Discovery Health Medical Scheme Classic Comprehensive Plan (🇿🇦 2026)

Overall, the Discovery Health Medical Scheme Classic Comprehensive Medical Aid Plan is a trustworthy and comprehensive medical aid plan. The Discovery Health Medical Scheme Classic Comprehensive Medical Aid Plan starts from R10,037  ZAR.  Discovery Health has a trust score of 4.8.      

Discovery Health Medical Scheme Classic Comprehensive - 22 Key Point Quick Overview

1. ✅ Discovery Health Classic Comprehensive Overview
2. ✅ Classic Comprehensive Contributions, Annual Medical Savings Account
3. ✅ Discovery Health Comprehensive Plan Benefits Summarized
4. ✅ Classic Comprehensive Benefits and Cover Comprehensive Breakdown
5. ✅ Personal Health Pathways
6. ✅ Personal Health Fund
7. ✅ Discovery Health app
8. ✅ Discovery Hospital At Home
9. ✅ Discovery Health Comprehensive Day-to-Day Benefits
10. ✅ Classic Comprehensive Day-to-day Cover
11. ✅ Discovery Maternity and Early Childhood Benefit
12. ✅ Discovery Chronic Benefits
13. ✅ Discovery Chronic Medicine
14. ✅ Discovery Care Programs
15. ✅ Discovery Comprehensive Cancer Cover
16. ✅ Discovery Hospital Benefit
17. ✅ Discovery Annual Limits
18. ✅ Discovery Health Comprehensive Cover for Day Surgery Network Procedures
19. ✅ Discovery Health Classic Comprehensive Exclusions and Waiting Periods
20. ✅ Discovery Health Classic Comprehensive Plans Compared
21. ✅ Our Verdict on Discovery Health Classic Comprehensive
22. ✅ Discovery Health Classic Comprehensive Frequently Asked Questions

Discovery Health Medical Scheme Classic Comprehensive Overview

  👉 The Discovery Health Medical Scheme Classic Comprehensive starts from R10,037  ZAR . It is part of a series of comprehensive medical insurance plans offered by Discovery Health Medical Scheme. The Classic Comprehensive plan is a top-tier medical aid plan that provides exceptional coverage for those willing to pay a premium price.     The Discovery Health Medical Scheme Comprehensive Series includes the following plans:  

•  Classic Comprehensive
•  Classic Smart Comprehensive

  👉 It should be noted that a late joiner fee may apply to all Comprehensive Series Plans according to CMS guidelines.   👉 Gap Cover is available on the Classic Comprehensive Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Discovery Health Medical Scheme has a trust rating of 4.8.    

Discovery Health Medical Scheme Classic Comprehensive Contributions, Annual Medical Savings Account, and Annual Threshold Amounts

Classic Comprehensive Monthly Contributions

 

Classic Comprehensive Annual Medical Savings Account (MSA)

 

Classic Comprehensive Annual Threshold Amounts

 

Comprehensive Plan Benefits Summarized

 

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Classic Comprehensive Benefits and Cover Comprehensive Breakdown

Emergency Cover

  In case of a traumatic incident or after a traumatic event, you can get help from a trained professional. Calling Emergency Assist will help you and your loved ones in need.  Furthermore, family members can get help after a traumatic event at any time.   The survivors of gender-based violence can receive counseling and other support as part of this service.   Discovery Health Emergency Cover covers the following medical services:  

• ✅ The emergency vehicle (or other medical transport).
• ✅ The hospital’s account of the incident.
• ✅ The observations of the physician who admitted you to the hospital.
• ✅ The anesthesiologist.

Any additional approved healthcare provider.  

👉 Prescribed Minimum Benefits

All medical schemes are required by the Prescribed Minimum Benefit (PMB) provisions of the Medical Schemes Act 131 of 1998 and its Regulations to cover the costs associated with the diagnosis, treatment, and care of:  

• ✅ A life-threatening medical condition
• ✅ A defined listing of 271 conditions
• ✅ A list of 27 chronic illnesses.

  Your medical condition must be on the Prescribed Minimum Benefit (PMB) conditions list to qualify for coverage. Furthermore, the necessary treatment must correspond to the treatments listed in the benefits.  In addition, you are required to utilize designated service providers (DSPs) within the Discovery Health network.   Once your condition has stabilized, you will be transferred to a hospital or other service providers in the Discovery Health network, if necessary, according to the scheme’s rules.   Discovery Health Medical Scheme will cover up to 80% of the Discovery Health Rate if you do not use a DSP (DHR). Your responsibility will be to determine the difference between what Discovery Health will pay and the actual cost of your treatment.   Furthermore, Discovery Health Medical Scheme will pay according to your plan’s benefits if these criteria are met.  

