Personal Health Fund

The Personal Health Fund is an added category for day-to-day healthcare funding. You accumulate value by engaging with Personal Health Pathways and completing your recommended next best actions and challenges. You can use the accumulated funds for qualifying out-of-hospital healthcare expenses such as general practitioner (GP) and specialist consultations, medicines, pathology and radiology. The Personal Health Fund preserves the Medical Savings Account, if you have one, since we fund healthcare expenses from the Personal Health Fund first.

The maximum benefit amount depends on your chosen plan type and family structure on your membership.

What is the once-per-lifetime benefit for new joiners

New members of Discovery Health Medical Scheme in 2026 will have access to an extra once-per-lifetime benefit which you can unlock by activating Personal Health Pathways, enabling fitness and sleep tracking, and completing your high-value action on your Personal Health Pathway before it expires. You must complete all these steps within 90 days of joining the Scheme to unlock this benefit. The same maximum limits that apply to the base Personal Health Fund also apply to the once-per-lifetime benefit, but the once-per-lifetime benefit will be available over two calendar years.

Who qualifies for the once-per-lifetime benefit for new joiners

The once-per-lifetime Personal Health Fund benefit in 2026 is available to all new members joining new policies in 2026 who did not have access to the WELLTH Fund or the once-off Personal Health Fund benefit in previous years.

This means the following members will not qualify for the once-off benefit in 2026:

1. Members who had a Discovery Health Medical Scheme membership between 1 January 2023 and 31 December 2025
2. Members joining policies that existed between 1 January 2023 and 31 December 2025
3. Members joining policies where the principal or main member on the policy had a Discovery Health Medical Scheme membership between 1 January 2023 and 31 December 2025

The Personal Health Fund is available for all Discovery Health Medical Scheme plan types to every person on the membership, regardless of their age.

We'll automatically activate the Personal Health Fund for you and your dependants once an adult on the membership has activated their Personal Health Pathway.

Here's how to activate your Personal Health Pathway:

Download the Discovery Health app if you haven't already.
Go to 'Personal Health Pathways'.
Click through the onboarding screens and read about the key features of Personal Health Pathways, including how to link device.
Click Continue to access Personal Health Pathways and automatically accept the terms and conditions.

Make sure you download the latest version of the Discovery Health app. To enable notifications, open your device's settings and find the Discovery Health app. Then, go to 'Notifications' and turn on 'Allow Notifications'. Once enabled, you'll start getting important updates and reminders directly from the app.

Learn more about Personal Health Pathways.

If you don't qualify for Personal Health Pathways because you are younger than 18 years of age, you will be able to unlock the full value of your Personal Health Fund by completing a Health Check or Kids Health Check. If you can't take part in Personal Health Pathways because of severe illness or because you are on palliative care, then the full value of the Personal Health Fund will be made available to you, if you qualify for this benefit.

There are even more ways for you to build up your Personal Health Fund in 2026:

1. On 1 January 2026, you will get a Personal Health Fund Advance of up to R1,000 per adult member.
2. You'll earn up to R500 for every health action you complete in Personal Health Pathways.
3. You'll earn up to R100 a week for completing exercise or sleep actions in Personal Health Pathways when no health actions are surfaced or snoozed.
4. Once each adult on the plan has completed at least two next best actions, the children's benefit allocation will unlock in full.
5. You can get more Personal Health Fund allocations (over and above the annual Personal Health Fund limit) for doing Personal Health Pathways Challenges. You'll get up to R1,500 for each successfully completed challenge, depending on your plan type.
6. If you're a new member to Discovery Health Medical Scheme, you can earn a once-off Personal Health Fund benefit for activating Personal Health Pathways. Make sure you enable exercise and sleep tracking and complete your high-value next best action within 90 days of joining.

You'll be able to accumulate funds up to a maximum per member, depending on your overall family or policy limit.

For example, a Classic Saver policy providing cover for one adult will be allocated an annual Personal Health Fund up to a maximum of R2,500. If the policy covers one adult and one child, the maximum annual benefit value allocated will be R3,750 and if the policy covers 3 adults and 3 children, the maximum benefit value will be R10,000 for the year.

