Discovery Medical Aid Benefits – May NewsletterEstimated Reading Time: 4 Minutes

Discovery Medical Aid Benefits 2025

Discovery Medical Aid Benefits: Discovery members should always check what Discovery Medical Aid 2025 benefits are available on their plan. It is always a good time to check that the monthly premium amount paid is delivering value for money. There are easy to understand 2025 plan guides that make this task easy. We also provide detailed comparisons of 12 of the best Discovery Medical Aid Plans on this site.

12 Of The Best Discovery Medical Aid Plans Compared

Know Your Discovery Medical Aid Benefits

Today We Discuss Scopes – An Important Procedure Often Overlooked

Endoscopic procedures such as gastroscopies, colonoscopies, sigmoidoscopies and proctoscopies may require a co-payment from the day-to-day benefits (or from the member if they have no day-to-day benefits). The balance and related accounts paid from the hospital benefit, depending on where the scope is taking place.

You need to preauthorise your Scope.

KeyCare Plans:

Scopes are covered for children aged 12 and younger, or when related to surgery, or for Prescribed Minimum Benefits (PMB) claims. Scopes must be authorised, and take place at a KeyCare Day Surgery Network provider in order to be paid.

Core Plans:

Upfront payment of R4,500 in the Day Clinic Network, or R5,500 if more than one scope. This increases to R7,000 or R7,700 in a day clinic or hospital not part of the network, and R9,600 if more than one scope in a non -network facility. Delta options pay R10,700 for non-network facilities. For In-Hospital claims, the upfront payment is R7,700, or R6,400 if the doctor is a network doctor . If more than one scope is completed, then payment is R9,600 or R7,950.

There is no co- payment for scopes in the rooms of a doctor in the network, subject to the rate of pay for your plan, and R1,750 if not in the network (R3,000 if more than one scope performed).

Smart Plans:

Upfront payment of R4,500 in the Day Clinic Network, or R5,500 if more than one scope. Smart Classic and Smart Essential pay R12,200 in a non-network facility and Smart Essential Dynamic and Smart Active pay R14,750 in non-network facilities.

For In-Hospital claims, the upfront payment is R7,700, or R6,400 if the doctor is a network doctor . If more than one scope is completed, then payment is R9,600 or R7,950. There is no co- payment for scopes in the rooms of a doctor in the network, subject to the rate of pay for your plan, and R1,750 if not in the network (R3,000 if more than one scope performed).

Saver Plans:

Upfront payment of R4,500 in the Day Clinic Network, or R5,500 if more than one scope. Classic, Essential and Coastal members pay R7,000 or R7,700 in a day clinic or hospital not part of the network, and R9,600 if more than one scope in a non-network facility. Delta options pay R10,700 for non-network facilities.

For In-Hospital claims, the upfront payment is R7,700, or R6,400 if the doctor is a network doctor . If more than one scope is completed, then payment is R9,600 or R7,950. There is no co-payment for scopes in the rooms of a doctor in the network, subject to the rate of pay for your plan, and R1,750 if not in the network (R3,000 if more than one scope performed).

Priority Plan:

Upfront payment of R4,500 in the Day Clinic Network, or R5,500 if more than one scope. Essential Priority members pay R7,000 or R7,250 in a day clinic or hospital not part of the network, and R9,100 if more than one scope in a non-network facility. For In-Hospital claims, the upfront payment is R7,250, or R5,850 if the doctor is a network doctor . If more than one scope is completed, then payment is R9,100 or R7,400.

There is no co-payment for scopes in the rooms of a doctor in the network, subject to the rate of pay for your plan, and R1,750 if not in the network (R3,000 if more than one scope performed).

Executive, Classic Comprehensive, Classic Smart Comprehensive:

Upfront payment of R4,500 in the Day Clinic Network, or R5,500 if more than one scope. Classic Comprehensive members pay R7,000 in a day clinic not part of the network, and Classic Comprehensive Smart members pay R12,200 out of network.

For In-Hospital claims, the upfront payment is R6,550, or R5,250 if the doctor is a network doctor . If more than one scope is completed, then payment is R8,100 or R6,600. There is no co-payment for scopes in the rooms of a doctor in the network, subject to the rate of pay for your plan, and R1,750 if not in the network (R3,000 if more than one scope performed).

Please remember to pre-authorise your scope, as payment is dependant on authorisation.

Discovery Medical Aid Benefits – Health Checks For All

Discovery offers one Health Check a year for all members, paid from the Screening Benefit. You do not need to be a Vitality member to have a Health Check, but will earn Vitality points if you are a Vitality member.

The usual Health Check includes a body mass index calculation (weight, height, waist), blood pressure reading, finger-prick tests for glucose and cholesterol and your smoking status. Tests will differ if the member is under 18 or over 65.

When results are outside of health range, Discovery will recommend that members consult their GP or specialist for further testing. The Health Check is therefore the first step in seeing your health trend, and taking early action to prevent potential future chronic illness.

Health Checks can be completed at Discovery Stores, linked pharmacies such as Dis -Chem and Clicks, and can be booked at home if you are unable to travel to a store or pharmacy.

Discovery website: What Is A Discovery Health Check?

Vitality Ster Kinekor Rewards

If you’re heading to the movies, make sure you have your Vitality movie card.

3 Rewards To Make Your Movie Days Great

1. 1. Adults: Your Vitality movie card gives you 50% off all 2D, 3D and Cinema Nouveau tickets, any day of the week.
   2. Children: If your child has completed the Vitality Kids online Health Review (every 12 months), then they enjoy 2D, 3D and Cinema Nouveau movies (age appropriate) that start before 7pm, any day of the week.
   3. All members: All members get 25% off Cine Prestige, NT Live or IMAX movie tickets, any day of the week.

Discovery website: How to activate the Vitality Kids Ster-Kinekor movie benefit?

Discounts are available only once per movie, so if you want to see a movie a second time, you will need to pay full price the second time. Members can have both a Vitality movie card and a Ster-Kinekor club card, but cannot use both at the same time for the same booking.

How To Activate

The Vitality Ster- Kinekor movie benefit can be activated on the Discovery App on your phone, and is a digital card that can be accessed in the digital cards section of the Discovery App. Each family member will have their own movie card number.

When you book your movie at the cinema, simply show your card. When you book online, select your seat and then scroll down to tick the option for Vitality and put in your Vitality movie card number. If booking more than one ticket, you will need to select this and put in the movie card number for each seat you are booking.

Discovery Medical Aid Benefits 2025

Medical Aid Quotes | Gap Cover Quotes | Life Insurance | Vitality

Disclaimer: The information and opinions in this document have been recorded and arrived at in good faith and from sources believed to be reliable, but no representation or warranty, expressed or implied, is made to their accuracy, completeness or correctness. The information is provided for information purposes only and should not be construed as the rendering of advice. Informed Healthcare Solutions accordingly accepts no liability whatsoever for any direct, indirect or consequential loss arising from the use of this document or its contents. IHS is a licensed financial service provider: FSP # 12239