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Discovery Health Medical Scheme

Discovery Health

Discovery Health Medical Scheme is the largest open medical scheme in South Africa, with an open market share of 57.6% (based on beneficiaries, according to the CMS Annual Report for the year ended December 2021) and covering 2 810 992 beneficiaries at 31 December 2022. Discovery Health Medical Scheme is a non-profit entity governed by the Medical Schemes Act 131 of 1998, as amended, and regulated by the Council for Medical Schemes (CMS). It is a registered open medical scheme that any member of the public can join, subject to the Scheme rules. The Scheme belongs to its members and an independent Board of Trustees (the Trustees or the Board) oversees its activities. The Scheme outsources its administration and managed care functions to Discovery Health (Pty) Ltd through a formal contractual arrangement.

Discovery Health medical aid special benefits

  • Annual increases to member contributions are consistently lower than the industry average.
  • All members have unrestricted access to oncology, renal and HIV management programs.
  • No limits apply for hospital cover on any Discovery plan.
  • The Medical Savings Account works like a bank account. What you don’t spend, you carry over to the next year.
  • Discovery Vitality wellness programme offers rewards and discounts.

Discovery Medical Aid Plans:

Classic Delta Saver

  • Unlimited private hospital cover in the Delta Hospital Network
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • A Medical Savings Account for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network and kids casualty visits

KeyCare Start Regional

Available only in the following six locations:
Western Cape – Bellville, George;
Mpumalanga – Mbombela, Trichardt;
Limpopo – Tzaneen, Polokwane

  • Cover for emergencies – Cover for emergencies in any private hospital.
  • Unlimited hospital cover in the KeyCare Start Regional network hospitals
  • Full cover in hospital for Specialists – Guaranteed full cover in hospital for specialists on the KeyCare network, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Extensive maternity cover – Cover for comprehensive pre- and postnatal healthcare services for maternity and early childhood
  • Oncology cover – Oncology treatment covered in up to 100% of the Discovery Health Rate in a state facility
  • Chronic Illness Benefit – Essential cover for chronic medicine on the KeyCare medicine list for all Chronic Disease List conditions when you use a KeyCare Start Regional network GP
  • Day-to-day benefits – GP consultations and day-to-day benefits – Unlimited virtual and face-to-face GP consultations, blood tests, X-rays or medicine if referred by the KeyCare Online Practice or the KeyCare Start Regional network GP
  • Extensive maternity cover – Cover for comprehensive pre- and postnatal healthcare services for maternity and early childhood
  • Oncology cover – Oncology treatment covered in up to 100% of the Discovery Health Rate in a state facility
  • Chronic Illness Benefit – Essential cover for chronic medicine on the KeyCare medicine list for all Chronic Disease List conditions when you use a KeyCare Start Regional network GP
  • Day-to-day benefits – GP consultations and day-to-day benefits – Unlimited virtual and face-to-face GP consultations, blood tests, X-rays or medicine if referred by the KeyCare Online Practice or the KeyCare Start Regional network GP
  • Specialist consultations – Up to 2 specialist visits, if referred by a KeyCare Start Regional network GP
  • Eye care – Cover for an eye test and glasses at a KeyCare network optometrist
  • Dentistry – Cover for consultations, fillings and tooth removals at a dentist in the dentist network

KeyCare Core Plan

  • Unlimited hospital cover in their Hospital Network
  • Guaranteed full cover in hospital for specialists on the KeyCare network, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth

KeyCare Start

  • Full cover at your chosen KeyCare Start Network hospital.
  • Guaranteed full cover in hospital for specialists on the KeyCare network, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Unlimited cover for medically appropriate GP consultations, blood tests, X-rays, basic dentistry, eye care and medicine on our KeyCare networks

KeyCare Plus Plan

  • Unlimited hospital cover in the KeyCare Hospital Network
  • Guaranteed full cover in hospital for specialists on the KeyCare network, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Unlimited cover for medically appropriate GP consultations, blood tests, X-rays, basic dentistry, eye care and medicine on our KeyCare networks

Coastal Core Plan

  • Full cover at any private hospital in the four coastal provinces.
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling

Essential Delta Core Plan

  • Unlimited private hospital cover in their Delta Hospital Network
  • Guaranteed full cover in hospital for specialists on a payment arrangement, 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling

Essential Core Plan

  • Unlimited private hospital cover
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 100% of the DHR for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • No Medical Savings Account
  • Cover for comprehensive pre- and postnatal healthcare services for maternity and early childhood
  • No Day-to-day Extender Benefit (DEB) cover
  • Cover for medical emergencies when travelling

Classic Delta Core Plan

  • Unlimited private hospital cover in thier Delta Hospital Network
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling

Classic Core Plan

  • Unlimited private hospital cover
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling

Essential Dynamic Smart Plan

  • Unlimited hospital cover at Private hospitals in the Essential Dynamic Smart Hospital Network and as referred by AskDiscovery
  • Guaranteed full cover in hospital for specialists we have a payment arrangement with, and up 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Day-to-day cover for consultations with a Smart Network GP, acute medicine cover for over the counter (OTC) medicine, and eye and dental check-up, with fixed co-payments and/or limits, subject to plan rules
  • Cover for medical emergencies when travelling

Essential Smart Plan

  • Unlimited hospital cover in the Smart Hospital Network
  • Guaranteed full cover in hospital for specialists we have a payment arrangement with, and up 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Day-to-day cover for consultations with a Smart GP, certain acute medicine when prescribed by a Smart GP and over-the-counter medicine, eye and dental check-up with fixed co-payments and/or limits, subject to plan rules
  • Cover for medical emergencies when travelling

Classic Smart Plan

  • Unlimited hospital cover in the Smart Hospital Network
  • Guaranteed full cover in hospital for specialists we have a payment arrangement with, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Day-to-day cover for consultations with a Smart GP, certain acute medicine when prescribed by a Smart GP and over-the-counter medicine, eye and dental check-up and sports-related injuries, with fixed co-payments and/or limits, subject to plan rules
  • Cover for medical emergencies when travelling

Coastal Saver Plan

  • Unlimited private hospital cover at any hospital in the four coastal provinces
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up 100% for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • A Medical Savings Account for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network

Essential Delta Saver

  • Unlimited private hospital cover in their Delta Hospital Network
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • A Medical Savings Account for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network

Classic Saver Plan

  • Unlimited cover in any private hospital
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • A Medical Savings Account for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network and kids casualty visits

Essential Priority Plan

  • Unlimited cover in any private hospital
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 100% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • A savings account and limited Above Threshold Benefit (ATB) for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network

Classic Priority Plan

  • Unlimited cover in any private hospital
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List conditions when you use a Network Pharmacy
  • A savings account and limited Above Threshold Benefit (ATB) for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Cover for medical emergencies when travelling
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network and kids casualty visits

Classic Smart Comprehensive Plan

  • Unlimited private hospital cover
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for approved medicine on our medicine list at a network provider.
  • Cover for comprehensive pre- and postnatal healthcare services for maternity and early childhood
  • Access to specialised, advanced medical care in South Africa and abroad
  • Cover for medical emergencies when travelling
  • A savings account for your day-to-day healthcare needs

Classic Comprehensive Plan

  • Unlimited private hospital cover
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the Discovery Health Rate (DHR) for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List (CDL) conditions plus some additional chronic conditions
  • A high savings account and a limited Above Threshold Benefit (ATB) for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • Access to specialised, advanced medical care in SA and abroad
  • Cover for medical emergencies when travelling
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network and kids casualty visits

Executive Plan

  • Unlimited cover in any private hospital, including private ward cover
  • Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 300% of the Discovery Health Rate (DHR) for other specialists and 200% of the DHR for other healthcare professionals
  • Full cover for chronic medicine for all Chronic Disease List (CDL) conditions plus some additional chronic conditions, as well as access to an exclusive list of brand medicine exclusive list of brand new treatments and medicines
  • The highest savings account and an unlimited Above Threshold Benefit (ATB) for your day-to-day healthcare needs
  • Comprehensive benefits for maternity and early childhood that cover certain healthcare services before and after birth
  • The Overseas Treatment Benefit gives you access to specialized, advanced medical care in South Africa and abroad. Access to full cover for second opinion services, and cover up to US$1 million for medical emergencies when travelling outside of South Africa.
  • Additional cover from the Day-to-day Extender Benefit (DEB) when your Medical Savings Account (MSA) runs out for essential healthcare services in our network and kids casualty visits

Click here to speak with one of our Advisors to explore whether Discovery Health is the correct option for your unique medical aid needs

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