You can earn more Personal Health Fund value for completing Challenges. This is over and above the annual Personal Health Fund benefit limits. The extra value for Challenges is allocated to each qualifying adult, for each successfully completed Challenge, up to a maximum of two Challenges in each benefit year.

The Personal Health Fund Advance is an amount of up to R1,000 per adult member allocated on 1 January every year. You qualify for this if you've done all the following:

• Activated Personal Health Pathways
• Enabled exercise or sleep tracking
• Done a Health Check in the previous calendar year

You get this advance amount so that you can start the year with a positive balance in your Personal Health Fund, which lets you preserve your Medical Savings Account. Keep completing your next best actions in your Personal Health Pathway so you can build up even more funds in your Personal Health Fund.

The Personal Health Fund Advance is part of the base Personal Health Fund benefit and accumulates to the maximum Personal Health Fund limit per qualifying adult on the policy.

If you are an adult member (aged 18 and over) on Discovery Health Medical Scheme, you qualify for the advance if you have:

1. Activated Personal Health Pathways
2. Enabled exercise and sleep tracking in Personal Health Pathways
3. Completed a Health Check in the previous calendar year.

You do not get the advance if you are younger than 18 years or do not qualify for Personal Health Pathways.

If you haven't activated Personal Health Pathways:

• Download the Discovery Health app if you haven't already.
• Activate Personal Health Pathways.
• Link your device or phone as part of the activation.

If you've already activated Personal Health Pathways, but skipped the step to link your device, you can do one of the following:

• Go to your pathway, click Get active and get rewarded and follow the prompts.
• Go to Device Management in the menu at the top right of the screen and follow the prompts.

In 2025, you can enable sleep data permissions and start sharing sleep data with Discovery Health if you have an Apple, Samsung, Garmin or Oura device.

Even though the sleep ring and weekly Vitality Sleep Rewards are not available yet, we want to make sure you're ready for them.

To unlock your Personal Health Fund Advance in January, if you have a device that is compatible for sleep tracking in 2025 (Apple, Garmin, Samsung or Oura) you must make sure that:

You have both sleep and exercise tracking enabled
You are actively sharing both types of data with Discovery.

It's important to remember that this is only to unlock your Personal Health Fund Advance. You will not qualify for any weekly Sleep Rewards or sleep-related Scheme benefits until the sleep ring and Sleep Benefit are available in 2026.

If you have a medical reason for not being able to take part in Vitality Active Rewards or the exercise ring in your Personal Health Pathway, then you must still activate the Personal Health Pathway and you must give evidence of being medically excluded. Once we have verified this, then you will not have to enable exercise tracking. You must still enable sleep tracking if you have a compatible device.

If you complete your Health Check during 2026 after it surfaces as a next best action in your Personal Health Pathway:

You will earn the Personal Health Pathways Miles linked to completing that action.
You will qualify for the Personal Health Fund Advance of up to R1,000 on 1 January 2027.
You will not earn an extra Personal Health Fund amount in 2026 for completing the Health Check in 2026, as you would have already received the Personal Health Fund Advance for it on 1 January 2026.

If you complete your Health Check during 2026 after it surfaces as a next best action in your Personal Health Pathway:

You will earn the Personal Health Pathways Miles rewards linked to completing that action.
We will add R1,000 to your 2026 Personal Health Fund balance.
You will qualify for the Personal Health Fund Advance of up to R1,000 on 1 January 2027.

No. You will get the Personal Health Fund Advance if you completed the Health Check, activated Personal Health Pathways and enabled exercise and sleep tracking. It doesn't matter if the 'Do a Health Check' tile didn't surface for you.

The Personal Health Fund will be pro-rated for members during the year. All the benefit limits will be adjusted if you join or rejoin a plan partway through the year.

If you change your plan type during the year, any Personal Health Fund value already earned and claims already funded will not be affected. However, your potential earnings or limits will be adjusted to your new plan. This will affect the Personal Health Fund value you earn for completing actions and Challenges in Personal Health Pathways going forward.

The extra Personal Health Fund amount that you earn for completing a Challenge in Personal Health Pathways depends on the plan type you are on when you complete the Challenge.

You can earn up to R500 towards your Personal Health Fund for completing health actions, depending on your benefit limits.

