Assisted Reproductive Therapy Benefit

Members registered on the Oncology Programme who meet the Scheme's benefit entry criteria, have access to cryopreservation and egg and sperm storage of up to five years. Egg cryopreservation is covered for female members up until the age of 42.

Cover is up to 75% of the agreed Discovery Health Rate up to a limit of R129 000 per year. You will have to pay a co-payment of 25% of the costs for assisted reproductive therapy and any other costs not covered by the benefit.

We pay up to two cycles of assisted reproductive therapy (ART), including egg donated cycles, if you are 25 to 39 years old and one cycle from the age of 40 up to and including 42 years of age, per year. If you are 43 years of age up to and including 50 years of age, we will cover one egg donated IVF cycle per year, including the egg donor matching fee.

Although Assisted Reproductive Therapy is not part of the Prescribed Minimum Benefits (PMB), infertility is classified as a PMB condition by the Council for Medical Schemes (CMS). This means that all schemes must provide funding for the diagnosis, treatment and care of infertility, subject to a defined basket of care, regardless of a member's chosen plan type. You can read more about PMB cover in the Assisted Reproductive Therapy benefit guide.

This cover is automatically activated when the Assisted Reproductive Therapy Benefit is activated successfully. Semen analysis for male partners also qualifies for cover under the Prescribed Minimum Benefits. You can contact us to activate this portion of the benefit. Please send an email with the membership details for the female who will be undergoing treatment, as well as the male partner (if they are on a different policy), to PMB_APP_FORMS@discovery.co.za. We will communicate the outcome of this application by email, within 2 to 3 working days thereafter.