The Saver Series
The Saver Plans offer you extensive in-hospital cover and a savings account for day-to-day benefits
You have access to additional benefits
- Emergency response services nationwide with Discovery 911
- Cover for medical emergencies when you travel overseas, up to R5 million for each person
- Evacuation benefits for medical emergencies when travelling in Africa
Hospital Benefits
We cover you in hospital for emergency and planned hospital admissions. In an emergency, go straight to hospital but call us or get someone to call us within 12 hours. For planned hospital admissions, please call us 48 hours before you go to hospital to confirm your admission
| Saver Series | |
|---|---|
| Overall limit | There is no overall hospital limit on the Saver Plans Limits apply to some healthcare services and procedures only |
| Choice of hospitals | The Coastal Saver Plan* covers you in any private hospital in the coastal provinces |
| Procedures and consultations by specialists participating in direct payment arrangements | We pay in full if you consult a specialist who charges the Premier Rate. If you are on a Classic Plan we cover a wider range of specialists in full |
| Other healthcare professionals | Classic Saver and Classic Delta Saver: We pay up to 200% of the Discovery Health Rate Essential Saver, Classic Delta Saver and Coastal Saver: We pay up to 100% of the Discovery Health Rate |
| Radiology and pathology | We cover these expenses in full up to the Discovery Health Rate |
| Endoscopies (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy) | The first R2 200 of your hospital account is paid from your Medical Savings Account. We pay the balance of the hospital account and your related accounts from your Hospital Benefit. |
| MRI and CT scans | As part of an approved hospital admission: no overall limit If admitted for conservative back and neck treatment: We pay the first R1 975 of the scan code from your Medical Savings Account. We pay the balance in full up to the Discovery Health Rate.** |
| Dentistry | There is an overall limit of R13 100*** per person. The first R1 975 of your hospital account is paid from your Medical Savings Account. We pay the balance of the hospital account from your Hospital Benefit.** |
| Cochlear implants and auditory brain implants and processors | R126 000 for each person for each benefit |
| Internal nerve stimulators | R96 000 for each person |
| Hip and knee joint prostheses | R31 500 for each prosthesis for each event |
| Prosthetic devices used in spinal surgery | R20 000 for each level, limited to two levels for each procedure, and one procedure for each person each year |
| Mental health benefit | 21 days for each person |
| Alcohol and drug rehabilitation | 21 days for each person |
| Terminal care benefit | R23 400 for each person |
| Dialysis | We cover these expenses in full as long as we have approved your treatment plan and you use a provider in our network |
* On the Coastal Plan you must go to a hospital in one of the four coastal provinces for a planned hospital admission. If you don’t use these hospitals, Discovery Health will pay up to a maximum of 70% of the hospital account and you will need to pay the difference. This does not apply in an emergency.
** We pay all related accounts from the available funds in the Medical Savings Account. A related account is any approved account for expenses you incur during your hospital stay, other than the hospital account itself.
*** We pro-rate this benefit according to when you join the medical scheme. Your hospital account is paid up to this limit.
For more detailed information on how we cover specific healthcare services go to Do We Cover
The benefits described in this section are subject to clinical guidelines and policies.
Cover for day-to-day medical benefits
We pay for your day-to-day medical expenses like GP visits, x-rays and blood tests from your Medical Savings Account as long as you have money available.
Discovery Health pays claims for some day-to-day expenses to make the money in your Medical Savings Account last longer.
- GP network - If you go to a GP in our network, you will only pay a portion of the consultation fee from your Medical Savings Account. We pay the balance of the consultation fee.
- Screening and Prevention Benefit - The Screening and Prevention Benefit covers a range of healthcare services, including the following group of tests at a Discovery Wellness Network provider: blood glucose, blood pressure, cholesterol and body mass index. The benefit also covers a mammogram, Pap smear, PSA and HIV screening tests. Members from the age of 65 and members registered for certain chronic conditions are also covered for a seasonal flu vaccine from this benefit.
- Trauma Recovery Extender Benefit - We will cover out-of-hospital claims for your recovery after certain traumatic events. The cover applies for the rest of the year in which the trauma takes place.
Day-to-day benefits
| Professional services | |
|---|---|
| General practitioners* | These expenses are limited to available funds in your Medical Savings Account |
| Specialists | |
| Allied healthcare professionals (for example physiotherapists, chiropractors, occupational and speech therapists) | |
| Radiology and pathology | |
| Mental health benefit (including psychologists and psychiatrists) | |
| Private nursing | |
| Antenatal classes | |
| Pregnancy scans (Up to two 2D scans for each pregnancy. 3D scans covered as 2D scans) | |
| Dentistry | |
| Endoscopies (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy) in your doctor’s rooms | There is no limit on these health services. Discovery Health pays for these claims without using your Medical Savings Account. |
| MRI and CT scans | There is no overall limit. The first R1 975 of your scan code is paid from available funds in your Medical Savings Account. We cover the balance in full at the Discovery Health Rate. |
| Medicine | |
| Prescribed medicine (schedule 3 and above) Over-the-counter medicine, including prescribed schedule 0, 1 and 2 medicine and lifestyle enhancing products | The claims for these expenses are limited to available funds in your Medical Savings Account. |
| Appliances and equipment | |
| External medical items Hearing aids Optical (includes cover for spectacles, frames, contact lenses and surgery to correct refractive errors of the eye, eg excimer laser) | The claims for these expenses are limited to available funds in your Medical Savings Account. |
* Any time that you have no day-to-day benefi ts available and you visit a GP in our network, you will only pay a portion of the consultation fee from your pocket, while Discovery Health pays the balance.
** We pro-rate this benefit according to when you join the medical scheme.
Annual Medical Savings Account amounts
| Main member | Adult | Per child (to a maximum of three) | |
|---|---|---|---|
| Classic Saver | R4 212 | R3 312 | R1 680 |
| Essential Saver | R2 004 | R1 500 | R792 |
| Coastal Saver | R3 252 | R2 436 | R1 308 |
| Classic Delta Saver | R3 360 | R2 652 | R1 344 |
| Essential Delta Saver | R1 596 | R1 200 | R636 |
2010 Monthly contributions
| Family size | Classic Saver | Essential Saver | Coastal Saver | Classic Delta Saver | Essential Delta Saver |
|---|---|---|---|---|---|
| Main member | R1 404 | R1 116 | R1 086 | R1 122 | R892 |
| Adult dependant | R1 105 | R836 | R813 | R884 | R669 |
| Child * | R562 | R445 | R437 | R449 | R356 |
* We count a maximum of three children when we work out the monthly contribution.
General exclusions
Discovery Health does not cover certain healthcare services. You can find a full list of these exclusions here.
How to join Discovery Health
We market our Discovery Health Plans through independent and accredited financial advisers. If you want a financial adviser to help you choose a Health Plan to suit the needs of your family, please send us your contact details and we will contact you.