Discovery Health Medical Aid
Overall, Discovery Health Medical Aid offers 7 healthcare plans namely Executive, Comprehensive, Priority, Saver, Keycare, Core, and Smart with 25 options starting from R1102 per month. Discovery Health Medical Aid has a trust score of 4.7 out of 5.
🔎 Medical Aid | 🥇 Discovery Health |
📌 Number of Markets | 40 |
👥 Number of Employees | 13,500 |
📊 GCR Rating | AAA |
📍 Number of plans | 25 |
🚑 Hospitals in Network | 150+ |
🏠 Home care | ✅ Yes |
Discovery Health Review – Analysis of Medical Aids’ Main Features
- ✅ Discovery Health At a Glance
- ✅ Discovery Health Regulation
- ✅ Discovery Health Plan Overview
- ✅ Discovery Health Advantages over Competitors
- ✅ Overview of Discovery Health Gap Cover
- ✅ Discovery Health Medical Savings Account
- ✅ How to apply for Medical Aid with Discovery Health
- ✅ How to Submit a Claim with Discovery Health
- ✅ How to Submit a Compliment or Complaint with Discovery Health
- ✅ How to switch my Medical Aid to Discovery Health
- ✅ Discovery Health Customer Support
- ✅ Discovery Health vs Momentum Health vs Bonitas Medical Fund – A Comparison
- ✅ Discovery Health Member Reviews
- ✅ Discovery Health – Our Verdict
- ✅ Discovery Health Pros and Cons
- ✅ Conclusion
- ✅ Discovery Health Frequently Asked Questions
Medical aid Discovery Health At a Glance
🔎 Medical Aid | 🥇 Discovery Health |
📌 Date Established | 1992 |
📍 Headquartered | Sandton, Johannesburg, South Africa |
✔️ Registration Number | Discovery Insurance Group – 1999/007789/06 |
👥 The average number of members | 3.3 million |
➡️ Number of Markets | 40 |
👤 Number of Employees | 13,500 |
📈 GCR Rating | AAA |
📉 Listed on the JSE | ✅ Yes |
📊 JSE Stock Symbol | JSE: DSY |
🔍 Recent Market Cap Reported | 85.3 billion ZAR |
💯 Average Customer Rating | 4.4/5 |
✒️ Average Number of Reviews | 20,000+ |
📌 Market Share | 56.7%+ |
📍 Number of Plans | 25 |
🚑 Number of Hospitals in Network | 150+ |
🏠 Home Care | ✅ Yes |
📱 Mobile App | ✅ Yes |
💻 Social Media Platforms and Links | ✅ Yes |
📖 Discovery Health Magazine for clients | ✅ Yes |
🖥️ Medical Claims Portal | ✅ Yes |
😷 Information Hub for COVID-19 | ✅ Yes |
⚕️ Chronic Illness Benefits | ✅ Yes |
📈 Number of PMB Diagnoses | 271+ |
📉 Number of PMB Chronic Conditions | 27+ |
🚩 Screening and Prevention offered | ✅ Yes |
👶 Maternity Benefit | ✅ Yes |
💵 Medical Aid Contribution Range (ZAR) | 1,102 ZAR – 10,303 ZAR |
⛔ Average Waiting Period | 3 to 12 months |
💳 Late-joiner penalties charged | ✅ Yes |
🌎 Is International Medical Cover offered | ✅ Yes |
📍 International Travel Benefit (ZAR) | Up to 5 million ZAR |
Discovery Health Regulation
The Council for Medical Schemes regulates Discovery Health Medical Scheme. The Council governs South Africa’s medical plan business for Medical Schemes (CMS), a regulating body set up under the Medical Schemes Act, No. 131 of 1998 (the Act). The CMS is responsible for a range of tasks related to the oversight of medical insurance plans, such as:
- ✅ Responsible for registering medical insurance plans and ensuring they comply with the law and other laws.
- ✅ Making sure healthcare plans have the money to pay claims.
- ✅ Examining and authorizing proposed price hikes for medical plans.
- ✅ Accepting and examining member complaints and initiating disciplinary action against medical plans that violate the Act or other applicable rules.
- ✅ Helping medical insurance plans follow the law and other laws.