 Screening and Prevention

    This benefit covers certain diagnostic procedures that detect early warning signs of serious diseases.  The Discovery Health Medical Scheme's wellness providers cover a variety of screening tests, including blood glucose, cholesterol, HIV, Pap smear or HPV test for cervical screening, mammograms or ultrasounds, and prostate screenings.   After all your membership members have completed their health check, you can access additional screening and preventive healthcare services through the Personal Health fund (Previously known as WELLTH Fund.)   The Discovery Health Medical Scheme Screening and Prevention covers the following:  

• ✅ Screening for kids will assess the child’s growth and development, including weight, height and body mass index measurements, blood pressure, and more.
• ✅ Screening for Adults includes blood pressure, blood glucose, HIV, and more. Discovery also covers mammograms, breast ultrasounds, pap smears, and more.

  Screening for Seniors (65>) includes risk screening assessments and referrals to Premier Plus GPs according to the screening results.  

Personal Health Pathways

    Personal Health Pathways leverages a sophisticated digital health platform that combines actuarial and lifestyle data with behavioral science to engage you in a personalized programme that drives you towards healthier habits and behavior change.   Personal Health Pathways is a new, innovative personalized care programme designed to help everyone achieve better health. It combines data with actuarial and behavioral science to create a personalized pathway (a plan of what you must do) for each member. Your pathway consists of curated sequence of health and lifestyle actions, tailored to your unique needs, encouraging you to healthier habits and positive behavior changes.    

Next best actions are hyper-personalized just for you

Your healthcare pathway is personalized for you. For a member with 12 actions, there are more than 7 million possible pathways to completing those actions.         By leveraging sophisticated data-science and machine-learning models, these actions have been personalized for you based on your unique health status and engagement patterns.   Actions are clinically relevant, shown at the right time and in the right sequence, and automatically update and adjust based on your changing healthcare needs.  

Personal Health Fund

    The Personal Health Fund is applicable for any out-of-hospital healthcare costs, including GP visits, specialist consultations, medications, pathology, and radiology services.   Upon accepting the terms and conditions for Personal Health Pathways and fulfilling your recommended next best action, you can accumulate extra value in your annual Personal Health Fund.   This benefit is accessible to all eligible members of the Discovery Health Medical Scheme, and for qualifying healthcare services, we reimburse up to the maximum of the Discovery Health Rate, subject to the overall benefit limit. The amount of additional day-to-day funding available in your Personal Health Fund is determined by your membership plan.   New enhancements for your Personal Health Fund:

• Increased Personal Health Fund value from the beginning of the year: You can now commence the year with an advance of up to R1,000 per adult in the Personal Health Fund by completing three straightforward actions.

Elevated annual Personal Health Fund limits: You can access in advance up to R1,000 base Personal Health Fund on the Comprehensive Series. Doubling the Personal Health Fund value for adults who complete Personal Health Challenges: Adults who fulfill their Personal Health Pathway challenges in 2026 can enhance their Personal Health Fund and earn up to R3,000, effectively doubling their annual Personal Health Fund limit.   All new joining members will receive their complete Personal Health Fund allocation, up to R1,500 per policy, which will be available immediately in the first year of membership.  

• Members are required to: – Activate Personal Health Pathways – Enable tracking of physical activity and sleep. – Complete their one-time high-value action on Personal Health Pathways.
• This is a once-in-a-lifetime benefit, designed to provide new members with the strongest possible start to their healthcare journey. Members must complete their high-value next best action tile on Personal Health Pathways within 90 days of joining the Scheme to activate the benefit.

•  Limited to R3000 per adult dependent.
•  Limited to R1500 per two-year-old or older child dependent.
•  Limited to R12000 per family.
•  The allocation for child dependents will be unlocked once the adult members have unlocked the Personal Health Fund.

How the Personal Health Fund works

  The Personal Health Fund represents a new category of healthcare funding giving a you access to up to R10,000 in day-to-day, risk-funded benefits for medical expenses each year.   The benefit works in three simple steps:   👉 Step 1

•  Download the Discovery Health App and understand your next best actions.
•  You can view your next best actions on the Personal Health Pathways programme, available on the Discovery Health App and Discovery website.

