Blood tests
A blood test is any test designed to discover abnormalities in a sample of a person's blood, such as the presence of alcohol, drugs or bacteria or to determine the blood group.
Important note about blood tests
Discovery Health does not cover some blood tests (such as the ALCAT test). To find out if a specific blood test is covered you can access Do We Cover on this website.
The way we pay for blood tests depends on your plan type and if you have the blood test in or out of hospital.
Executive plan
Blood tests done in hospital
We will pay these claims from your Medical Savings Account (MSA), as long as you have money available. We also pay these claims from your Above Threshold Benefit after you have reached the Annual Threshold. We pay claims from your Above Threshold Benefit up to a maximum of the Discovery Health Rate.
Blood tests done out-of-hospital
We will pay claims for pathology from your Medical Savings Account (MSA), as long as you have money available. We also pay for pathology from your Above Threshold Benefit up to a maximum of the Discovery Health Rate, if you have reached the Annual Threshold.
We pay for pathology when you have a gap in your cover – here’s how
If you have used up the money you have available in your Medical Savings Account for the year before you reach your Annual Threshold and there is a gap in your cover, also referred to as a Self-payment Gap, we will cover pathology at our network providers. You have this cover if your GP or specialist requests the appropriate tests using the Discovery Health pathology form.
To have this extended cover for pathology, please ask your healthcare professional to use the Discovery Health pathology form for all your tests, whether there is a gap in your cover or not.
Comprehensive and Priority Series
Blood tests done in-hospital
We pay for the blood tests from your chosen health plan’s Hospital Benefit, up to a maximum of the Discovery Health Rate, as long as these tests are part of your confirmed or approved hospital admission.
Blood tests done out-of-hospital
We will pay claims for pathology from your Medical Savings Account (MSA), as long as you have money available. We also pay for pathology from your Above Threshold Benefit up to a maximum of the Discovery Health Rate, if you have reached the Annual Threshold.
We pay for pathology when you have a gap in your cover – here’s how
If you have used up the money you have available in your Medical Savings Account for the year before you reach your Annual Threshold and there is a gap in your cover, also referred to as a Self-payment Gap, we will cover pathology at our network providers. You have this cover if your GP or specialist requests the appropriate tests using the Discovery Health pathology form.
To have this extended cover for pathology, please ask your healthcare professional to use the Discovery Health pathology form for all your tests, whether there is a gap in your cover or not.
Saver Series
Blood tests done in-hospital
We pay for the blood tests from the Hospital Benefit up to a maximum of the Discovery Health Rate as long as it is related to your confirmed hospital admission.
Blood tests done out-of-hospital
We will pay these claims from your Medical Savings Account (MSA), as long as you have money available.
Core Series
Blood tests done in-hospital
We pay for the blood tests from the Hospital Benefit up to a maximum of the Discovery Health Rate as long as it is related to your confirmed hospital admission.
Blood tests done out-of-hospital
Because the Core Series does not have a Medical Savings Account, you need to pay for blood tests done out of hospital.
KeyCare Series
Blood tests done in-hospital
We pay for the blood tests from the Hospital Benefit up to a maximum of the Discovery Health Rate as long as it is related to your confirmed hospital admission.
Blood tests done out-of-hospital (only covered on the KeyCare Plus Plan)
We pay for blood tests if your chosen general practitioner in the KeyCare GP network requests it and if the blood tests is on the list of blood tests that we cover. Your chosen KeyCare GP will know which blood tests are covered and which are not.
