Affordable in-hospital cover, chronic cover and day-to-day benefits
Here's what you get:
- Unlimited private hospital cover in the Smart Hospital Network.
- Guaranteed full cover in hospital for specialists who we have a payment arrangement with, and up to 200% of the DHR on Classic and up to 100% of the DHR on Essential for other healthcare professionals.
- Full cover for chronic medicine on our formulary for all Chronic Disease List conditions on our medicine list when you use a network pharmacy.
- Cover for comprehensive pre- and postnatal healthcare services and early childhood.
- Day-to-day cover for your GP consultations, acute medicine cover for over-the-counter (OTC) medicine, eye and dental check-up and sports-related injuries, with fixed co-payments and/or limits. This cover depends on the plan you choose.
Our Smart Plan
| Classic | Essential | Essential Dynamic | Active Smart | |
| Hospital cover | ||||
| 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% | 100% | 100% | 100% |
| Other healthcare professionals are covered at a percentage of the Discovery Health Rate. | 200% | 100% | 100% | 100% |
| Chronic illness cover | ||||
| Chronic condition: Cover for 27 Chronic Disease List conditions (once approved) according to the Prescribed Minimum benefits. | ||||
| Chronic medicine: Full cover for approved medicine on our medicine list at a designated service provider pharmacy. | ||||
| 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. On Essential Smart we cover cancer treatment in our network. | R250 000 | R250 000 | R250 000 | Covered at a network provider, limited to Prescribed Minimum Benefits |
| Day-to-day cover | ||||
| Unlimited GP consultations with a fixed co-payment for each consultation. | R70 | R125 | R125 | R125 |
| One eye test at an optometrist with a fixed co-payment for the test. | R70 | R125 | R125 | R125 |
| One dental check-up with a fixed co-payment for the check-up. | R125 | R190 | R190 | R190 |
| Cover for acute medicine categories, up to an annual limit. | ||||
| Cover for over-the-counter (OTC) medicine obtained from a network pharmacy. | ||||
| Cover for over-the-counter (OTC) medicine obtained from a network pharmacy | ||||
| Cover for sports-related injuries: basic X-rays, two specialist visits and a total of four visits to either a physiotherapist, biokineticist or chiropractor when referred by a Smart Network GP. You will have to pay R125 for each visit. | ||||
This is only a summary of the key benefits. Please consult the health plan guide for more details. Discovery Health Medical Scheme Rules apply.