  👉 Step2

•  Complete the recommended health actions and build up the Personal Health Fund, up to the maximum annual limit.
•  For every completed next best action on Personal Health Pathways, you accumulate R500 into your Personal Health Fund.
•  You can continue to accumulate funds up to a maximum limit each year, based on the family structure of the membership.
•  Any unused funds in the Personal Health Fund expire at the end of a benefit year and do not carry over to the next benefit year.

  👉 Step3

•  You can use available funds on any day-to-day medical expenses, such as GP visits, specialist consultations, physiotherapy and medicine.

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Discovery Health app

    The Discovery Health app gives you access to a truly personalized health experience and allows you to navigate the healthcare system easily. Access the advice and healthcare support that you need, 24/7, through the app’s innovative features.  

Your access to care at home

     

👉 Discovery Hospital at Home

Hospital at Home patients receive specialized care from a dedicated medical staff in the comfort of their own homes. Each of these benefits and services contributes to your overall health and well-being.   They all work together to make your healthcare more efficient and your life safer. Suppose you have a valid pre-authorization for hospitalization. In that case, Discovery Health will use your Hospital Benefit to cover any services provided as part of Discovery’s Hospital at Home program.   For those who meet the program’s clinical and benefit criteria, this unlocks cover for approved medical devices and services.  

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👉 Home Care Cover

Discovery Home Care is a service that provides you with high-quality care in the comfort of your own home if your doctor recommends it as an alternative to hospitalization. Postnatal care, end-of-life care, intravenous infusions (drips), and wound care are provided. These services are covered by the Hospital Benefit, pending authorization.  

👉 Home Monitoring Device Benefit for essential home monitoring

Discovery Health Medical Scheme provides home-based access to health and wellness services. Connected Care is an integrated ecosystem of benefits, services, and digitally connected capabilities designed to assist you in managing your health and wellness.  

Comprehensive Day-to-Day Benefits

Discovery Health Medical Scheme will cover your day-to-day medical expenses with funds from your Medical Savings Account (MSA) or Day-to-Day Extender Benefit (DEB).   👉 The Medical Savings Account (MSA)

• ✅ Discovery Health pays for the day-to-day medical expenses of its members, such as consultations with GPs and specialists, medicine (excluding registered chronic medicine), radiology, and pathology, from the available funds in the member’s Medical Savings Account (MSA).
• ✅ Any unused funds will be carried over to the next year. In addition, members can have their claims paid at the Discovery Health Rate (DHR) or at cost.
• ✅ If you have elected to have your claims paid by the MSA at cost, the Scheme will automatically pay any claims that exceed the DHR.
• ✅ You can request a special payment from your MSA if you have elected to have claims paid from your MSA at the DHR.
• ✅ Furthermore, you will want claims paid more than the DHR or benefit limits from the available funds in your MSA.
• ✅ If they are over the DHR, claims paid from the MSA do not add up to the Annual Threshold.
• ✅ On the Classic Smart Comprehensive Plan, you can access unlimited GP consultations in the Smart GP Network, until you reach the Annual Threshold. You will have to pay the first R70; the rest of the consultation fee will be covered up to the Discovery Health Rate (DHR).

    However, you are covered by a defined set of daily benefits, including Smart GP visits, specific specialist consultations, and other essential healthcare services.   👉 The Day-to-Day Extender Benefit (DEB)

• ✅ Pays for certain day-to-day benefits after the MSA has been depleted and before the Annual Threshold is reached.
• ✅ Covers video call consultations with a network of primary care physicians and pharmacy clinic consultations within our defined wellness network.
• ✅ You also have unlimited coverage for face-to-face consultations with a network GP when referred to by a virtual GP in the pharmacy clinic or following a video call consultation.
• ✅ Discovery Health will cover in-person visits up to the Discovery Health Rate (DHR).

  On Comprehensive Classic plan, children under 10 are eligible for two visits yearly.   👉 The Self-payment Gap (SPG)

• ✅ If your MSA runs out before you reach your Annual Threshold, you will be responsible for paying claims out of pocket until you reach your Annual Threshold.
• ✅ This time frame is referred to as the Self-Payment Gap (SPG).