Furthermore, if a medical scheme is found to violate the law, the CMS has the authority to issue administrative fines and penalties.
Discovery Health Plan Overview
Discovery Medical Aid Plans
🔎 Plan | 💴 Contributions Range (Main) ZAR | 💵 Contributions Range (+ Adult) ZAR | 💶 Contributions Range (+ Child) ZAR | 💷 Medical Savings (Up to) | 💴 Annual Threshold (ZAR) | 💵 Above Threshold (ZAR) | 📈 PMB Diagnosis | 📉 Chronic Conditions |
🥇 Executive Plan | 10,303 | 10,303 | 1,969 | R30,900 (Main)
R30,900 (+1 Adult)
R5,904 (+1 Child) | R35,230 (Main)
R35,230 (Adult)
R6,680 (Child) | Unlimited | 271 | 27 |
🥈 Comprehensive Series | 7,163 – 8,381 | 6,611 – 7,927 | 1,674 | R25,104 (Main)
R23,748 (+1 Adult)
R5,004 (+1 Child)
| R28,810 (Main)
R28,810 (Adult)
R5,500 (Child) | R35,000 (Main)
R35,000 (Adult)
R8,500 (Child) | 271 | 27 |
🥉 Priority Series | 4,531 – 5,272 | 3,562 – 4,158 | 1,809 – 2,108 | R15,792 (Main)
R12,456 (+1 Adult)
R6,312 (+1 Child)
| R22,890 (Main)
R17,210 (Adult)
R7,620 (Child) | R19,370 (Main)
R13,820 (Adult)
R6,770 (Child) | 271 | 27 |
🏅 Saver Series | 2,673 – 4,182 | 2,017 – 3,299 | 1,072 – 1,676 | R10,020 (Main)
R7,908 (+1 Adult)
R4,020 (+1 Child) | None | None | 271 | 27 |
📌 Core Series | 2,281 – 3,322 | 1,716 – 2,621 | 915 – 1,329 | No MSA | None | None | 271 | 27 |
📌 Smart Series | 1,565 – 2,627 | 1,565 – 2,073 | 1,049 – 1,881 | No MSA | None | None | 271 | 27 |
📌 Keycare Series | 1,102 – 3,354 | 1,102 – 3,354 | 336 – 897 | No MSA | None | None | 271 | 27 |
Read more about gap cover medical aid
Discovery Health Executive Plan
If you need significant medical coverage, the Executive Plan is for you. It provides unlimited hospitalization coverage at a facility of your choosing and 300% coverage of in-hospital specialist expenses.
Several diagnostic and therapeutic treatments, including specialist radiography and scopes, have co-payments. Claims are paid daily out of savings, with supplementary benefits applied after savings are depleted.
There are no limits on the number of times you may see a primary care physician or a specialist or have tests run, like a CAT scan or an MRI.
Discovery Health Comprehensive Series
The Comprehensive plans are ideal for families that need significant medical coverage since they include unlimited hospitalization. In addition, specialized radiology, scopes, and dental procedures have co-payments.
First, daily claims are covered by savings, then by a gap in self-payment, and finally by supplemental benefits.
General practitioner and specialist visits, pathology, radiography, radiographs, x-rays, routine dental exams, and MRI/CT scans are all covered without restriction. The Classic Smart Comprehensive Plan restricts your access to day-to-day benefits and relies on a hospital network.
Once the limit is reached, the plan risk is used to cover day-to-day claims.
Discovery Health Priority Series
The Priority series is ideal for families that need extensive medical coverage since it provides unlimited hospitalization. There is an extensive list of hospital services that incur co-payments.
First, daily claims are covered by savings, then by a gap in self-payment, and finally by a capped benefit handed out over a certain level.
Discovery Health Saver Series
Saver plans are ideal for new families since they provide unlimited hospital coverage. Specialized radiology, scopes, and dental procedures all have co-payments. In addition, money set aside for emergencies is used to cover regular expenses.
Discovery Health Core Series
The Core series is great for young, healthy people since it provides limitless hospital coverage. Specialized radiology, scopes, and dental procedures all have co-payments. However, the coverage provided by this policy is limited to hospitalization and not to regular claims.
