Here’s what you get:
Unlimited private hospital cover in the Smart Network
Guaranteed full cover in hospital for specialists we have a payment arrangement with
Up to 200% of the Discovery Health Rate on the Classic Plan and 100% on the Essential Plan for other healthcare professionals we don’t have an arrangement with
Full cover for approved chronic medicine for all conditions on our Chronic Disease List when you use MedXpress, MedXpress partner pharmacies, Clicks or Dis-Chem
Day-to-day cover for your GP consultations, acute medicine, eye and dental check-up and sports-related injuries, with a fixed co-payment, dependent on the plan you choose
Cover for medical emergencies when you travel outside South Africa
Our Smart Plan
| Classic | Essential | |
|---|---|---|
| Hospital cover | ||
| Unlimited private hospital cover at a network hospital | ||
| Full cover with a specialist we have a payment arrangement with | ||
| Specialists we don't have a payment arrangement with are covered at a percentage of the Discovery Health Rate | 200% | 100% |
| Other healthcare professionals are covered at a percentage of the Discovery Health Rate | 200% | 100% |
| Chronic illness cover | ||
| Chronic condition: Cover for 27 Chronic Disease List conditions (once approved) according to the Prescribed Minimum benefits | ||
| Chronic medicine: Full cover for approved medicine on our medicine list at a designated service provider pharmacy | ||
| Cancer cover | ||
| We cover a set amount in full over a 12-month period. Costs above this amount attract a 20% co-payment. Prescribed Minimum Benefit conditions are covered in full | R200 000 | R200 000 |
| Day-to-day cover | ||
| Unlimited GP consultations with a fixed co-payment for each consultation | R50 | R100 |
| One eye test at an optometrist with a fixed co-payment for the test | R50 | R100 |
| One dental check-up with a fixed co-payment for the check-up | R100 | R150 |
| Cover for acute medicine categories, with a R10 payment for each medicine item | ||
| Cover for sports-related injuries: basic X-rays, two specialist visits and a total of four visits to either a physiotherapist, biokineticist or chiropractor when referred by a Smart Network GP. You will have to pay R100 for each visit | ||
This is only a summary of the key benefits. Please consult the health plan guide for more details. Discovery Health Medical Scheme Rules apply.
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