  You must continue to submit claims throughout the SPG so that we know when you reach your Annual Claims Threshold.   👉 The Above Threshold Benefit (ATB) Over Threshold After your Annual Threshold, the benefit covers daily expenses. Some claims do not meet your Annual Threshold or ATB payment:

• ✅ Medicine that you do not need a prescription for (over-the-counter medicine)
• ✅ Childhood vaccines and immunizations
• ✅ Lifestyle-enhancing products
• ✅ Claims more than the Discovery Health Rate (DHR).
• ✅ Claims paid more than annual benefit limits.

  The Above Threshold Benefit (ATB) is unlimited, so it covers all or a portion of daily expenses at the Discovery Health Rate (DHR), and various benefit caps may apply.  You must pay the difference between the DHR and the claimed amount and any amount that exceeds the annual benefit limit (where applicable).    

Classic Comprehensive Day-to-day Cover

     

Discovery Maternity and Early Childhood Benefit

With the Discovery Health Classic Comprehensive, you get coverage for healthcare services related to your pregnancy and treatment for the first two years of your baby’s life.  This applies from the date of activation of the benefit for each pregnancy and each child from birth until they are two years old.  Discovery Health Maternity Benefit covers the following:  

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👉 During Pregnancy:

• ✅ Scans and Screenings
• ✅ Twelve antenatal consultations with a midwife, GP, or gynecologist.
• ✅ 2 x 2D ultrasound scans
• ✅ Nuchal translucency test
• ✅ 3D and 4D scans up to the 2D scan rate.
• ✅ Non-invasive Prenatal Test (NIPT)
• ✅ One flu vaccination during pregnancy.
• ✅ Your Hospital Benefit covers the costs associated with labor and delivery.
• ✅ You are also covered for up to R2,800 per day in a private ward during your delivery hospital stay.

  Discovery Health Medical Scheme will cover predetermined blood tests to confirm your pregnancy.   You might like to know more about medical aid that covers pregnancy immediately👉 After giving birth, Discovery Health Medical Scheme covers the following:

• ✅ Up to R6,500 for registered essential devices like breast pumps and smart thermometers. However, you are responsible for 25% of the total cost of these devices.
• ✅ GP and Specialist help for two visits for up to 2 years.

  Postnatal care, including complications during delivery, nutritional assessment, etc.   👉 Prenatal and postnatal care includes:

• ✅ Five antenatal or postnatal classes.
• ✅ One Breastfeeding consultation.

Chronic Benefits

💙 The Chronic Disease List lists 27 conditions for which the Chronic Illness Benefit (CIB) provides cover (CDL). In addition, on Classic Comprehensive, you are covered for the 22 additional conditions listed on the Additional Disease List (ADL).  

👉 Discovery Health Medical Scheme pays for consultations and medicines in the following ways:

• ✅ You must select a primary care physician from the Discovery Health Network to manage your chronic conditions.
• ✅ You must see a Discovery Health Network physician to receive full coverage for your doctor visits. Use of a non-network primary care physician will incur a 20% co-payment.

    Discovery Health Medical Scheme will pay up to the Discovery Health Rate (DHR) for medications purchased at one of the network pharmacies. The DHR for medication consists of the price of the medication and the dispensing fee.   👉 Chronic Benefit Cover Summarized    

Chronic Medicine

👉 Using a pharmacy in their networks

• Utilize their designated service providers (DSPs).

👉How to get your medicine

•  You now have greater convenience and flexibility in managing your medicine needs. Order from your preferred pharmacy partner. Our partners include Clicks, Dis-Chem, Medirite and other independent pharmacies.
• Our enhanced online platforms give you greater control. From uploading your prescriptions to tracking your deliveries, you can now manage all your medicine needs more smoothly than ever before.

👉Medicine tracker

• You can set up reminders to help you take your medicine on time and as prescribed. Your approved chronic medicine will automatically be displayed; you will then be prompted to take your medicine and confirm when you have taken each dose.

   

Discovery Health Medical Scheme's Care Programs

    Discovery Health Medical Scheme will cover preventative and condition-specific care programs that assist with managing diabetes, mental health, HIV, and heart-related conditions.  You must be registered with these condition-specific care programs to access additional benefits and services.   On a personalized dashboard, you and your Premier Plus GP can identify the next steps to manage your condition and optimally maintain your health over time.  The cover is subject to the Scheme’s clinical entry requirements, treatment protocols, and guidelines.    

Comprehensive Cancer Cover

    You have access to comprehensive cancer treatment coverage. This includes access to expensive medications, innovative treatments, and extended coverage once certain thresholds are reached.    

