Discovery Health | Medical Aids in South Africa

Medical Aid Plans

Discovery is South Africa's largest medical scheme and provides cover for approximately 2.8 million lives. It offers a choice of 23 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. Premiums for a single member range from R968 to R7 688 and the Classic Saver is the most popular option. All options offer maternity and preventative care benefits. A defined list of procedures, on all options, needs to be done in a Network Day Hospital to avoid a co-payment. Annual contribution increases will be effective from 1st May 2022.


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%. Co-payments are applied to specialized radiology and / or scopes and a few other procedures. 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.

Executive plan
Comprehensive

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 Classic Smart Comprehensive plan uses a network of hospitals and offers limited day to day benefits. Once threshold reached, day to day claims are paid from scheme risk.

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.

Priority series
Saver series

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.

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. Both options apply some co-payments to in-hospital procedures and the Essential option has a comprehensive list of in-hospital exclusions. The Classic option also provides cover for some sports related injuries. All treatments are subject to provider networks and co-payments.

Discovery Health Smart series
Core series

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.

Keycare Series

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

Keycare series

Lifestyle Programme

Vitality is a Health Programme that rewards members for living well. You can earn Vitality Health points by getting active, eating well and doing all your health checks. Members will enjoy a variety of rewards at each Vitality status level and will increase your status as you get healthier.