Discovery out-of-hospital benefits: 2017

Nov 7, 2016

Click here to compare out-of-hospital benefits across all schemes, or use the menu bar above for more options. Discovery home page.

Executive Plan

Comprehensive Series

Discovery Classic Comprehensive 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Comprehensive cover with savings, extended fund, and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.

1. GP consultations:

Paid from day-to-day benefit
While in the Self Payment Gap, face-to-face and video call consultations with a GP in Premier Plus Network are paid by scheme
While in the Self Payment Gap, kids under 10 years have access to two casualty visits per year and video call consults with a pediatrician with whom Discovery has payment arrangement

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,506	R4,264	R898
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R13,512	R12,792	R2,688
(SP) Self Payment:	R1,988	R2,708	R262
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

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2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit
While in the Self Payment Gap, scheme will still pay for blood tests at partner clinic pharmacies

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

The first R2,750 from day-to-day benefit, balance paid by scheme

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefits. Includes allied, therapeutic and psychology services

Main	M1	M2	M3+
R15,560	R21,200	R25,900	R30,000

For a defined list of conditions you get unlimited cover for biokineticists, acousticians, physiotherapists, occupational therapists, and speech and language therapists. Speak to Discovery directly

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Discovery Classic Delta Comprehensive 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Comprehensive cover with savings, extended fund, and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.

1. GP consultations:

Paid from day-to-day benefit
While in the Self Payment Gap, face-to-face and video call consultations with a GP in Premier Plus Network are paid by scheme
While in the Self Payment Gap, kids under 10 years have access to two casualty visits per year and video call consults with a pediatrician with whom Discovery has payment arrangement

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,059	R3,842	R807
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R12,168	R11,520	R2,412
(SP) Self Payment:	R3,332	R3,980	R538
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit
While in the Self Payment Gap, scheme will still pay for blood tests at partner clinic pharmacies

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

The first R2,750 from day-to-day benefit, balance paid by scheme

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefits. Includes allied, therapeutic and psychology services

Main	M1	M2	M3+
R15,560	R21,200	R25,900	R30,000

For a defined list of conditions you get unlimited cover for biokineticists, acousticians, physiotherapists, occupational therapists, and speech and language therapists. Speak to Discovery directly

View this plan | Sign up for this plan

Discovery Classic Comprehensive Zero MSA 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Comprehensive cover with no savings, a self-payment gap and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). All else paid from out of pocket, unless PMB.

1. GP consultations:

Paid from day-to-day benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,380	R3,199	R674
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Comprehensive cover with no savings, a self-payment gap and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
(SP) Self Payment:	R#VALUE!	R#VALUE!	R#VALUE!
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Only covered once Annual Threshold is reached

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefits. Includes allied, therapeutic and psychology services

Main	M1	M2	M3+
R15,560	R21,200	R25,900	R30,000

For a defined list of conditions you get unlimited cover for biokineticists, acousticians, physiotherapists, occupational therapists, and speech and language therapists. Speak to Discovery directly

View this plan | Sign up for this plan

Discovery Essential Comprehensive 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Comprehensive cover with savings, extended fund, and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.

1. GP consultations:

Paid from day-to-day benefit
While in the Self Payment Gap, face-to-face and video call consultations with a GP in Premier Plus Network are paid by scheme

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,787	R3,580	R762
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R6,816	R6,444	R1,368
(SP) Self Payment:	R8,684	R9,056	R1,582
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

The first R2,750 from day-to-day benefit, balance paid by scheme

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefits. Includes allied, therapeutic and psychology services

Main	M1	M2	M3+
R9,450	R13,350	R17,300	R20,400

For a defined list of conditions you get unlimited cover for biokineticists, acousticians, physiotherapists, occupational therapists, and speech and language therapists. Speak to Discovery directly

View this plan | Sign up for this plan

Discovery Essential Delta Comprehensive 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Comprehensive cover with savings, extended fund, and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.

1. GP consultations:

Paid from day-to-day benefit
While in the Self Payment Gap, face-to-face and video call consultations with a GP in Premier Plus Network are paid by scheme

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,410	R3,221	R684
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R6,132	R5,796	R1,224
(SP) Self Payment:	R9,368	R9,704	R1,726
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

The first R2,750 from day-to-day benefit, balance paid by scheme

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefits. Includes allied, therapeutic and psychology services

Main	M1	M2	M3+
R9,450	R13,350	R17,300	R20,400

For a defined list of conditions you get unlimited cover for biokineticists, acousticians, physiotherapists, occupational therapists, and speech and language therapists. Speak to Discovery directly

View this plan | Sign up for this plan

Saver Series

Discovery Classic Saver 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. GP consultations:

GP in Premier Plus network: M =3 consults and M+ =6 consults. Face-to-face or video call.
Kids under 10 years: 2 casualty visits per year and video call consults with a pediatrician with whom Discovery has payment arrangement
Otherwise, paid from day-to-day benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,577	R2,029	R1,031
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R7,728	R6,084	R3,084