These are mostly hospital plans with day-to-day coverage restricted to network GP consultations, acute and OTC medications, dental check-ups, eye exams, certain preventive care, and maternity benefits.
Both plans require you to pay a percentage of the bill for hospital care, with the Essential plan including more services and the Preferred plan leaving out more. Furthermore, some sports-related injuries are covered by the Classic plan as well.
There are deductibles and co-pays associated with all procedures.
These basic capitated network services are great for those with little financial resources. However, all hospital treatments are contingent on using in-network providers and according to in-network standards, and a lengthy list of restrictions apply in this context.
Discovery Health Advantages over Competitors
Discovery Health offers affordable plans for all budgets and health needs in 40 markets worldwide. Other main advantages include:
- ✅ Members can get cashback when they join Vitality, a science-based behavior change tool that tracks your progress toward a healthier you and rewards you with a premium suite of health, lifestyle, and leisure perks for your efforts.
- ✅ Discovery Health offers private healthcare coverage through hundreds of partners up to 200% on certain plans.
- ✅ Clients can get extensive coverage for in-hospital and day-to-day needs.
- ✅ There is extended chronic medicine, with over 271 diagnoses and 27 conditions.
- ✅ Certain plans have access to unlimited Above Threshold.
- ✅ Discovery Health can understand how to structure best every individual’s incentive to provide them with the best health outcome.
- ✅ Discovery Health provides 25 tailor-made plans and options to choose from.
- ✅ Discovery Health gives its customers access to several wellness and preventative avenues and incentives for maintaining a healthy lifestyle.
- ✅ For example, customers who use fitness trackers like Fitbit, Garmin, and Polar may get points by documenting their exercise routines.
Woolworths, British Airways, and Virgin Active are just a few of the many partners that address all aspects of a healthy lifestyle, from nutrition to fitness to travel.
READ More: Best Comprehensive Medical Aid Plans
Overview of Discovery Health Gap Cover
Discovery Health Gap coverage is a temporary insurance plan that gives additional protection to individuals who already receive medical assistance. Furthermore, with Discovery Health, members can expect access to the following:
- ☑️ In- and Out-of-Hospital Cover
- ☑️ Comprehensive Cancer Cover
- ☑️ Hassle-Free Payments
- ☑️ Extended Cover for Scans and Scopes
- ☑️ Affordable Premiums
- ☑️ International Travel Cover
- ☑️ Admission Extenders
You might also like to read more about Gap cover :
Discovery Health Medical Savings Account
Discovery Health offers a Medical Savings Account (MSA) on the Executive, Comprehensive (but not the Classic Smart Comprehensive), Priority, and Saver plans. The purpose of this savings account is for Discovery to pay day-to-day medical expenses, such as the following:
- ✅ Doctors’ Visits
- ✅ Specialist consultations
- ✅ Medicine (prescribed and over the counter), except for approved chronic medication
- ✅ Radiology and Pathology Accounts, and others.
Furthermore, Discovery Health’s Executive, Comprehensive, and Priority plans are subject to a Self-Payment Gap or SPG when they run out of savings. As a result, members must pay for healthcare expenses until they reach the Annual Threshold.
How to apply for Medical Aid with Discovery Health
Medical Aid Quote Discovery Health Medical Scheme process explained
To apply for Medical Aid through Discovery Health, you must:
- ✅ Visit the official Discovery website.
- ✅ Click on the “Medical Aid” Tab on the homepage.
- ✅ Click on “Get a Medical Aid Quote” to receive a tailor-made quote on one of Discovery’s 25 plans.
- ✅ Alternatively, click on “Our Medical Aid Plans” from the top bar, followed by “Compare Our Plans,” to view up to three side-by-side to help you decide.
- ✅ Once you have decided, click the “Join Now” banner to get started, and this will automatically redirect you to a screen where you can choose from “Get a quote in 60 seconds,” “Compare your medical aid,” or “Join now – I knew which plan I want.”
- ✅ Next, indicate who you want to cover by entering the number of members in the respective fields and clicking “Get Started.”
- ✅ Next, complete the online application and ensure that you provide details in all fields marked with *.
- ✅ Once your application is submitted, Discovery Health will contact you to finalize the application.
New Members 35 years or older may be subject to late-joiner penalties on Discovery Health Medical Aid Plans.
