Overall, the Classic Smart Comprehensive Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and access to a wellness program for its Family Members. The Discovery Health Medical Scheme Classic Smart Comprehensive Medical Aid Plan starts from R7,945 ZAR.
| 👤 Main Member Contribution | R7,945 |
| 👥 Adult Dependent Contribution | R7,337 |
| 🍼 Child Dependent Contribution | R1,885 |
| 🔁 Gap Cover | ✅ Yes |
| 📊 Above Threshold Benefit (ATB) | ✅ Yes |
| 💶 Medical Savings Account | None |
| 💵 Oncology Cover | R375,000 |
| 💷 Prescribed Minimum Benefits | ✅ Yes |
| 😷 Screening and Prevention | ✅ Yes |
| 🏠 Home Care | ✅ Yes |
💙 The Discovery Health Medical Scheme Classic Smart Comprehensive starts from R7,945. It is part of a series of comprehensive medical scheme plans offered by Discovery Health Medical Scheme.
💙 The Classic Smart Comprehensive plan is a good option for those who want comprehensive coverage and are willing to pay higher contributions.
The Discovery Health Medical Scheme Comprehensive Series includes the following plans:
💙 It should be noted that all Discovery Health Medical Scheme Comprehensive Series plans may be subject to a late joiner fee.
💙 The plan offers excellent benefits, including comprehensive in and out-of-hospital cover and wellness and prevention programs. Gap Cover is available on the Classic Smart 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.
👉🏾 Download the comprehensive-plan-guide-2025 from Discovery Health Medical Scheme.
| 👤 Main Member | 👥 +1 Adult Dependent | 🍼 +1 Child Dependent |
| R7,945 | R7,337 | R1,855 |
| 👤 Main Member | 👥 +1 Adult Dependent | 🍼 +1 Child Dependent |
| R32,250 | R32,250 | R6,160 |
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| ✅ Day-to-Day Cover | – |
| 🟥 Medical Savings Account (MSA) | 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). If your MSA is set to pay at cost, the R70 co-payment will be paid from the available money allocated to the MSA. They pay for video consultations in full, up to the DHR. Once you reach the Annual Threshold, they pay your claims from the available money in your limited Above Threshold Benefit |
| 🟧 Day-to-Day Extender Benefit (DEB) | This benefit is not available on the Classic Smart Comprehensive Plan |
| 🟨 MRI and CT scans | They pay up to the The Discovery Health Rate (DHR) if the scan is related to your current and approved hospital admission from your Hospital Benefit. If the scan is not related to your admission or is for conservative back and neck treatment, they pay the first R3,850 from your available day-to-day benefits and the rest from your Hospital Benefit, up to the DHR. For conservative back and neck scans, cover is limited to one scan per spinal and neck region. |
| ✅ Additional Chronic Cover | – |
| 🟦 Specialized Medicine and Technology Benefit | The Specialized Medicine and Technology Benefit covers the latest treatments up to R200,000 per person annually. |
| 🟪 Medicine Cover – Additional Disease List (ADL) | The Additional Disease List covers medicine for life-threatening or degenerative conditions (ADL) |
| ✅ Cancer Cover | – |
| 🟪 Oncology Benefit | Discovery Health covers the first R375,000 of your approved cancer treatment over 12 months. Discovery Health will cover 80% of additional costs without limit. |
| 🟥 Oncology Innovation Benefit | You have cover for a sub-set of innovative cancer medicine (on our defined list) that meet the Scheme’s criteria. You will need to pay 50% of the account |
| ✅ Hospital Cover | – |
| 🟧 Hospitals you could go to | Private Smart Hospital Network hospitals |
| 🟨 Where there is a defined list of procedures that can be done in a Day Surgery Network | Private Smart Day Surgery Network facility. |
| 🟦 Cover for Specialists, GPs, and other Healthcare Providers/Professionals | Paid up to 200% of the DHR |
💙 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:
💙 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:
💙 To qualify for coverage, your medical condition must be on the Prescribed Minimum Benefit (PMB) conditions list. 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 Medical Scheme 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 Medical Scheme 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 unmet.
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💙 This benefit covers certain diagnostic procedures that detect early warning signs of serious diseases. The Discovery Health Medical Scheme 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.
💙 The Discovery Health Screening and Prevention covers the following:
💙 Screening for Seniors (65>) includes risk screening assessments and referrals to Premier Plus GPs according to the screening results.
💙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.
💙 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.
