Comprehensive in-hospital medical aid cover, chronic cover and day-to-day benefits
Here's what you get:
- Unlimited private hospital cover
- Guaranteed full cover in hospital for specialists who we have a payment arrangement with, up to 200% of the Discovery Health Rate (DHR) on Classic plans and up to 100% of the DHR on Essential plans for other healthcare professionals
- Full cover for chronic medicine on our formulary for all Chronic Disease List (CDL) conditions
- Cover for up to two cycles of assisted reproductive therapy (ART) if you meet the scheme's benefit and clinical entry criteria. We will fund 75% of the treatment up to an overall limit of R129 000 per year.
- Cover for comprehensive pre- and postnatal healthcare services for maternity and early childhood
- Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for GP consultation fees and kids casualty visits available on Classic plans. The DEB is not available on the Classic Smart Comprehensive plan.
- A high savings account and a limited Above Threshold Benefit (ATB) for your day-to-day healthcare needs. On Classic Smart Comprehensive you have cover for a set of defined day-to-day benefits
The Comprehensive Series
| Classic | Classic Smart | ||||
| Hospital cover | |||||
| Unlimited private hospital cover at any hospital | |||||
| Unlimited private hospital cover at a network hospital | |||||
| Full cover with a specialist we have a payment arrangement with | |||||
| Specialists we don't have a payment arrangement with are covered at a percentage of the Discovery Health Rate | 200% | 200% | |||
| Other healthcare professionals are covered at a percentage of the Discovery Health Rate | 200% | 200% | |||
| Chronic illness cover | |||||
| Chronic condition: Cover for 27 Chronic Disease List conditions (once approved) according to the Prescribed Minimum Benefits | |||||
| Chronic condition: Cover for additional conditions (once approved) on our Additional Disease List | |||||
| Chronic medicine: Full cover for approved medicine on our medicine list | |||||
| Cancer cover | |||||
| We cover a set amount in full over a 12-month period. Costs above this amount attract a 20% co-payment. Prescribed Minimum Benefit conditions are covered in full | R 500 000 | R 375 000 | |||
| Extended Oncology Benefit | |||||
| You have extended cover in full for a defined list of cancers and treatments. | |||||
| Day-to-day cover | |||||
| Medical Savings Account: Percentage of your contribution that goes into an MSA | 25% | 15% | |||
| Day-to-day Extender Benefit pays for certain day-to-day benefits after the money in your MSA has run out and before you reach your Annual Threshold | |||||
| Limited Above Threshold Benefit: Once your claims add up to your Annual Threshold | |||||
This is only a summary of the key benefits. Please consult the health plan guide for more details. Discovery Health Medical Scheme Rules apply.
