Discovery Health vs Medihelp
Discovery Health Medical Scheme versus Medihelp compared and revealed.
We tested them side by side and verified their medical aid plans benefits, affordability, and much more.
This is a complete guide to Discovery Health and Medihelp in South Africa.
In this in-depth guide you’ll learn:
- What is a Medical Scheme?
- Why do you need medical aid?
- Are medical schemes expensive in South Africa?
- How to compare medical aids against each other?
- Which should you choose: Discovery Health or Medihelp?
So if you’re ready to go “all in” with Discovery Health versus Medihelp in South Africa, this guide is for you.
Let’s dive right in…
Discovery Health vs Medihelp Summary
Overall Comparison
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Medihelp |
| General comparison | 5/5 | 5/5 |
| Number of plans | 7 | 9 |
| Lowest premium | R1 102.00 (KeyCare Series) | R894.00 (MedElect Student) |
| Highest premium | R10 303.00 (Executive Plan) | R12 792.00 (MedPlus) |
| Student Plan | No | Yes |
| Gap Cover | Yes | Yes with another provider |
| Hospital plans | Yes | Yes |
| Maternity benefits | Yes | Yes |
| Number of members | 3.3 million | 200 000+ |
Plan benefits
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Medihelp |
| Name of Plan | • Executive Plan • Comprehensive Series • Priority Series • Saver Series • Core Series • Smart Series • KeyCare Series | • MedElect Student • MedMove! • MedVital! • MedAdd • MedSaver • MedElect • MedPrime • MedElite • MedPlus |
| Price per plan | • Executive Plan: R10,303 • Comprehensive Series: R7,163 • Priority Series: R4,531 • Saver Series: R2,673 • Core Series: R2,281 • Smart Series: R1,565 • KeyCare Series: R1,102 | • MedElect Student: R894.00 • MedMove!: R1 476.00 • MedVital: R2 598.00 • MedAdd: R3 354.00 • MedSaver: R3 516.00 • MedElect: R2 820.00 • MedPrime: R4 782.00 • MedElite: R7 368.00 • MedPlus: R12 792.00 |
| GP Visits | Network only | Network and Non Network |
| GP in room visits | Network only | Network and Non Network |
| Specialist visits | Yes (in and out of hospital) | Yes |
| Acute medication | Yes | Yes |
| Chronic medication | Yes | Yes |
| Basic pathology | Yes, up to Discovery Health Rate | Yes |
| Basic and emergency dentistry | Basic only | Yes and differs from plan to plan |
| Basic optometry | Yes, 100% of Discovery Health Rate | Yes, with exception of the Student plan |
| HIV benefit | Yes | Yes |
| Maternity benefit | Yes | Yes |
| Road accident claims | Yes, full cover | Will give assistance |
Discovery Health vs Medihelp
Both Discovery Health and Medihelp are well-known medical aid names that provide a comprehensive selection of tailored plans. Here, we compare in these two medical aid schemes to help you decide on the best option for your healthcare needs in 2024.
Which offers more affordable cover – Discovery Health or Medihelp?
Although Medihelp offers the lowest premium on its MedElect Student plan, Discovery Health also offers affordable plans. Overall, both Discovery Health and Medihelp offers a good selection of affordable medical aid plans designed for singles, families, and pensioners.
Do both schemes offer gap cover?
Gap insurance is a short-term insurance policy that offers shortfall coverage when doctors and specialists charge fees that exceed the medical aid rates of cover. Gap insurance works in conjunction with your medical insurance.
The gap cover provider will compensate you for a portion of the difference between your medical bills and what your medical insurance would cover in exchange for a monthly premium. If you use a healthcare provider who is not part of your medical plan’s network, you may end up paying more for services at private hospitals than your plan would.
Discovery Health does offer gap cover. The gap cover products from Discovery Health cover for shortfalls on approved in-hospital specialist claims, specific out-of-hospital costs related to an approved hospital admission and shortfalls on approved emergency international claims while travelling outside of South Africa.
You also get cover for co-payments on approved endoscopies, MRI and CT scans, and cancer-related claims. Your cover depends on the Discovery Gap Cover option you choose. An overall annual limit of R185 000 applies to each person.
Medihelp does not offer direct Gap Cover within the medical scheme but advise you to take out gap cover from an independent insurer. Anyone who is an up to date member of Medihelp and who meets the age requirement can apply for cap cover for Medihelp.
Do both schemes offer hospital plans?
Yes, both Discovery Health and Medihelp offer hospital plans. Discovery Health’s hospital plans include unlimited private hospital cover, guaranteed full cover in hospital for specialists, and full cover for chronic medication.
