Discovery Health Medical Aid Comparison - 2012 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
 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 892  
  Spouse/Adult dependant R 669  
  Per Child (Max 3) R 356  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 844  
  Spouse/Adult dependant R 633  
  Per Child (Max 3) R 339  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 1,229  
  Spouse/Adult dependant R 967  
  Per Child (Max 3) R 491  
       
.
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 3,828  
  Member+Spouse R 6,696  
  Member+Spouse+Child1 R 8,232  
  Member+Spouse+Child2 R 8,768  
  Member+Spouse+Child3 R 11,304  
  Member+Child 1 R 5,364  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,277  
  Spouse/Adult dependant R 957  
  Per Child (Max 3) R 513  
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 2,352  
  Member+Spouse R 4,116  
  Member+Spouse+Child1 R 5,052  
  Member+Spouse+Child2 R 5.988  
  Member+Spouse+Child3 R 6,924  
  Member+Child 1 R 3,288  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,312  
  Spouse/Adult dependant R 982  
  Per Child (Max 3) R 524  
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 3,960  
  Member+Spouse R 7,068  
  Member+Spouse+Child1 R 8,652  
  Member+Spouse+Child2 R 10,236  
  Member+Spouse+Child3 R 11,820  
  Member+Child 1 R 5,544  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,320  
  Spouse /Adult R 1,038  
  dependant    
  Per Child (Max 3) R 529  
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 4,956  
  Member+Spouse R 8,856  
  Member+Spouse+Child1 R 10,836  
  Member+Spouse+Child2 R 12.816  
  Member+Spouse+Child3 R 14,796  
  Member+Child 1 R 6,936  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,652  
  Spouse/Adult dependant R 1,300  
  Per Child (Max 3) R 660  
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  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 5,544  
  Member+Spouse R 9,912  
  Member+Spouse+Child1 R 12,132  
  Member+Spouse+Child2 R 14.352  
  Member+Spouse+Child3 R 16,572  
  Member+Child 1 R 7,764  
       
  Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 8,200  
  Spouse/Adult dependant R 6,150  
  Per Child (Max 3) R 2,690  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,850  
  Spouse/Adult dependant R 1,457  
  Per Child (Max 3) R 740  
       
       
       
       
       
       
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  Internal Prostheses:    
  See detailed benefit schedule  
  Specialised medicine & technology  
   benefit up to R200,000 per person  
   per anuum  
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  (Add. 33 Chronic Disease Conditions)  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 7,452  
  Member+Spouse R 14,496  
  Member+Spouse+Child1 R 15,972  
  Member+Spouse+Child2 R 17,448  
  Member+Spouse+Child3 R 18,924  
  Member+Child 1 R 8,928  
       
   Insured Network Benefit  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 10,090  
  Spouse/Adult independant R 10,090  
  Per Child (Max 3) R 1,900  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,485  
  Spouse/Adult dependant R 2,350  
  Per Child (Max 3) R 494  
       
       
       
       
       
       
       
. 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  Internal Prostheses:    
  See detailed benefit schedule  
  Specialised medicine & technology  
   benefit up to R200,00 per person  
   per annum  
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Add. 33 Chronic Disease Conditions  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 8,280  
  Member+Spouse R 16,104  
  Member+Spouse+Child1 R 17,760  
  Member+Spouse+Child2 R 19,416  
  Member+Spouse+Child3 R 21,072  
  Member+Child 1 R 9,936  
       
   Insured Network Benefit  
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 10,090  
  Spouse/Adult independant R 10,090  
  Per Child (Max 3) R 1,900  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2760  
  Spouse/Adult dependant R 2,609  
  Per Child (Max 3) R 552  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 20,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Does not apply  
       
       
   R2,300 per person from  
   Network providers  
     
     
     
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m: R0 - R6,250  
  Principal Member R 465  
  Spouse /Adult R 465  
  dependant    
  Per Child (Max 3) R117  
       
  Income p/m: R6,251 - R8,300  
  Principal Member R 579  
  Spouse /Adult R 579  
  dependant    
  Per Child (Max 3) R 144  
       
  Income p/m: R8,301+  
  Principal Member R 894  
  Spouse /Adult R 894  
  dependant    
  Per Child (Max 3) R 202  
       
       
       
       
       
       
       
       
       
       
       
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:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 20,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% MSR  
  GP's: No Limit from KeyCare  
    Network Providers  
  Specialists: R 2,300 per person  
    from Network Providers  
  Conservative Dentistry:  
    No Limit from KeyCare  
    Network Providers.  
       
       
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m:               R0 - R3,900  
  Principal Member R 485  
  Spouse /Adult R 485
  dependant    
  Per Child (Max 3) R129  
       
  Income p/m:          R3,901-R6,250  
  Principal Member R 581  
  Spouse /Adult R 581  
  dependant    
  Per Child (Max 3) R 168  
       
  Income p/m:        R6,251 - R8,300  
  Principal Member R 813  
  Spouse /Adult R 813  
  dependant    
  Per Child (Max 3) R 228  
       
  Income p/m:                   R8,301 +  
  Principal Member R 1,211  
  Spouse /Adult R 1,211  
  dependant    
  Per Child (Max 3) R 324  
       
       
       
       
       
 

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.