Hospital Benefit

The Classic Comprehensive includes hospitalization coverage. Furthermore, there is no limit on the total amount covered by Hospital Benefits.    

• ✅ This benefit covers the costs associated with hospitalization.
• ✅ Unlimited cover in any private hospital approved by the Scheme, subject to network requirements.
• ✅ You are covered for planned hospital stays.
• ✅ It would help if you utilized a network hospital.
• ✅ You may visit any private hospital approved by the Scheme for funding on the remaining plans.
• ✅ On all health plans, the funding of newly licensed facilities is subject to Scheme approval.
• ✅ Your Hospital Benefit is used to cover planned hospital stays.

  Discovery Health Medical Scheme pays up to 200% of the Discovery Health Rate (DHR).     👉 Pre-operative Management Programme for major surgeries

• ✅ For arthroplasty, colorectal surgery, coronary artery bypass graft, radical prostatectomy, and mastectomy, you are covered for a pre-operative nurse assessment, a consultation (face-to-face, virtual, or telephonic) with your treating healthcare professional, and specific laboratory, pathology, and radiology tests.
• ✅ Clinical entry and treatment guidelines govern cover.

👉 Healthcare Providers and Services     👉 Scopes You are responsible for the following amount depending on where your scope is performed. Your Hospital Benefit will cover the remaining hospital and related charges.           Furthermore, the following will apply to the scopes of Classic Comprehensive:  

• ✅ The Classic Comprehensive plan will require an upfront payment of R7250
• ✅ When a gastroscopy and colonoscopy are performed, a higher initial payment of R8,400 will be required.

  No co-payment applies for scopes performed at an in-rooms network provider. The following co-payment will apply for scopes performed at a non-network provider :   Single Scope: R1,800 co payment. Bi-directional scopes:  R3,100 co payment.  

Discovery Annual Limits

     

Discovery Health Medical Scheme Comprehensive Cover for Day Surgery Network Procedures

Discovery Health Medical Scheme will provide cover for certain day surgery procedures. A day surgery may take place in a hospital, a day clinic, or an independent facility. Furthermore, these services are covered by your Hospital Benefit.         Discovery Health Medical Scheme will pay for hospitalization-related services, including all authorized healthcare professionals, services, and medications.  Utilize physicians, specialists, and other healthcare professionals with whom Discovery Health Medical Scheme will have a payment arrangement.   Discovery Health Medical Scheme will cover the full cost of these services.  

• ✅ Discovery Health Medical Scheme pays up to 200% of the Discovery Health Rate (DHR).

  Furthermore, go to a facility not part of the Day Surgery Network. You must pay the following amounts upfront:     If any of these procedures are on the list of hospital admission procedures with an upfront payment, the higher of the two upfront payments will apply. The following list provides the procedures that can be performed in a Day Surgery Network:  

• ✅ Biopsies
• ✅ Breast Procedures
• ✅ Ear, nose, and throat procedures
• ✅ Eye Procedures
• ✅ Ganglionectomy
• ✅ Gastrointestinal scopes and procedures
• ✅ Gynecological Procedures
• ✅ Orthopedic Procedures
• ✅ Removal of a foreign body
• ✅ Simple superficial lymphadenectomy
• ✅ Skin procedures
• ✅ Urological procedures

Discovery Health Medical Scheme Comprehensive Additional Benefits

     Assisted Reproductive Therapy (ART)

• ✅ Depending on age, the Scheme covers one or two annual ART cycles if you meet its benefit entry criteria.
• ✅ This benefit covers the following:
• ✅ Consultations
• ✅ Ultrasounds
• ✅ Oocyte retrieval
• ✅ Embryo transfer and freezing
• ✅ Lab fees
• ✅ Medicine
• ✅ Embryo and sperm storage
• ✅ This benefit covers egg donation cycles.
• ✅ Cryopreservation and egg and sperm storage for five years are available to Oncology Programme participants who meet clinical entry criteria.
• ✅ Discovery Health will pay 75% of the Discovery Health Rate up to R135,000 per person annually.

  You must pay up to 25% or any amount that exceeds the Discovery Health Rate (DHR).   Claims Relating to Traumatic Events

• ✅ Trauma Recovery Extender Benefit covers out-of-hospital trauma claims.
• ✅ The Trauma Recovery Extender Benefit pays claims for the rest of the year and the year after.
• ✅ For the year the trauma occurs and the year after, you and your dependents on your health plan can receive six counseling sessions per person per year from a psychologist, clinical social worker, or registered counselor.