All Medihelp’s plans give you access to quality care at private hospitals with no overall annual limit. Some Medihelp plans offer you a choice between using any hospital or a network hospital when you join the network version of the plan at a considerably lower premium, which is made possible by negotiating tariffs with efficient networks of hospitals and day procedure facilities.
Who is Discovery Health?
Discovery Medical Health is a non-profit organisation controlled by the Medical Schemes Act 131 of 1998, as amended, and the Medical Schemes Council (CMS). According to the Scheme guidelines, it is a recognised open medical scheme that anybody can join.
Members own the Scheme, and its operations are controlled by an independent Board of Trustees (the Trustees or the Board). The Scheme outsources its administration and managed care functions to Discovery Health (Pty) Limited under a formal contractual relationship.
One of the Scheme’s strategic priorities is value-based healthcare. Their strategy, which places their members at the centre of care, compensates providers based on health outcomes rather than the volume of services they deliver.
It gives members access to programmes and providers committed to continuous quality improvement.
Discovery Health strives to ensure that our members have access to the safest, most efficient, and effective healthcare available in South Africa through a variety of quality of care programmes and innovations that are regularly examined by the Scheme on an ongoing basis.
The Scheme also provides its participants with information relevant to their needs.
Who will benefit from Discovery Health?
Discovery Health offers comprehensive medical cover that is well-suited towards established families and higher income earners. Discovery Health offers a comprehensive selection of plans, with greater coverage being afforded at higher premiums, with additional benefits for these members.
It is worth noting that Discovery Health operates on a network-based coverage basis, so that individuals should first check whether they reside in areas that fall within the pre-selected GP, hospital and specialist network, making it a better option for those residing in urban areas.
The Discovery Health Smart Series consist out of the following plans:
✅ Essential Smart Medical Aid Plan
Who is Medihelp?
Medihelp is the second largest self-administered medical aid in South Africa and has been serving the interests of members for the past 117 years. It has close to 200 000 beneficiaries, and remain one of the top five choices of medical aids in the industry.
The sole objective of Medihelp, as a self-administered medical aid, is to look after its members and provide for their medical need. All South Africans are welcome to apply, whether they are students, newly employed individuals looking to enrol in a medical insurance plan for the first time, independent business owners searching for a trustworthy healthcare provider for their staff, or parents supporting expanding families.
Medihelp’s reserve level is well above the legal requirement and its ability to pay members’ claims is rated amongst the highest in the industry at AA minus by Global Credit Rating (GCR), the largest independent rating company in Africa.
Medihelp is owned by its members and handles administrative duties as processing and paying claims, pre-authorisation and communication with members in-house.
MediHelp has the following 11 plans to choose from:
- 💙 MediHelp Medprime
- 💙 MediHelp MedPrime Elect
- 💙 MediHelp MedPlus
- 💙 MediHelp MedElite
- 💙 MediHelp MedVital
- 💙 MediHelp MedVital Elect
- 💙 MediHelp MedSaver
- 💙 MediHelp MedMove
- 💙 MediHelp MedElect
- 💙 MediHelpMedAdd
- 💙 MediHelp MedAdd Elect
Who will benefit from Medihelp?
All Medihelp plans are designed to provide solid cover for what is considered essential to preserve and protect your health. It makes provision for students, singles, couples, families and pensioners.
FAQ
Which medical aid offers the cheapest medical plan, Discovery Health or Medihelp?
Medihelp has the cheap has the cheapest medical plan between the two medical aids with its MedElect Student plan at R894.00 per month. This plan is specifically aimed at students. Discovery Health’s cheapest plan is its KeyCare Series plan at R1,102.00 per month.
Which medical aid, Discovery Health or Medihelp are the most popular?
Discovery has the most members by far at 3.3 million compared to the 200 000+ of Medihelp. It is definitely the most popular of the two.
Do Discovery and Medihelp medical aids offer the option of gap cover?
Discovery Health does offer the option to apply for gap cover. Medihelp does not offer direct gap cover but advises its members to take out gap cover from an independent insurer.
Do Discovery Health and Medihelp medical aids have a waiting period?
Yes, both Discovery Health and Medihelp have a three-month waiting period during which you are unable to submit a claim.
Which is the best medical aid between Discovery Health and Medihelp.
Discovery Health was founded in 1992 and provides fair pricing and a variety of packages to meet a variety of budgets and medical needs. Medihelp, on the other hand must be one of the oldest medical aid schemes in South Africa. It was founded in 1905 as the Civil Service Medical Benefit Association. Today it is one of the largest open medical aids in South Africa.
