Start your COVID-19 risk assessment
You can understand your risk status at any point in time by completing the COVID-19 risk assessment. The assessment is a set of questions which determines if you may be presenting with symptoms suggestive of COVID-19 disease or may have been exposed to COVID-19 infection and need a consultation with a doctor.
Connecting you to doctors like never before
Discovery Health app is a digital platform that connects you to a range of home-based healthcare services for all levels of care.
Funded by Discovery Health Medical Scheme, it enables an end-to-end healthcare journey. The Discovery Health app revamps the online consultation experience by bringing it closer to a face-to-face doctor visit.
The WHO Global Outbreak Benefit
Overview
This benefit is available to all members of Discovery Health Medical Scheme during a period declared as an outbreak. This benefit ensures you have access to vaccination screening consultations, testing, and management and appropriate supportive treatment as long as you meet the Scheme's Benefit entry criteria. You get cover for a defined basket of care for out-of-hospital healthcare services related to the outbreak disease.
When are you covered?
This benefit, available on all plans, is covered by the Scheme for cases of outbreak diseases and out-of-hospital healthcare services related to COVID-19 and does not affect your day-to-day benefits, where applicable.
What are you covered for?
The basket of care includes:
- COVID-19 vaccine and the administration of the vaccine
- Screening consultations with a network GP (either virtual consultations, telephone or face-to-face)
- COVID-19 PCR screening and Rapid Antigen tests if referred by a network GP who has screened you. You also have access to rapid antigen testing in hotspot areas where available
- A defined basket of pathology for COVID-19 positive members
- A defined basket of x-rays and scans for COVID-19 positive members
- Supportive treatment, including medicine and a home monitoring device to track oxygen saturation levels for at risk members who meet the clinical entry criteria
Hospital cover information
Your hospital admission is subject to approval and preauthorisation. Sub-limits and clinical guidelines apply to certain healthcare services in hospital. In-hospital treatment related to COVID-19 for approved admissions is covered from the Hospital Benefit based on your chosen health plan and in accordance with Prescribed Minimum Benefits (PMB) where applicable.
What is covered
Risk assessment
You and your family can understand your risk status at any point in time by completing the COVID-19 risk assessment or by calling us and following the prompts to complete the COVID-19 risk assessment. The assessment is a set of questions which determines if you may be presenting with symptoms suggestive of COVID-19 disease or may have been exposed to COVID-19 infection and need a consultation with a doctor.
Screening
This benefit covers COVID-19 screening consultations, if a consultation is necessary. You can choose to either access a virtual or face-to-face screening consultation at a network provider. Virtual consultations provide a safe alternative to face-to-face consultations for patients and doctors, and contributes to the important containment measures that will reduce the impact of the outbreak.
Testing
You have access to two COVID-19 PCR and two Rapid Antigen tests, per year, regardless of the outcome of the test. Cover is unlimited, where approved as Prescribed Minimum Benefits (PMBs). Screening tests are covered in full when referred to PathCare by the doctor that screened you, or when you have your screening at a Dischem pharmacy, where a nurse will screen you prior to the test being performed. This includes pre-admission PCR testing for approved hospital admissions, when referred by the doctor that screened you. Registered healthcare professionals that are members of Discovery Health Medical Scheme, have access to four Rapid Antigen and two PCR tests a year.
Long COVID Recovery Programme
Enhancements to the WHO Global Outbreak Benefit give members on Discovery Health Medical Scheme diagnosed with long COVID who meet the Scheme's clinical benefit entry criteria, cover for:
- A defined number of face-to-face and/or online consultations
- A defined basket-of-care of relevant pathology and radiology tests
- Appropriate supportive treatment for symptoms and rehabilitation, where necessary.
You can access the Long COVID Recovery Programme four weeks after acute COVID-19 illness. Your doctor must complete and submit a claim with the appropriate long COVID ICD-10 code.
COVID-19 vaccine
You are covered for the COVID-19 vaccine and the administration of the vaccine. In South Africa members will have access to different vaccines, depending on the procurement and distribution from the National Department of Health. Each vaccine may have its own frequency limits depending on whether a single or double dose is indicated.
Home monitoring for at-risk qualifying members
If you meet the qualifying clinical entry criteria for at risk members, Discovery will reach out to you and issue you with a pulse oximeter device (one device per family), through our network provider, to track and monitor your oxygen saturation levels.You will also be covered for up to two consultations with a Discovery wellness specialist, to track and monitor oxygen-saturation levels and a follow-up virtual consultation with a GP, where necessary.