Hippo Partners - Discovery Health

Discovery Health

This is South Africa’s largest medical scheme and provides cover for approximately 2.7 million lives.

It offers a choice of 23 different medical aid options. The Classic options cover in-hospital specialist bills at 200% whilst these are paid at 100% on the Essential options. Members have the choice of using a hospital of choice or a plan that uses a network of hospitals (the Delta options). The Coastal options are targeted specifically for people living at the coast. All option offer maternity benefits.

Premiums for a single member range from R697 to R5950 and the Classic Saver is the most popular option.

By joining the Vitality loyalty programme members are rewarded for good health behavior and practices and also save on gym membership, shopping, movie tickets and travel.

Options:

Executive Plan
The Executive Plan is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 300%.  Day to day claims are paid from savings with additional benefits applying after savings are exhausted. Unlimited cover for GP & specialist consults, pathology, radiology, specific scopes and MRI/CT scans.

Comprehensive Series
The Comprehensive series offer unlimited hospital cover and are suited for families requiring extensive medical cover. Co-payments are applied to specialized radiology and / or scopes and dentistry.   Day to day claims are paid from savings, a self payment gap and then from additional benefits. Unlimited cover for GP & specialist consults, pathology, radiology, basic dental check-ups and MRI/CT scans. The Comprehensive Zero MSA does not provide a savings plan. 

Priority Series
The Priority series offer unlimited hospital cover and are suited for families requiring additional medical cover. Co-payments are applied to an extensive list of in-hospital procedures.  Day to day claims are paid from savings, a self payment gap and then from a limited above threshold benefit.

Saver Series
The Saver series offer unlimited hospital cover and are suitable for young families. Co-payments are applied to specialized radiology and / or scopes and dentistry.  Day to day claims are paid from savings.

Core Series
The Core series offer unlimited hospital cover and are ideal for young, health individuals. Co-payments are applied to specialized radiology and / or scopes and dentistry.  This is a hospital plan and does not provide cover for day to day claims. 

Smart Plans
These are mainly hospital plans with day to day benefits limited to network GP consults, acute and Over-The-Counter medicines, dental check-up, eye test plus some preventative care and maternity benefits. The Classic option also provides cover for some sports related injuries. All treatments are subject to provider networks and co-payments.  

Keycare Series
These are entry level capitated network products which are affordable and ideal for low earning individuals. All treatments are subject to provider network protocols. A comprehensive list of in-hospital exclusions apply. 

 


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