If you do not have any currently surfaced, snoozed or temporarily dismissed health actions in your Personal Health Pathway and you haven't yet reached your benefit limits, you'll accumulate up to R100 in your Personal Health Fund for each qualifying exercise action you complete until the next health action is recommended.

For qualifying exercise actions to earn value towards your Personal Health Fund, you must link a device and activate the exercise ring on your Personal Health Pathway.

If you do not have any currently surfaced, snoozed or temporarily dismissed health actions in your Personal Health Pathway and you haven't yet reached your benefit limit, you'll accumulate up to R100 in your Personal Health Fund for each qualifying exercise or sleep action you complete until the next health action is recommended.

For qualifying exercise actions to earn value towards your Personal Health Fund, you must link a device and activate the exercise ring on your Personal Health Pathway.

The WELLTH Fund benefit expired on 31 December 2025 for members who joined the Scheme in 2024 and unlocked the WELLTH Fund in 2024. Any positive balance at the end of 2025 will not be carried over to 2026.

Once your Personal Health Fund balance shows the funds you've earned, you can start using the funds that qualify for paying for your day-to-day benefits.

No. You can't choose where the claims will be paid from. Qualifying claims will be paid first from your Personal Health Fund (up to R500 per family per year for over-the-counter medicine and up to 100% of the Scheme Rate for all qualifying claims). After that, they will be paid from your day-to-day benefits if these apply.

The funds earned in your Personal Health Fund will be valid until the end of the calendar year in which you earned them. It doesn't matter when in the year you earn the funds.

You can track this through the Personal Health Fund dashboard in the Discovery Health app or on the Discovery website, as well as on your claims statement.

You can view your balance on the Personal Health Fund dashboard, which is available in the Discovery Health app and on the Discovery website.

Once all the adult dependants on your membership (aged 18 years and older) have completed at least two qualifying next best actions, you will unlock the full child value.

To unlock the child's yearly Personal Health Fund benefit portion on a policy, all the adults on the policy must complete two next best actions. These next best actions must usually be priority health actions. If you don't have any priority health actions, then exercise or sleep actions will count towards the required two next best actions. In a week where you don't have priority health actions, and you have completed both your exercise and sleep actions, only one of these (the action completed first in the week) can count towards the required two next best actions to unlock the child's Personal Health Fund benefit.

To unlock the child's once-per-lifetime benefit value on a policy, all the adults on the policy must activate Personal Health Pathways, enable exercise and sleep tracking and complete their high-value next best action within 90 days of joining the Scheme.

The funds that have already accumulated will not be adjusted.

The maximum benefit limit you can earn as an individual or family may be adjusted to reflect the new plan or family size.

There will be no effect on the claims that have already been paid from your Personal Health Fund.

Any funds that are in your Personal Health Fund are what you earned by taking part in Personal Health Pathways and getting to understand your health better. This means you won't have to pay back any funds you've already used. You will lose any funds that are still in your Personal Health Fund when you cancel your membership.

No. The Personal Health Fund is available alongside your Medical Savings Account. Claims will not accumulate towards the Annual Threshold, Above Threshold Benefit or benefit limits.

No. This is a Scheme-funded benefit. If you cancel your membership of Discovery Health Medical Scheme, you'll lose any funds that are still in your Personal Health Fund.

You probably completed multiple actions when you were close to reaching your Personal Health Fund limit. Once these actions are marked as complete, and you've reached your Personal Health Fund limit, you will no longer accumulate funds towards your Personal Health Fund. This means that any recommended actions that you still need to complete will no longer carry a Personal Health Fund value.

Yes. From 2025 onwards, your Health Check will be funded from the Screening and Prevention Benefit if you are in a three-month general waiting period. The check forms part of your health assessment in your application to join Discovery Health Medical Scheme. This means that if a Health Check shows as your high-value action on your Personal Health Pathway, and you complete it, the Health Check will be funded and you will unlock your once-off benefit.

We pay for over-the-counter medicine from the available funds in your Personal Health Fund up to a maximum amount of R500 per family per year. Once this limit has been reached, then any other claims for over-the-counter medicine will be paid from your Medical Savings Account (if you have one) or you will have to pay them yourself.