Network medical aid plans offer you affordable, high-quality cover. Here's how.
Here's everything you need to know about being on a medical aid plan that asks you to make use of healthcare providers that are part of a network.
Certain medical aid plans are 'network' plans, which means that you may need to use healthcare providers that are part of the medical aid's network. Ultimately, a network plan offers convenience and affordability. Here's how they work.
What are network plans?
When you are on a network medical aid plan, you are asked to make use of specific hospitals, pharmacies, GPs or specialists. The medical aid has arrangements with these healthcare providers to deliver care at a lower cost than at providers who are not part of the network.
Discovery Health Medical Scheme (DHMS) has several networks available on various medical aid plan options, including the Delta, Smart, Coastal, and KeyCare Networks. Members are encouraged to get to know which healthcare providers are part of their specific plan's network.
Why are network plans more affordable? Because network arrangements mean lower costs for care, medical schemes can offer members' a lower monthly premium contribution.
What are the benefits of being on a plan that uses network providers?
Fact or fiction? Busting myths around network plans
There are several misconceptions around health plans that make use of networks. We're here to separate fact from fiction and bust common myths around network plans.
If I need emergency care and I am not near a network hospital it means that I won't get treated.
In a medical emergency, you are not restricted to a network hospital. You can go to any private hospital.
- A medical emergency is the sudden and unexpected onset of a health condition that requires immediate medical and surgical treatment. Not receiving this treatment will place the person at risk of permanent
By choosing a network plan I am compromising on my healthcare.
There is no compromise. Choosing a network plan offers you access to high quality care in private hospitals.
There aren't enough network hospitals
There are over 170 private hospitals nationwide that form part of the Discovery Health networks.
Which Discovery Health Medical Scheme plans are on a network?
When comparing network plans, look for the words 'Delta', 'Smart', 'Coastal' and 'Keycare'. When you see either of these four words in the name of the plan - it means that the respective plan is a network plan. You can view all Discovery Health Medical Scheme plans here.
Getting to know the ins and outs of your specific health plan will allow you to make the most of your health benefits. Take some time to get to know your cover so that you can access high-quality healthcare that is convenient and affordable.
The Discovery Health Medical Scheme is an independent non-profit entity governed by the Medical Schemes Act, and regulated by the Council for Medical Schemes. It is administered by a separate company, Discovery Health (Pty) Ltd, an authorised financial services provider.