💙 You can access your personalized health pathway through the Discovery Health app making it easy for you to seamlessly navigate
the healthcare system and to know what will have the biggest impact on your health.
💙 Completing these health and exercise actions will not just have a positive impact on your health but you can get rewarded along the way. You don’t have to be a Discovery Vitality member to access these rewards.
💙 You can also unlock additional healthcare benefits when you complete your health and exercise next best actions.
💙 The Personal Health Fund is a new category of healthcare funding which you can accumulate as you engage in your Personal Health Pathway
and complete your next best health actions. The fund can be used for day-to-day medical expenses.
💙 Following the success of the WELLTH Fund in 2023 and 2024, all new joining members will continue to get a once-per-lifetime benefit, built into the Personal Health Fund in 2025.
💙 You will accumulate additional value in your annual Personal Health Fund by completing your next best actions indicated on Personal Health Pathways. The amount available in additional day-to-day funding is defined by your membership.
💙 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
👉 Step2
👉 Step3
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💙 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.
| ❤️ Health Monitoring Devices | Access to the most up-to-date medical examination, remote monitoring, and point-of-care devices to facilitate the delivery of quality care at home. |
| 🧡 Electronic Prescriptions | Electronic prescribing for expedited access to medications. |
| 💛 Home Nurses | Hospital-related care is provided at home by registered nurses. |
| 💚 Medicine Ordering and Tracking | Order and track the delivery of your medication from the dispensary to your door. |
| 💙 Online Coaches | At-home consultations with a coach to help you better manage your chronic and acute conditions, including COVID-19. |
| 💜 Condition-Specific Information | Educational content pertinent to your condition is readily accessible. |
💙 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 Medical Scheme will use your Hospital Benefit to cover any services provided as part of the 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 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.
💙 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.
💙 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)
💙 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)
💙 On Classic plans, children under 10 are eligible for two visits yearly.
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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:
💙 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).
| ☀️ Day-to-Day Benefits | How Members of this plan are covered |
| 👩⚕️ Unlimited GP Consultations within the Smart GP network | You have access to unlimited GP consultations in the Smart GP Network. You will have to pay the first R70. We will pay the rest of the consultation fee, up to the DHR. They cover video consultations with a Smart Network GP in full, up to the DHR. Once you reach the Annual Threshold, we pay your claims from the available money in the limited Above Threshold Benefit. |
| 👨⚕️ Specialists who we have a payment arrangement with | They pay up to the rate that we have agreed on with the specialist |
| 👁️ Eye tests at an optometrist within the Smart Optometry Network | (This limit covers lenses, frames, contact lenses and surgery or any healthcare service to correct refractive errors of the eye.) R7,250 per person |
| 🦷 Defined dental check-ups at any dentist, dental therapist, or an oral hygienist | R36,150 per person |
| 💊 Over-the-counter medicine, childhood vaccines,immunisation and lifestyle-enhancing products | They pay these claims from the available money in your MSA. These claims do not add up to the Annual Threshold and are not paid from the limited ATB. |
| 💉 Acute Medicine obtained from a pharmacy within the MedXpress Network | Network Pharmacy covers acute medicine categories, subject to the annual prescribed medicine limit. |
| 🏈 Sports injuries, when activated and referred by a Smart Network GP | Basic x-rays, two specialist visits, four physiotherapists, biokinetics, or chiropractor visits for sports injuries are covered if activated and referred by your Smart Network GP. These visits and specialists with whom Discovery Health does not have a payment arrangement will be covered by the DHR. The annual Allied, therapeutic, and psychology healthcare services limit applies. |
💙 With the Discovery Health Medical Scheme Classic Smart Comprehensive Plan, 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:
During Pregnancy:
💙 Discovery Health Medical Scheme will cover predetermined blood tests to confirm your pregnancy.
After giving birth, Discovery Health covers the following:
💙 Postnatal care, including complications during delivery, nutritional assessment, etc.
Discovery Health prenatal and postnatal care includes:
💙 The Chronic Disease List lists 27 conditions for which the Chronic Illness Benefit (CIB) provides cover (CDL). In addition, on Classic Smart 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.
| 1️⃣ Prescribed Minimum Benefit (PMB) Conditions | Under the Prescribed Minimum Benefits, you can receive treatment for a set of medical conditions (PMBs). The PMBs cover the 27 chronic conditions in the Chronic Disease List (CDL). |
| 2️⃣ Medicine Cover for the Chronic Disease List | You have cover for all chronic medications on the Scheme’s approved list. Discovery Health will cover you up to the Chronic Drug Amount (CDA) monthly maximum for medications that are not on the Scheme’s list. |
| 3️⃣ Medicine Cover for Additional Diseases List (ADL) | Discovery Health provides cover for additional disease list medications (ADL). You are covered for medications up to the monthly CDA. No drug list is applicable. |
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💙 They cover you in full for approved chronic medicine on our medicine list (formulary). For medicine that is not on our list, we cover you up to the
generic Reference Price, where a generic alternative exists, up to a set
monthly rand amount. This amount is called the Chronic Drug Amount (CDA).
