Chronic illnesses and other medical conditions

Chronic Illness Benefit

All our plans provide comprehensive cover for a list of chronic conditions. For us to cover your medicine from the Chronic Illness Benefit, we need to approve your application.

To apply, complete the Chronic Illness Benefit application form. 

Our chronic disease management programmes offer you:
Access to information on your condition, as well as support and guidance.
Consultations and diagnostic tests and medicine related to your condition as a Prescribed Minimum Benefit.
Approved chronic medicine according to the Chronic Illness Benefit formulary, from pharmacies we have an agreement with.
Access to other healthcare professionals we have an agreement with.
Additional cover on some health plans.
Members can request additional cover for an approved chronic condition, provided the member completes the application form together with his or her doctor, and the request is approved.

Cancer treatment

We cover you for cancer treatment on the DiscoveryCare Oncology programme. Please let us know as soon as you are diagnosed with cancer so that we can register you on the Oncology Programme. This will help you get the most out of your oncology benefits.


Benefits of the Oncology Programme include:

  • Full cover for approved cancer-related treatment up to a rand amount over a 12-month cycle. Once your treatment costs go over this amount, Discovery Health will pay 80% of the costs of all further treatment and you will need to pay the balance from your pocket. This amount could be more than 20% if your treatment cost is higher than the Discovery Health Rate. This includes cover for chemotherapy, radiotherapy and other treatment prescribed by your cancer specialists.
  • Cover for pathology, radiology, medicine and other cancer-related treatment provided by other healthcare professionals
  • Access to donor searches for bone marrow transplants

Any cancer-related treatment that falls within the Prescribed Minimum Benefits is always covered in full, with no co-payment if you use service providers who we have an agreement with.


You need to register for the Oncology Benefit

You or your treating doctor can register for the Oncology Benefit. Contact the DiscoveryCare oncology team:

We need a copy of your histology or pathology.


Advanced Illness Benefit for advanced cancer

Members with cancer have access to a comprehensive palliative care programme. This programme offers extensive out-of-hospital care for members with cancer at home.

The existing Compassionate Care Benefit provides members, in their final months of life, with access to a defined basket of services such as pain, hydration, general nursing care and supportive care up to an overall benefit limit.

To ensure that members with advanced cancer benefit from optimal palliative care, we have enhanced the existing Compassionate Care Benefit. Members can discuss their options with their treating doctor or oncologist.

The Advanced Illness Benefit provides members with access to:

GPs specialising in end-of-life care who will assist in coordinating and improving the care of DHMS members on the Advanced Illness Benefit

  • The healthcare provider will facilitate the care through HealthID by use of a Care Plan tailored for the member
  • All medicine, oxygen and surgical requirements prescribed will be delivered via MedXpress when required

Personalised high-touch experience and a defined home-based care programme through Discovery HomeCare

  • Access to personalised care services such as oxygen, wound care, home nursing and pain management for the member
  • Access to counselling services for member and family

A dedicated care coordinator who will:

  • Remain with the member and the family throughout
  • Manage the relationship between the member and the multi-disciplinary team on an ongoing basis ensuring the member receives the best of care



HIV and AIDS can be a sensitive matter, whether one has the condition or not. Our skilled and professional consultants respect your right to privacy and will help you get access to clinically sound and cost-effective treatment for your individual case. 

We will always deal with each case with complete confidentiality.

To register on the Discovery HIVCare Programme, call us on 0860 99 88 77 or email

Download the HIVCare Programme application form

Benefits of our HIVCare Programme include:
Access to skilled and professional consultants who will ensure your receive clinically sound and cost-effective treatment.
No overall limits for hospitalisation.
A specific number of consultation and HIV-specific blood tests.
Cover for antiretroviral medicine from our HIV ARV medicine list (formulary).
Cover for supportive medicine from our HIV supportive medicine list (formulary).
Additional cover if your doctor appeals for this cover.
Cover for infant formula and medicine to prevent transmission of HIV from mother to child, from our HIV nutritional and mother-to-child prevention medicine list (formulary).

Designated service providers (DSPs) for HIV medicine

All members who are registered on the HIVCare Programme must use designated service providers (DSPs) to get their monthly HIV medicine to avoid a 20% non-designated service provider co-payment.

Currently, Discovery MedXpress is the designated service provider for HIV medicines for all members registered on the HIVCare Programme. Members on the Smart Plan also have the option to use their selected designated network pharmacy (Clicks or Dis-Chem) for their HIV medicine.

Should more pharmacies be added as designated service providers during 2016 an updated list of designated service providers for HIV medicine will be published.

More about MedXpress

Chronic Renal Dialysis

Discovery Health Medical Scheme covers renal dialysis in- and out-of-hospital.

Members need to get their out-of-hospital dialysis treatment from our designated service providers for full cover and to avoid co-payments on dialysis accounts.

To apply for Chronic Renal failure, complete the Chronic Illness Benefit application form.

About the KidneyCare Programme

The KidneyCare Programme focuses on members with chronic kidney disease who need dialysis.

Living with chronic kidney disease is a lifelong journey, often made difficult because of the significant need for regular care, complex medicine, restrictive diets, and numerous tests and investigations.

The KidneyCare Programme is designed to ensure that our medical scheme members living with chronic kidney disease are managed according to international best practice guidelines, to ensure the best quality of care and quality of life.

Through the KidneyCare Programme, we will:
Collect clinical, blood, and urine test data from investigations that has been done to monitor your condition.
Compile and distribute confidential reports to you and your doctor about the above data to assist you and your doctor in managing your condition.
Distribute educational material to so that you are fully informed of opportunities to improve your own management. This includes brief daily SMS messages and an educational booklet.
Ensure that your care plan about appointments and investigations is clearly communicated to you and your doctor.
Most importantly, we hope to support you in this journey of managing your chronic kidney disease.
More information on kidney disease


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.

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