Get a Discovery Health Medical Aid quote from our Dedicated Medical Aid Specialists Broker
How to Submit a Claim with Discovery Health
Discovery makes it easy for members to submit a Medical Aid Claim by offering online portals on the official website and the mobile app. Members can submit a claim by:
- ✅ Scanning and uploading it on the website.
- ✅ Emailing a digital copy of the claim to [email protected]
Download and install the Discovery app from Google Play or the App Store, log in using your credentials and the scan option in-app to submit your claim. Furthermore, if your claim has a QR code, you can easily scan the code within the app and submit your claim.
How to Submit a Compliment or Complaint with Discovery Health
Compliments
Compliments about Discovery Health can be submitted directly to the scheme using the following:
- ✅ Telephone number
- ✅ The online “Get Help Service”
- ✅ The Ask Discovery Bot on WhatsApp
- ✅ Discovery Customer Support on WhatsApp
Furthermore, customers can leave compliments regarding Discovery Health on popular customer reviews sites and online services.
Complaints
Complaints about Discovery Health can be submitted directly to the scheme using the following:
- ✅ Telephone number
- ✅ The online “Get Help Service”
- ✅ The Ask Discovery Bot on WhatsApp
Finally, Discovery Customer Support is made available on WhatsApp.
How to switch my Medical Aid to Discovery Health
To switch from an existing medical aid to Discovery Health, you must notify your current medical aid scheme of your intentions to end cover. Once you have notified your current medical scheme of your intentions to end cover, you can apply to Discovery Health from the website or by calling them directly and following the application process.
Poll: Best Medical Aids in South Africa
Discovery Health Customer Support
Discovery Health Customer Support can be contracted from 7 am to 8 pm Monday to Friday and 8 am to 1 pm on Saturdays using the following communication channels:
- ✅ Call their customer service center at 0860 99 88 77.
- ✅ Email them at [email protected]
- ✅ Contact them through their website by filling out the online form at https://www.discovery.co.za/contact-us.
- ✅ Visit a Discovery Health Medical Scheme branch in person. You can find the location of a branch near you by using the branch locator tool on their website at https://www.discovery.co.za/branch-locator.
- ✅ Contact Discovery Health via WhatsApp or reach out to them through one of the social platforms on which the scheme is active.
- ✅ Discovery medical aid contact number for Emergency or medically equipped transport 0860 999 911
If you are a Discovery Health Medical Scheme member, you can contact them through the Discovery app or the member website.
Discovery medical aid contact number for service providers 0860 44 55 66 or email [email protected]
Discovery Health vs Momentum Health vs Bonitas Medical Fund – A Comparison
🔎 Medical Aid | 🥇 Discovery Health | 🥈 Momentum Health | 🥉 Bonitas Medical Fund |
📌 Years in Operation | 30 Years | 56 Years | 40 Years |
📍 Average # Members | 3.3 million | 290,000+ | 750,000+ |
📈 GCR Rating | AAA | AA | AA |
📉 Number of Employees | 13,500 | 1 | 150+ |
📊 Market Share | 56.7% | Unknown | Unknown |
📌 Market Coverage | 40 Markets | 6 | Unknown |
📍 Customer Rating | 4.4/5 | 4.2/5 | 4.9/5 |
📈 Number of reviews | 20,000+ | 10,000+ | 5,000+ |
📉 Mobile App | ✅ Yes | ✅ Yes | ✅ Yes |
📊 Contribution Range (ZAR) | 1,102 – 10,303 ZAR | 541 – 13,572 ZAR | 1,378 – 9,853 ZAR |
International Travel Benefit (ZAR) | Up to 5 million ZAR | Up to 10 million ZAR | Up to 10 million ZAR |
📌 Market Capitalization | 86.2 billion ZAR | 24.2 billion ZAR | – |
READ more about Discovery Health versus other Medical aid providers:
Discovery Health Member Reviews
Great Support.
Recently, I worked with a Discovery consultant, and she was quite helpful. I felt like I could trust her advice since I could see that she genuinely cared about my predicament and had extensive training in the subject matter. In addition, she had all the qualities of a successful doctor or psychiatrist, including empathy, compassion, and efficiency. Well done, Discovery, for selecting capable leaders such as her. – Adem Waters
Happy Customer.