💙 Medicine cover for the Additional Disease List is not available on the Smart Comprehensive plan.
💙 They pay up to a maximum of the Discovery Health Rate (DHR) for
medicine that you buy from one of their network pharmacies. The DHR for
medicine is the price of the medicine and the fee for dispensing it.
| 🅰️ Plan | 📌 Designated Service Provider (DSP) |
| 🅱️ Classic Smart Comprehensive | Any given pharmacy in the Discovery network (more than 2,500 pharmacies) |
💙On the Comprehensive plans, you can buy your medicine from any pharmacy in Discovery pharmacy network. There are over 2,500
pharmacies to choose from
Medicine Tracker
💙 You can set reminders and prompts to help you take your medication as prescribed and on time. For example, your approved chronic medication will be displayed automatically. You will be prompted to take your medication and confirm each dose.
💙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.
| 🔴 Discovery Health Disease Prevention Programme | Comprehensive Premier Plus GPs can enroll you in the Disease Prevention Programme if you have cardiometabolic risk syndrome. GPs, dietitians, and health coaches coordinate care. Consultations, pathology tests, and medicine are covered for enrolled members. Health coaching will help you manage your condition daily. |
| 🟠 Discovery Health Mental Health Care Programme | Once enrolled by your network psychologist or Comprehensive Premier Plus GP, you have defined major depression cover. The program provides medication coverage, virtual and in-person psychotherapy, and additional GP visits for treatment evaluation, tracking, and monitoring. Relapse prevention programs cover psychiatry consultations, counseling, and care coordination for qualifying members. |
| 🟡 Discovery Health Diabetes Care Programme | Your Comprehensive Premier Plus GP can enroll you in the Diabetes Care Programme if you receive the Chronic Illness Benefit (CIB) for diabetes. The program covers extra glucometer strips and dietitian and biokinetics visits. A nurse educator can help you manage your condition. |
| 🟢 Discovery Health HIV Care Programme | Your Comprehensive Premier Plus GP registers you on the HIV program, which includes social worker cover. Confidentiality is guaranteed. Avoid a 20% co-payment by getting your medicine from a DSP. |
| 🟣 Discovery Health Cardio Care Programme | If referred by your Comprehensive Premier Plus GP and enrolled in the Cardio Care Programme, you can receive a defined basket of care and an annual cardiovascular assessment for hypertension, hyperlipidemia, or ischemic heart disease on the Chronic Illness Benefit (CIB). |
💙 You have access to comprehensive cancer treatment coverage. This includes access to expensive medications, innovative treatments, and extended coverage once certain thresholds are reached.
| 🔴 Discovery Health Prescribed Minimum Benefits (PMB) | PMB cancer treatment is always covered. PMB treatment costs total the cover. Discovery Health will fully cover PMB cancer treatment if it exceeds the cover amount. |
| 🟠 Discovery Health Oncology Benefit | After Discovery Health approves your cancer treatment, the Oncology Care Programme covers you. Discovery Health will cover approved cancer treatment for 12 months. Classic Smart Comprehensive covers the first R375,000. Discovery Health will cover up to 80% of the additional costs if your treatment exceeds the cover amount unless the Oncology Innovation and Extended Oncology Benefit cover it. Discovery Health Rate covers 100% of cancer-related healthcare services (DHR). If your doctor charges more, you may have a co-payment. |
| 🟡 Discovery Health Oncology Innovation Benefit | The Scheme covers a list of innovative cancer drugs. Members must cover these treatments up to 25%. |
| 🟢 Discovery Health – Covering Medicine | To avoid a 20% co-payment, get your approved oncology medicine from a DSP on the Scheme’s medicine list. Ask your doctor if they use the Scheme’s DSPs for your in-room or facility treatment. |
| 🔵 Discovery Health 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. |
💙 The Classic Smart Comprehensive includes hospitalization coverage. Furthermore, there is no limit on the total amount covered by Hospital Benefits.
💙 Discovery Health Medical Scheme pays up to 200% of the Discovery Health Rate (DHR).