  To qualify, members must apply for this benefit.    Africa Evacuation Cover

• ✅ Emergency medical evacuations from sub-Saharan African countries to South Africa are covered.
• ✅ Excludes pre-existing conditions.

International Travel Benefit

• ✅ While traveling outside South Africa, you are covered for emergency medical costs up to R5 million per person.
• ✅ The cover lasts 90 days after leaving South Africa.
• ✅ This benefit excludes pre-existing conditions.

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  Suppose the elective treatment is freely available in South Africa and covered by your plan. In that case, Discovery Health Medical Scheme might cover it at equivalent local costs.   International Second Opinion Services

• ✅ The Clinic by Cleveland Clinic provides second opinions for life-threatening and life-changing conditions through your specialist.
• ✅ Discovery Health will pay 75% for second opinions.

Spinal Care Programme

• ✅ Conservative spinal treatment out-of-hospital includes virtual and face-to-face consultations with an appropriately registered allied healthcare professional.

In-Room Procedures

• ✅ The cover is limited to specialist room procedures.
• ✅ Hospital Benefit covers up to the Scheme-authorized rate.

Specialized Medicine and Technology Benefits

• ✅ The Specialized Medicine and Technology Benefit covers specific new treatments.
• ✅ There is a limit of R200,000 per person per year.
• ✅ This benefit is subject to a 20% co-payment.

Advanced Illness Benefit

• ✅ Members receive comprehensive palliative care.
• ✅ This program covers unlimited home care, care coordination, counseling, and supportive care for appropriate end-of-life clinical and psychologist services.

  Your palliative care treatment plan includes GP consultations.  

Discovery Health Medical Scheme WHO Outbreak Benefit

👉 The basket of care includes the following:

• ✅ COVID-19 vaccines and their administration according to the COVID-19 guidelines of the National Department of Health.
• ✅ Screening consultations
• ✅ COVID-19 PCR and Rapid Antigen screening tests if referred by a qualified medical practitioner.
• ✅ A set of defined pathology tests for COVID-19-positive individuals.
• ✅ A predetermined assortment of x-rays and scans for COVID-19-positive individuals.
• ✅ Members at risk who meet the clinical entry criteria will receive supportive care, including medication and a home monitoring device to track oxygen saturation levels.

  When you are admitted to the hospital because of symptoms of COVID-19, you will be covered by the Hospital Benefit of the Classic Comprehensive and, if necessary, the PMBs.

Classic Comprehensive Value-Added Offers

• ✅ Healthy Care at Clicks or Dis-Chem offers discounts on personal and family products. Healthy Care includes baby care, dental care, eye care, foot care, sun care, hand care, first aid, and over-the-counter medicine.
• ✅ Your plan’s optometrists offer 20% off frames and lenses when you pay immediately.
• ✅ Expectant parents can cryogenically store their newborn baby’s umbilical cord blood and tissue stem cells at a discounted rate with Netcells’ exclusive offer.
• ✅ Vitality, the world’s leading science-based wellness program, rewards healthy living. As a result, Discovery Vitality members live longer and healthier lives.

    Discovery Health Medical Scheme collaborates with MyHealthTeam, a global leader in online patient communities. This gives members with diabetes, heart disease, and long-term COVID access to a digital community of patients to manage their conditions.  

Classic Comprehensive Exclusions and Waiting Periods

Exclusions include the following:

• ✅ Reconstructive surgical procedures and treatments, including cosmetic procedures and treatments.
• ✅ Otoplasty for bat ears, blepharoplasty, and port-wine stains (eyelid surgery).
• ✅ Breast reductions or augmentations and gynecomastia are considered cosmetic procedures.
• ✅ Obesity
• ✅ Frail care
• ✅ Abuse of alcohol, drugs, or solvents.
• ✅ Willful and significant infraction of the law.
• ✅ Willful participation in a war, a terrorist act, a riot, a civil disturbance, a revolt, or an uprising.
• ✅ Injuries incurred or medical care rendered during travel to or within a country at war.
• ✅ Experimental, unproven, or unregistered treatments or practices.
• ✅ Rescue and search.