I have been with you for an exceedingly long time, and I agree with most of your other customers that you do an excellent job of paying claims and providing excellent service. – Lily-Mae Baker
Top Choice.
The agent I spoke with today blew me away; he was kind, sympathetic, and skilled. He probed me in the correct places, which led to a quick answer to my inquiry. – Pauline McClain
Discovery Health – Our Verdict.
Discovery Health is still noticeably young compared to other popular medical aid schemes. However, in the past 30 years, Discovery has shown immense innovation in providing tailor-made products and services to its over 3 million members. Furthermore, Discovery Health Medical Scheme offers some of the most flexible options that suit any budget, and the medical coverage members can expect to receive is amazing.
Furthermore, there are travel benefits of up to 5 million ZAR and a large hospital network of over 150 facilities.
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Discovery Health Pros and Cons
✅ Pros | ❎ Cons |
Discovery Health provides a range of health coverage plans to accommodate a variety of budgets and demands | Premiums for Discovery Health’s plans, especially for more extensive plans, might be too high for certain individuals |
You may use Discovery Health’s extensive network of healthcare professionals when you need medical assistance | Discovery Health’s plans have limits and limitations, as do other medical insurance policies |
Some of the medical insurance plans provided by Discovery Health include coverage for chronic diseases, hospitalization, and emergency medical evacuation | Some individuals may find filing a claim to Discovery Health to be difficult or time-consuming |
Conclusion
Overall, Discovery provides extensive benefits with the Core and Comprehensive Gap cover and provides an innovative mobile app and portal for Android and iOS devices. Furthermore, Discovery Vitality is ideal for helping customers lead healthier lifestyles while they are rewarded for such.
You might like: 5 Best Medical Aids with No Late Joiner Penalty
Discovery Health Frequently Asked Questions
What types of medical insurance plans can I choose from with Discovery Health?
Discovery Health provides a variety of medical insurance policies, including hospital plans, comprehensive medical insurance plans, and chronic condition plans.
Can I use any healthcare provider with a Discovery Health plan?
No, you can only use healthcare professionals affiliated with Discovery Health. Before enrolling in a Discovery Health plan, verifying that your desired healthcare provider is in the network is essential.
Does Discovery Health cover pre-existing conditions?
This depends on your unique Discovery Health plan. Some plans can provide coverage for pre-existing conditions, while others do not. Therefore, reading and comprehending your plan’s terms and conditions is essential to know what is covered.
How can I file a claim with Discovery Health?
To submit a claim to Discovery Health, you must submit all supporting paperwork, such as medical bills and receipts. Claim submissions can be made online or through the Discovery mobile app for Android and iOS.
How long will Discovery Health take to process my claim?
Discovery Health’s processing time for claims varies based on the claim’s complexity and the attached documents. To guarantee fast processing, filing a claim as soon as possible after receiving medical care is suggested.
How to Downgrade my Plan with Discovery Health?
Members can downgrade their plan selection at any moment within their current medical plan by Logging into the official Discovery website and clicking on “Medical Aid” from the top toolbar on the homepage. Click on “Medical Aid” and “Manage Your Health Plan.” Next, click the option to “Change Your Health Plan” from the options provided.
How do I add a Beneficiary to Discovery Health?
If you want to add a child or adult dependent, you can log into your Discovery profile and Click on “Medical Aid” and “Manage Your Health Plan” from the list of options.
What is the best plan for Discovery?
The Executive Plan provides the most comprehensive cover for in-hospital and out-of-hospital benefits, extended chronic medicine coverage, and an unlimited Above Threshold Benefit. The in-hospital and day-to-day cover is comprehensive, with extended chronic medicine coverage and an unlimited Above Threshold Benefit.
How do I talk to a Discovery Health consultant?
You can call Discovery Health on 0860 99 88 77 to speak to a consultant.
How do I do an online Discovery Consultation?
You can log into the website or mobile app and request an online consultation through your profile.
Does Discovery Medical aid have a WhatsApp number?
Yes, you can reach “Ask Discovery” via WhatsApp at 0860 756 756.
Can my friend use my medical aid?