Pre-operative Management Programme for major surgeries:
Clinical entry and treatment guidelines govern cover.
The following table summarizes how Discovery Health Medical Scheme pays for approved hospital admissions within the Classic Smart Comprehensive.
Healthcare Providers and Services
| 🟥 The Hospital Account | Discovery pay the full account, at the rate agreed on with the hospital. They pay up to R2,700 per day in a private ward from the Maternity Benefit for deliveries. On Classic Smart Comprehensive, you must pay an upfront amount of R12,200 for planned admissions to hospitals that are not in the Smart Hospital Network. |
| 🟧 Upfront Payment for a defined list of procedures that are performed outside the Day Surgery Network | You will have to pay an upfront payment of R12,200. |
| 🟨 A defined list of procedures that are performed in a specialist’s room | Paid according to the agreed rate where authorized by Discovery Health |
| 🟩 Specialist with whom Discovery Health has an arrangement | The full account is covered according to the agreed rate |
| 🟦 Specialists with whom Discovery Health does not have an arrangement | Covered up to 200% of the DHR. |
| 🟪 Radiology and Pathology | Covered up to 100% of the DHR |
| ⬛ MRI and CT scans | Up to the Discovery Health Rate (DHR) if the scan is associated with your current, approved hospital admission under your Hospital Benefit. If the dental treatment is unrelated to hospitalization or for conservative back and neck treatment, Discovery Health will first cover the first R3,850 from the available day-to-day benefits, and then the remaining cost will be covered by the Hospital Benefit, up to the Discovery Health Rate (DHR). A maximum of one scan per spinal and cervical region applies to conservative back and neck scans. If your MRI or CT scan is unrelated to your hospital admission, you are responsible for the first R3,470 up to your Annual Deductible. |
| 🟨 Cataract Surgery at a network provider | Discovery pay the full account at the agreed rate at a network facility for cataract surgery. Discovery pay the hospital account at up to 80% of the Discovery Health Rate at any other facility. |
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.
| 🔎 Discovery Plan | 🅰️ Day Clinic Account | 🅱️ Hospital Account |
| 🟥 Classic Smart Comprehensive | R4,500 | This co-payment will be reduced from R6,550 to R5,250 if performed by a doctor in the Scheme’s value-based network. |
| 🟧 If a gastroscopy and colonoscopy are performed during the same admission | – | – |
| 🟨 Classic Smart Comprehensive | R5,500 | This co-payment will be reduced from R8,100 to R6,600 if performed by a doctor in the Scheme’s value-based network. |
💙 Furthermore, the following will apply to the scopes of Classic Smart Comprehensive:
💙 If scopes are performed in the doctor’s office as part of a confirmed Prescribed Minimum Benefits (PMB) condition or if the patient is under 12 years old, no upfront payment is required. Furthermore, the Hospital Benefit covers the bill.
| 🦻 Cochlear Implants, Auditory Brain Implants, and processors | R244,000 per person per benefit |
| ⚕️ Internal Nerve Stimulators | R185,550 per person. |
| 📌 Major Joint Surgery | If you use a provider in our network, you will not have a limit for planned hip and knee joint replacements. We pay up to 80% of the Discovery Health Rate (DHR) if you use a provider outside our network, to a maximum of R30,900 for each prosthesis, for each admission. The network does not apply to emergency or trauma-related surgeries. |
| 📍 Shoulder Joint Surgery | If you get your prosthesis from a provider in our network, there is no limit. DHMS pay up to R45,550 if you use a provider outside our network. |
| 💊 Alcohol and Drug Rehabilitation | They pay for 21 days of rehabilitation for each person each year. For detoxification, we cover for three days per approved admission, per person. |
| 🧠 Mental health | They cover the following: 21 days of admissions or up to 15 out-of-hospital consultations per person for major affective disorders, anorexia and bulimia. Up to 12 out-of-hospital consultations for acute stress disorder that is accompanied by recent significant trauma 3 days (per approved admission) for attempted suicide 21 days for all other mental health admissions. All mental health admissions are covered in full at a network facility. If you go somewhere else, we will pay up to 80% of the DHR for the hospital account. |
| 🦾 Prosthetic Devices used during Spinal Surgery | There is no overall limit if you get your prosthesis from oneof our preferred suppliers. If you do not use a preferred supplier, a limit of R26,200 applies for the first spinal level, and a limit of R52,400 applies for two or more levels. This benefit is limited to one procedure per person per year. We cover you in full for approved spinal surgery admissions if you use a provider in our spinal surgery network. They will pay up to 80% of the DHR for your hospital account if you have a planned admission outside our network. You also have cover for out-of-hospital conservative spinal treatment. |
| 🦷 Dental limit | There is no overall limit for basic dental treatment. They pay 100% of the Discovery Health Rate (DHR) for alldental appliances and prostheses, the placement of dental appliances and prostheses, and orthodontic treatment. For orthodontic treatment, we also pay the related accounts for orthognathic surgery. For anaesthetists, we pay up to 200% of the DHR. We cover these claims from your day-to-day benefits, up to a yearly limit of R36,150 per person or up to the Above Threshold Benefit limit – whichever one you reach first. If you join the Scheme after January, you will not receive the full limit, as we will calculate the benefit limit based on the number of months remaining in the year. |
💙 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 will have a payment arrangement. Discovery Health Medical Scheme will cover the full cost of these services.
