,  
   must be referred by GP.  
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
     
     
  MONTHLY CONTRIBUTIONS  
  Income: R0-R6,650  
  Principal Member R 556  
  Spouse/Adult dependant R 556  
  Per Child (Max 3) R 143  
       
  Income: R6,651-R8,800
 
  Principal Member R 693  
  Spouse/Adult dependant R 693  
  Per Child (Max 3) R 171  
       
  Income: R8,801 +  
  Principal Member R 1 070  
  Spouse/Adult dependant R 1 070  
  Per Child (Max 3) R 241  
       
       
       
       
       
       
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 28,500  
  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 2,550 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 - R6,650  
  Principal Member R 695  
  Spouse /Adult R 695  
  dependant    
  Per Child (Max 3) R 251  
       
  Income p/m:        R6,651 - R8,800  
  Principal Member R 973  
  Spouse /Adult R 973  
  dependant    
  Per Child (Max 3) R 272  
       
  Income p/m:                   R8,801 +  
  Principal Member R 1,448  
  Spouse /Adult R 1,448  
  dependant    
  Per Child (Max 3) R 388  
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 40,000  
  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 10,080  
  Member+Spouse R 19,620  
  Member+Spouse+Child1 R 21,624  
  Member+Spouse+Child2 R 23,628  
  Member+Spouse+Child3 R 25,632  
  Member+Child 1 R 12,084  
       
   Insured Network Benefit  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 11,350  
  Spouse/Adult independant R 11,350  
  Per Child (Max 3) R 2,150  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,362  
  Spouse/Adult dependant R 3,180  
  Per Child (Max 3) R 670  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
 
 

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.