No, you should note that using another person’s medical aid card, with or without their consent or knowledge, is fraudulent. This practice will report such instances to the relevant medical aid to avoid being perceived as complicit in the fraud.
Can I use my Discovery Medical Aid at Dischem?
Yes, you can access Vitality rewards when you swipe your Dis-Chem Benefit card when purchasing from Disc-Chem pharmacies across South Africa.
Can I put my girlfriend on my Discovery Medical Aid?
Yes. If your boyfriend or girlfriend resides with you, you can add them as an adult dependent to your medical insurance, just as you would if they were your spouse.
What is the best medical aid in SA?
Discovery Health Medical Scheme is a highly regarded medical aid provider in South Africa. Its comprehensive offerings provide its members with complete reassurance and security for their healthcare needs. With 25 distinct health plan options, you can select the plan that best fits your individual health and financial requirements.
What is the biggest medical aid in South Africa?
Discovery Health Medical Scheme is a leader in South Africa’s medical aid industry, with over 1.3 million members and 2.7 million beneficiaries. Despite the overall decline of beneficiaries in open schemes in South Africa, Discovery Health maintained its position, losing only 106 beneficiaries. These metrics showcase members’ strong commitment and trust in the services and benefits provided by Discovery Health Medical Scheme.
Does Discovery pay for emergency room visits?
Yes. Regardless of whether you are hospitalized, Discovery Health will cover your Hospital Benefit expenses. In the event of an emergency, any private hospital is accessible. Furthermore, Discovery Health will cover the cost of your hospital admission if it is an emergency, and there is no overall hospital coverage cap on your health plan.
Does Discovery pay for implants?
Yes. The approved Basic Dental Trauma Benefit coverage for dental appliances (implants), prostheses, and placement is subject to an annual maximum of R58 000 per person. Furthermore, coverage under the Basic Dental Trauma Benefit does not affect your regular benefits.
Does Discovery pay for depression?
Together with your Premier Plus general practitioner, the Mental Health Care Programme will assist you in actively managing major depression. In addition, this care program gives you and your Premier Plus general practitioner access to tools and benefits for monitoring and managing your condition to ensure that you receive high-quality, coordinated care.
Can I withdraw my Discovery Medical Savings?
These savings cannot be withdrawn in cash unless you leave the scheme (see below). Only if you leave the scheme can you use your savings to offset any amounts you owe the scheme, such as contributions.
What can I use my Discovery Medical Savings for?
Discovery Health will pay your day-to-day medical expenses, such as GP and specialist consultations and medicine, excluding registered and approved chronic medicine, radiology, and pathology, from your Medical Savings Account (MSA). In addition, unused funds will be carried over to the following year.
What happens to Discovery Medical Aid Savings at the end of the year?
Any remaining balance in the Medical Savings Account at the end of the year is carried over to the following year. If you leave the Scheme or downgrade your health plan before the end of the year, you might owe the Scheme the portion of your Medical Savings Account that you have used but not yet reimbursed.
How do you use day-to-day extender benefits from Discovery Health?
This payment is repaid in equal instalments as part of your monthly contribution. Discovery will pay your day-to-day medical expenses, such as GP and specialist visits, acute medicine, imaging, and pathology, using cash from your MSA. Any unused monies will be carried over to the following year.
How do I check my Discovery Medical Aid Savings?
You can check your Discovery Medical Aid Savings on the Discovery app or website. Alternatively, you can contact Discovery Health via the website (chatbot) or the email address or telephone number provided.
Does Discovery Medical Aid give cash back to members?
Through your Discovery Life Plan, you could earn additional cash rewards with the Double PayBack Benefit. This returns up to 100% of your premiums in cash. With Discovery Life, living a healthy lifestyle pays off.
How does the Discovery Day-to-day Extender Benefit (DEB) work?
The DEB pays for certain benefits after the MSA funds have been depleted.
This includes video call consultations with network GPs, pharmacy clinic consultations, and unlimited face-to-face consultations with network GPs referred following a video call consultation or by the pharmacy clinic virtual GP.
The DEB covers face-to-face consultations up to the Discovery Health Rate (DHR).
The Day-to-day Extender Benefit (DEB) also pays for certain benefits after depleting the MSA funds.