Comprehensive in-hospital medical aid cover, chronic cover and day-to-day benefits
Here's what you get:
- Unlimited private hospital cover in a general ward including private ward cover of up to R2,700 each day for your delivery.
- Guaranteed full cover in hospital for specialists who we have a payment arrangement with, up to 200% of the Discovery Health Rate (DHR) for other specialists.
- Guaranteed full cover in hospital for specialists who we have a payment arrangement with, and up to 200% of the Discovery Health Rate (DHR) for other specialists.
- Full cover for chronic medicine on our medicine list for all Chronic Disease List (CDL) conditions, medicines not on the list are covered up to 100% of the Discovery Health Rate DHR.
- 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 R135 000 per year.
- Extensive benefits for maternity and early childhood that cover certain healthcare services before and after birth.
- Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for certain benefits. 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 in any facility approved by the Scheme | |||||
| Unlimited private hospital cover in any facility approved by the Scheme | |||||
| 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 that meet the Scheme's criteria. | |||||
| 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.
