Please call us to see whether your treatment qualifies.
This benefit includes access to the Overseas Treatment Benefit, where you are covered when you travel to seek evidence-based healthcare not available in South Africa at a registered healthcare professional, up to a limit of R500 000 for each person. You will need to pay and claim back from us when you return to South Africa.
Entry criteria and a deductible of up to 20% apply to both benefits.
Empowering you to manage your day-to-day healthcare costs
We pay your day-to-day expenses from your Medical Savings Account on Executive, Comprehensive, Priority and Saver Plans. At the end of each year we carry over any leftover funds in your Medical Savings Account to the next year.
The GP network extends your day-to-day benefits
If you visit a general practitioner in the nationwide Discovery GP network, we will pay the consultation fee from your Medical Savings Account.
You have unlimited GP visits on KeyCare Plus
On the KeyCare Plus Plan we cover you for unlimited consultations at your chosen general practitioner in the KeyCare GP Network.
Certainty of cover for specialists
We pay specialist consultations and procedures in full from your available day-to-day benefits when you go to a specialist who charges the Premier Rate. KeyCare Plans have a separate group of participating specialists.
Detect any health problems early by using the Screening Benefit
The Screening Benefit covers blood glucose, blood pressure, cholesterol and body mass index measurements at a Discovery Wellness Network provider. The Screening Benefit also pays for a mammogram, Pap smear, prostate specific antigens (PSA) and HIV screening tests. These tests are paid by Discovery Health and we will not use your Medical Savings Account.
Cover for trauma recovery on all Health Plans except Core and KeyCare Core Plans
Certain traumatic events can result in extremely high costs after you leave the hospital. We cover your out-of-hospital medical expenses for the rest of the year in which the trauma takes place from the Trauma Recovery Extender Benefit. A highly skilled case manager will assist you to manage your benefits when you register for the Trauma Recovery Extender Benefit.
The Above Threshold Benefit offers extra day-to-day cover for Executive, Comprehensive and Priority Plans
The Executive, Comprehensive and Priority plans all include an Above Threshold Benefit that gives further day-to-day cover when your Medical Savings Account runs out and when your day-to-day claims add up to a set rand amount.
On the Executive and Comprehensive Plans, the Above Threshold Benefit is unlimited. On the Priority Plans, the Above Threshold Benefit has an overall limit.
The amounts we add up to your Annual Threshold
For you to get to your Above Threshold Benefit we add up claims to your Annual Threshold. Here are the amounts that we add up:
Comprehensive and Priority Plans
For Premier Rate specialists, we add up the Premier Rate. For non-participating specialists, we add up the Discovery Health Rate.
For generic medicines, we add up 100% of the Discovery Health Medication Rate. For non-generic medicines, we add up 75% of the Discovery Health Medication Rate.
All other health services
We add up the Discovery Health Rate. Over-the-counter medicines do not add up to your Annual Threshold.
For Premier Rate specialists, we add up the Premier Rate. For non-participating specialists, we add up to 300% of the Discovery Health Rate.
We add up to R332 for each consultation.
For generic medicines, we add up 100% of the Discovery Health Medication Rate. For non-generic medicines, we add up 90% of the Discovery Health Medication Rate.
All other health services
We add up the Discovery Health Rate. Over-the-counter medicines do not add up to your Annual Threshold. For each of these, we add up the amount to the benefit limit available.
We market our Discovery Health Plans through independent and accredited financial advisers. If you want a financial adviser to help you choose a Health Plan to suit the needs of your family, please send us your contact details and we will contact you.