💙 Furthermore, go to a facility not part of the Day Surgery Network. You must pay the following amounts upfront:
| 🟥 Discovery Plan | 🟧 Day Surgery Network for Your Plan | 🟨 Out-of-Network Upfront Payment |
| 🟩 Classic Smart Comprehensive | Day Surgery Network | R12,200 |
Assisted Reproductive Therapy (ART)
You must pay up to 25% or any amount that exceeds the Discovery Health Rate (DHR).
Claims Relating to Traumatic Events
To qualify, members must apply for this benefit.
Africa Evacuation Cover
International Travel Benefit
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
Spinal Care Programme
In-Room Procedures
Specialized Medicine and Technology Benefits
This benefit is subject to a 20% co-payment.
Advanced Illness Benefit
💙 Furthermore, Your palliative care treatment plan includes GP consultations.
💙 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.
Exclusions include the following:
💙 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:
💙 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.
💙 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.
| 🔎 Medical Aid Plan | 🥇 Discovery Health Classic Smart Comprehensive 2025 | 🥈 CompCare SYMMETRY 2025 | 🥉 Sasolmed Comprehensive 2025 |
| 👤 Main Member Contribution | R7,945 | R5,238 | R3,760 – R27,880 |
| 👥 Adult Dependent Contribution | R7,337 | R4,084 | R3,760 – R27,880 |
| 🍼 Child Dependent Contribution | R1,855 | R1,487 | R3,760 – R27,880 |
| 🔁 Gap Cover | ✅ Yes | None | ✅ Yes |
| 💴 Prescribed Minimum Benefits (PMB) | ✅ Yes | ✅ Yes | ✅ Yes |
| 😷 Screening and Prevention | ✅ Yes | ✅ Yes | ✅ Yes |
| ❤️ Medical Savings Account | None | ✅ Yes | None |
| 🥰 Maternity Benefits | ✅ Yes | ✅ Yes | ✅ Yes |
| 🏠 Home Care | ✅ Yes | ✅ Yes | None |
💙 The Classic Smart Comprehensive plan offered by Discovery Health Medical Scheme provides comprehensive in and out-of-hospital cover, with added benefits of wellness and prevention programs.
💙This plan is designed to be affordable while providing members with excellent benefits. As a result, the plan is ideal for those who want comprehensive coverage without paying high premiums. However, the Classic Smart Comprehensive plan does have some drawbacks.
💙 One of the main drawbacks is that it has higher co-payments than any other Comprehensive plan offered by Discovery Health Medical Scheme.
You might consider one of the following plans of The Discovery Health Comprehensive Series:
The Classic Smart Comprehensive plan is a medical aid plan offered by Discovery Health Medical Scheme that provides comprehensive in and out-of-hospital cover, wellness, and prevention programs, and affordable premiums.
The plan offers comprehensive in and out-of-hospital cover, wellness, and prevention programs, and affordable premiums compared to other Comprehensive plans. It is ideal for those who want comprehensive coverage without paying high premiums.
The Classic Smart Comprehensive starts from R7,945 per main member, R7,337 per adult, and R1,855 per child dependent.
Yes, the plan covers 27 chronic conditions and an additional 22 chronic conditions on top of the standard list.
Yes, the plan covers maternity benefits, including antenatal care, childbirth, and postnatal care.
Yes, the plan covers COVID-19 treatment, including hospitalization and related medical expenses.
Yes, the plan is subject to a network of providers, and co-payments apply for certain treatments and procedures.
The plan is subject to a network of providers. However, members can use providers outside the network for certain treatments and procedures, subject to co-payments.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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