What to do in an emergency

An emergency medical condition, also referred to as an emergency, is the sudden and unexpected onset of a health condition that requires immediate medical and surgical treatment. Failure to provide medical or surgical treatment would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part or would place the person's life in serious jeopardy. An emergency does not necessarily require a hospital admission. We may ask you or your treating provider for additional information to confirm the emergency.

Discovery 911

Discovery 911 offers real-time emergency care for all Discovery Health Medical Scheme members. For a medical emergency, call 0860 999 911.

This number is available 24 hours a day, seven days a week to receive emergency calls. The line is managed by highly qualified emergency personnel, who will assess each case and provide immediate feedback and assistance.

If you need medically equipped transport in South Africa, Discovery 911 will send emergency transport, for example an ambulance or helicopter, to take you to hospital. We will cover the costs from your Hospital Benefit, whether you are admitted to hospital or not.

You can go to any private hospital in an emergency. If you are admitted to hospital, we cover your emergency hospital admission. There is no overall limit for hospital cover on your health plan.

Casualty

We cover the costs of a casualty visit if you are admitted to hospital from the casualty unit. We pay the costs from your Hospital Benefit, as long as we confirm your admission. Some casualties charge a facility fee, which we do not cover.

If you go to a casualty or emergency room and you are not admitted to hospital, we pay the costs according to your health plan, unless it is an emergency or related to a Prescribed Minimum Benefit condition. Where treatment qualifies as a Prescribed Minimum Benefit, it will be paid for by the Scheme.

Executive, Comprehensive, Priority:
We pay for these claims as a day-to-day medical expense from your available Medical Savings Account and Above Threshold Benefit

Saver:
We pay for these claims as a day-to-day medical expense from your available Medical Savings Account.

Smart and Core:
You need to pay for these costs as your plans do not have a Medical Savings Account.

KeyCare Plus and KeyCare Start:

On the KeyCare Plus Plan, you have cover for one casualty visit a year at a casualty unit in the KeyCare Hospital Network. You have to pay an upfront amount of R475 to the casualty unit for each person needing care for an event. If you are on a KeyCare Start Plan, you can go to your chosen KeyCare Start GP or network GP that offers after-hours care.

Not all KeyCare network hospitals have casualty units. See the list of hospitals and casualty units.

KeyCare Core:
We do not cover casualty visits on these plans.