Discovery Health Is The Biggest Medical Aid Scheme In South Africa

Discovery Health Is The Biggest Medical Aid Scheme In South Africa

Discovery Health is the biggest medical aid scheme in South Africa and tends to dominate the South Afican Medical Aid industry. Discovery Health are an acutely inspired company and introduced a number of new concepts to the industry, including introducing the new reproduction savings plan schemes.
All benefits are accomplished - rated depending on when in the year one joins the scheme.
* A member has the option of downgrading their option at any time but may only upgrade without medical underwriting once per year effective from the 1st of January the following year.
Discovery Coastal Core and Classic Core
These are their Hospital plans. Both have unlimited Hospital benefits but cover claims at different rates;
* Coastal at NHRPL ( National Health Reference Price List ) * Classic at 2X NHRPL.
The Hospital bill would be paid in full for of impost agreements they have with the Hospital groups. To have the Surgeon and Anaesthetist bill fully covered, the member would have to use a practitioner who is censurable to charge the DHR ( Discovery Health Proportion ) or buy a gap product that will pay the singularity.
They both have the duplicate Chronic Medication benefit as well as Emergency Evacuation
Discovery Coastal Saver and Classic Saver
Both of these plans have unlimited Hospital benefits but cover claims at different rates. The Hospital bill would be paid in full owing to of excise agreements they have with the Hospital groups.
To have the Surgeon and Anaesthetist bill fully covered, the member would have to use a practitioner who is answerable to charge the DHR ( Discovery Health Standard ) or buy a gap product that will pay the variation. All day - to - day claims e. g. doctor’s consultations, medicines, etc, are paid from a savings account.
The add - on benefit of the savings account is a 50 % payment towards GP consultations paid by the medical aid if they are constrained in to Discovery, so only 50 % would be paid from the savings. Any portion of the savings not used would be carried forward to the following year. They both have the same Chronic Medication benefit as well as Emergency Evacuation i. e. Ambulance and Helicopter, etc.
Discovery Classic Comprehensive
This plan has unlimited Hospital benefits paid at 2X NHRPL ( National Health Reference Price List ) ratio.
The Hospital bill would be paid in full since of impost agreements they have with the Hospital groups. To have the Surgeon and Anaesthetist bill fully covered, the member would have to use a practitioner who is susceptive to charge the DHR ( Discovery Health Ratio ) or buy a gap product that will pay the differentiation.
Claims submitted to the medical aid would first be paid out of savings until that is exhausted and then from the Commencement benefit. The add - on benefit of the savings account is a 50 % payment towards GP consultations paid by the medical aid if they are decision-making in to Discovery, so only 50 % would be paid from the savings. Any portion of the savings not used would be carried forward to the following year.
There is a small gap between the savings limit and the Beginning benefit kicking in, called the self - payment gap, during which expenses must be paid by the member but the bills must still be submitted to the medical aid. Once all your accumulated day - to - day expenses ( irrespective of who pays them ) distance the Commencement Prodigal, it will pay all day - to - day expenses until the end of the year, subject to sub - limits. This plan also has an extended Chronic Medication benefit.
Discovery KeyCare Core
Discovery is the biggest medical aid in South Africa and dominates the medical aid environment. This is an inexpensive hospital plan, it has unlimited hospital cover paid at 100 % NHRPL but is only available from a limited list of private hospitals. It has a Chronic Medication Benefit as well as Emergency Evacuation i. e. Ambulance and Helicopter, etc.
Discovery KeyCare Plus
Discovery is the biggest medical aid in South Africa and dominates the medical aid environment. This is an inexpensive hospital plan, it has unlimited hospital cover paid at 100 % NHRPL but is only available from a limited list of private hospitals.
This is a network option, which means that you get unbounded primary care doctor’s consultations, medicines and basic dentistry is colossal from a network of practitioners. It has a Chronic Medication Benefit as well as Emergency Evacuation i. e. Ambulance and Helicopter, etc. Optional Further Benefits
This is Discovery’s Wellness Program and one of their innovations. It’s designed to applaud people to live a healthier, more overloaded lifestyle because healthy people claim less, but it doesn’t system part of the medical aid. Unequal to common belief, Vitality is a opposite high spirits that the member may choose to yoke at a cost.
It offers discounts on a whole scope of products and services based on your Vitality station, which ranges from blue to bronze to silver to gold. Your class would improve depending on how many points you accumulate through their various avenues e. g. lifestyle questionnaires, keeping member records current, having check - ups, being a non - smoker and way or maintaining your design weight.
Health Plan Protector
This policy pays back your medical aid premiums ( excluding savings ) less claims annually into a HealthFund, a portion of which is paid back to the member each year or every 5 years ( member’s choice ) with the full balance being paid out at the age of 65. Also, there is a 5 or 10 year medical aid premium waiver should the member die, become defective or claim a Category A severe disease. For more information, scrutinize the Health Plan Champion document (. pdf format )
Discovery Life Members of Discovery Health and Vitality can get as much as 32. 5 % discount off any Discovery Life policy. For more information, scrutinize the Why Discovery Life document (. pdf format ). Top - Up Cover
This is an independent product that can be used to increase your hospital cover limits to R2, 000, 000. Gap Cover This independent cover will pay the supplementary amount frantic by the surgeon and anaesthetist chief the NHRPL rate up to a maximum of 3 X NHRPL percentage. Learn more about GAP cover.