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Paid from day-to-day benefit

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefit

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Discovery Classic Delta Saver 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Network Hospitals. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. GP consultations:

GP in Premier Plus network: M =3 consults and M+ =6 consults. Face-to-face or video call.
Kids under 10 years: 2 casualty visits per year and video call consults with a pediatrician with whom Discovery has payment arrangement
Otherwise, paid from day-to-day benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,058	R1,623	R826
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R6,168	R4,860	R2,472

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Paid from day-to-day benefit

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefit

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Discovery Essential Saver 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. GP consultations:

GP in Premier Plus network: M =2 consults and M+ =4 consults. Face-to-face or video call.
Otherwise, paid from day-to-day benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,047	R1,536	R819
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,684	R2,760	R1,464

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Paid from day-to-day benefit

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefit

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Discovery Essential Delta Saver 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. GP consultations:

GP in Premier Plus network: M =2 consults and M+ =4 consults. Face-to-face or video call.
Otherwise, paid from day-to-day benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,634	R1,230	R655
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,940	R2,208	R1,176

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Paid from day-to-day benefit

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefit

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Discovery Coastal Saver 2017: Out Of Hospital Benefits

1. GP consultations:

GP in Premier Plus network: M =2 consults and M+ =4 consults. Face-to-face or video call.
Otherwise, paid from day-to-day benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,007	R1,506	R808
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,812	R3,612	R1,932

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Paid from day-to-day benefit

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefit

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Core Series

Discovery Classic Core 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Most day-to-day claims paid from out of pocket, unless PMB.

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,918	R1,510	R767
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

View this plan in full

2. Specialists consultations:

No benefit, unless PMB

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery Classic Delta Core 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB.

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,535	R1,209	R612
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

View this plan in full

2. Specialists consultations:

No benefit, unless PMB

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery Essential Core 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Most day-to-day claims paid from out of pocket, unless PMB.

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,648	R1,234	R661
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

View this plan in full

2. Specialists consultations:

No benefit, unless PMB

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery Essential Delta Core 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB.

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,317	R989	R528
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

View this plan in full

2. Specialists consultations:

No benefit, unless PMB

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery Coastal Core 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB.

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,496	R1,122	R596
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

View this plan in full

2. Specialists consultations:

No benefit, unless PMB

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Priority Series

Discovery Classic Priority 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.

1. GP consultations:

Paid from day-to-day benefit
While in the Self Payment Gap, face-to-face and video call consultations with a GP in Premier Plus Network are paid by scheme
While in the Self Payment Gap, kids under 10 years have access to two casualty visits per year and video call consults with a pediatrician with whom Discovery has payment arrangement

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,968	R2,337	R1,187
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits) with limited above threshold benefit. Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R8,904	R7,008	R3,552
(SP) Self Payment:	R4,246	R2,842	R748
Threshold (S+SP):	R13,150	R9,850	R4,300
Above Threshold:	11,150	7,950	3,850

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit
While in the Self Payment Gap, scheme will still pay for blood tests at their partner clinic pharmacies

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Paid from day-to-day benefit

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefits. Includes allied, therapeutic and psychology services

Main	M1	M2	M3+
R9,450	R13,350	R17,300	R20,400

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Discovery Essential Priority 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.

1. GP consultations:

Paid from day-to-day benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,551	R2,004	R1,012
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits) with limited above threshold benefit. Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,584	R3,600	R1,824
(SP) Self Payment:	R8,566	R6,250	R2,476
Threshold (S+SP):	R13,150	R9,850	R4,300
Above Threshold:	11,150	7,950	3,850

Compare with these plans:

View this plan in full

2. Specialists consultations:

Paid from day-to-day benefit

3. Pathology:

Paid from day-to-day benefit

4. General radiology:

Paid from day-to-day benefit

5. Specialised radiology:

Paid from day-to-day benefit

6. Supplementary Services: (Physio, etc)

Paid from day-to-day benefits. Includes allied, therapeutic and psychology services

Main	M1	M2	M3+
R6,250	R9,450	R11,750	R14,150

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Smart Series

Discovery Classic Smart 2017: Out Of Hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: GP consults, acute meds, eye and dental check up and sport related injuries, specialised radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.

1. GP consultations:

GP in Smart Plan Network: Unlimited
R50 co-payment per consult, excluding video call consults, which are covered in full
Sports related injuries: basic x-rays, two specialist consults, and four other consults when referred by a Smart Network GP, with a R100 co-payment for each consult

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,535	R1,209	R612
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, acute meds, eye and dental check up and sport related injuries, specialised radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

View this plan in full

2. Specialists consultations:

No benefit, unless PMB

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

R2,750 co-payment

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery Essential Smart 2017: Out Of Hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: GP consults, eye and dental check up. Limits and co-payments apply. All else paid from out of pocket, unless PMB.