  Unless included in Prescribed Minimum Benefits (PMBs) or Assisted Reproductive Therapy, infertility is not covered (ART) Benefit.   Discovery Health Medical Scheme's waiting periods are as follows:

• ✅ During your waiting periods, you will not have access to the Prescribed Minimum Benefits (PMBs) if you are subject to waiting periods due to never having belonged to a medical scheme or a break in membership of more than 90 days before joining Discovery Health Medical Scheme, including emergency admission cover.

  If you had less than a 90-day break in cover before enrolling in Discovery Health Medical Scheme, you might be eligible for Prescribed Minimum Benefits (PMBs) during waiting periods.  

Working to care for and protect you

What to do if you have a complaint

Their goal is to provide you with support when you need it most. They  hold your privacy in the highest regard. Their unwavering commitment to protecting your personal information and ensuring the security and confidentiality of your data is clearly outlined in their Privacy Statement.  

• To take your query further If you have already contacted Discovery Health Medical Scheme (DHMS) and feel that your query has still not been resolved, please complete our online complaints form on www.discovery.co.za. We would also love to hear from you if we have exceeded your expectations.
• To contact the Principal Officer If you are still not satisfied with the resolution of your complaint after following the process in the first step, you can escalate your complaint to the Principal Officer of the DHMS. You may lodge a query or complaint with the Scheme by completing the online form on www.discovery.co.za or by emailing [email protected].
• To lodge a dispute If you have received a final decision from DHMS and want to challenge it, you may lodge a formal dispute. You can find more information of the Scheme’s dispute process on www.discovery.co.za.
• To contact the Council for Medical Schemes DHMS is regulated by the Council for Medical Schemes. You may contact the Council at any stage of the complaints process. However, we encourage you to follow the steps above to resolve your complaint before contacting the Council.
• Contact details for the Council for Medical Schemes: Council for Medical Schemes Complaints Unit, Block A, Eco Glades 2 Office Park, 420 Witch-Hazel Avenue, Eco Park, Centurion 0157 | [email protected] | 0861 123 267 | www.medicalschemes.co.za

Classic Comprehensive Plans Compared

     

Our Verdict on Classic Comprehensive

The Classic Comprehensive plan offered by Discovery Health Medical Scheme is their most premium cover option, offering extensive benefits and generous cover. It includes extended coverage for oncology with a maximum cover of up to R500,000 for cancer and a medical savings account to cover day-to-day medical expenses.   The plan also provides extensive out-of-hospital coverage for procedures such as consultations, diagnostic tests, and medication. However, while the plan is also the most expensive option in their range, co-payments may apply for out-of-hospital procedures such as scopes and scans.   You might like to read more about The Discovery Health Medical Scheme Comprehensive Series plans:  

• 👉🏿 Classic Comprehensive
• 👉🏿 Classic Smart Comprehensive

Classic Comprehensive Frequently Asked Questions

What is the Classic Comprehensive medical aid plan?

The Classic Comprehensive plan is a premium medical aid plan offered by Discovery Health Medical Scheme, providing extensive benefits and cover for medical expenses.  

How much does the Classic Comprehensive plan cost?

The cost of the Classic Comprehensive plan varies based on individual circumstances such as age, health status, and chosen cover options. The main member starts at R10,037  ZAR. 

What oncology cover is included in the Classic Comprehensive plan?

The Classic Comprehensive plan offers extended coverage for oncology with a maximum coverage of up to R500,000 for cancer over a 12-month cycle. We pay in full. After you reach the limit, we pay 80% your costs, and this is no upper limit.  

Does the Classic Comprehensive plan have a medical savings account?

Yes, the Classic Comprehensive plan includes a generous medical savings account to cover day-to-day medical expenses.  

What out-of-hospital benefits are included in the Classic Comprehensive plan?

The Classic Comprehensive plan provides extensive out-of-hospital coverage for procedures such as consultations, diagnostic tests, and medication.  

Are any co-payments required for certain out-of-hospital procedures with the Classic Comprehensive plan?

Yes, co-payments may apply for certain out-of-hospital procedures such as scopes and scans.  

Can I choose my healthcare provider with the Classic Comprehensive plan?

Yes, you can choose your healthcare provider with the Classic Comprehensive plan, including any doctor or hospital registered with the scheme.  

What makes the Classic Comprehensive plan different from other medical aid plans?

The Classic Comprehensive plan is the most premium cover option in the Discovery Health Medical Scheme range, offering extensive benefits and cover for medical expenses.