1. GP consultations:

GP in Smart Plan Network: Unlimited
R100 co-payment per consult, excluding video call consults, which are covered in full
Sports related injuries: basic x-rays, two specialist consults, and four other consults when referred by a Smart Network GP, with a R100 co-payment for each consult

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,100	R1,100	R1,100
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, eye and dental check up. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

No benefit, unless PMB

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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KeyCare Series

Discovery KeyCare Plus A 2017: Out Of Hospital Benefits

In brief: Unlimited cover in KeyCare networks. Scheme pays out-of-hospital claims for: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.

1. GP consultations:

Chosen network GP: Unlimited
Non-network GP 4 consults per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R914	R914	R331
Children:	Pay for maximum 3 children
Income limit:	R0-R8,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

Strong>R3,570 per person

3. Pathology:

Some blood, urine and other fluid and tissue tests, as asked for by GP

4. General radiology:

Basic X-rays covered, if done at a network provider and asked for by the GP

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Plus B 2017: Out Of Hospital Benefits

1. GP consultations:

Chosen network GP: Unlimited
Non-network GP 4 consults per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,280	R1,280	R358
Children:	Pay for maximum 3 children
Income limit:	R8,101-R11,550 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

Strong>R3,570 per person

3. Pathology:

Some blood, urine and other fluid and tissue tests, as asked for by GP

4. General radiology:

Basic X-rays covered, if done at a network provider and asked for by the GP

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Plus C 2017: Out Of Hospital Benefits

1. GP consultations:

Chosen network GP: Unlimited
Non-network GP 4 consults per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,906	R1,906	R510
Children:	Pay for maximum 3 children
Income limit:	R11,551+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

Strong>R3,570 per person

3. Pathology:

Some blood, urine and other fluid and tissue tests, as asked for by GP

4. General radiology:

Basic X-rays covered, if done at a network provider and asked for by the GP

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Access A 2017: Out Of Hospital Benefits

In brief: Unlimited cover in state facilities, or Access network for some procedures. Scheme pays out-of-hospital claims for: maternity, specialists. All else paid from out of pocket, unless PMB.

1. GP consultations:

Chosen network GP: Unlimited
Non-network GP 4 consults per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R644	R644	R281
Children:	Pay for maximum 3 children
Income limit:	R0-R5,050 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

Emergencies, trauma, childbirth and cover for baby: R3,570 per person

3. Pathology:

Some blood, urine and other fluid and tissue tests, as asked for by GP

4. General radiology:

Basic X-rays covered, if done at a network provider and asked for by the GP

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Access B 2017: Out Of Hospital Benefits

1. GP consultations:

Chosen network GP: Unlimited
Non-network GP 4 consults per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R859	R859	R309
Children:	Pay for maximum 3 children
Income limit:	R5,051-R8,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

Emergencies, trauma, childbirth and cover for baby: R3,570 per person

3. Pathology:

Some blood, urine and other fluid and tissue tests, as asked for by GP

4. General radiology:

Basic X-rays covered, if done at a network provider and asked for by the GP

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Access C 2017: Out Of Hospital Benefits

1. GP consultations:

Chosen network GP: Unlimited
Non-network GP 4 consults per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,241	R1,241	R348
Children:	Pay for maximum 3 children
Income limit:	R8,101-R11,550 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

Emergencies, trauma, childbirth and cover for baby: R3,570 per person

3. Pathology:

Some blood, urine and other fluid and tissue tests, as asked for by GP

4. General radiology:

Basic X-rays covered, if done at a network provider and asked for by the GP

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Access D 2017: Out Of Hospital Benefits

1. GP consultations:

Chosen network GP: Unlimited
Non-network GP 4 consults per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,863	R1,863	R503
Children:	Pay for maximum 3 children
Income limit:	R11,551+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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2. Specialists consultations:

Emergencies, trauma, childbirth and cover for baby: R3,570 per person

3. Pathology:

Some blood, urine and other fluid and tissue tests, as asked for by GP

4. General radiology:

Basic X-rays covered, if done at a network provider and asked for by the GP

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Core A 2017: Out Of Hospital Benefits

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R731	R731	R190
Children:	Pay for maximum 3 children
Income limit:	R0-R8,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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View this plan in full

2. Specialists consultations:

R3,570 per person

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Core B 2017: Out Of Hospital Benefits

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R912	R912	R224
Children:	Pay for maximum 3 children
Income limit:	R8,101-R11,550 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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View this plan in full

2. Specialists consultations:

R3,570 per person

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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Discovery KeyCare Core C 2017: Out Of Hospital Benefits

1. GP consultations:

No benefit

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,408	R1,408	R318
Children:	Pay for maximum 3 children
Income limit:	R11,551+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

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View this plan in full

2. Specialists consultations:

R3,570 per person

3. Pathology:

No benefit, unless PMB

4. General radiology:

No benefit, unless PMB

5. Specialised radiology:

No benefit, unless PMB

6. Supplementary Services: (Physio, etc)

No benefit, unless PMB

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