Discovery Health vs Medimed
Discovery Health versus Medimed 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 Medimed in South Africa.
In this in-depth guide you’ll learn:
- What is a Medical Scheme?
- Which medical aid is the best for young families?
- Which medical aid is best for a young person?
- How to compare medical aids against each other?
- Which should you choose: Discovery Health or Medimed?
So if you’re ready to go “all in” with Discovery Health versus Medimed in South Africa, this guide is for you.
Let’s dive right in…
Discovery Health vs Medimed Summary
Overall Comparison
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Medimed |
| General comparison | 5/5 | 3/5 |
| Number of plans | 7 | 4 |
| Lowest premium | R1 102.00 (KeyCare Series) | R1 680.00 (Alpha) |
| Highest premium | R10 303.00 (Executive Plan) | R3 980.00 (Medsave Max) |
| Student Plan | No | No |
| Gap Cover | Yes | A member can apply with Momentum |
| Hospital plans | Yes | Yes |
| Maternity benefits | Yes | Yes |
| Number of members | 3.3 million | 6 000+ |
Plan benefits
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Medimed |
| Name of Plan | • Executive Plan • Comprehensive Series • Priority Series • Saver Series • Core Series • Smart Series • KeyCare Series | • Alpha • Medisave Essential • Medisave Max • Medisave Standard |
| 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 | • Alpha: R1 680.00 • Medisave Essential: R1 600.00 • Medisave Max: R3 980.00 • Medisave Standard: • R2 300.00 (Price per plan is determined by your income) |
| GP Visits | Network only | Yes |
| GP in room visits | Network only | Yes |
| 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 |
| Basic optometry | Yes, 100% of Discovery Health Rate | Yes |
| HIV benefit | Yes | Yes |
| Maternity benefit | Yes | Yes |
| Road accident claims | Yes, full cover | Will give assistance |
Discovery Health vs Medimed
Both Discovery Health and Medimed are known medical aid schemes 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 Medimed?
Although Discovery Health offers the lowest premium on its KeyCare Series plan, it also offers a greater selection of affordable medical aid plans.
Medimed only offers a choice between four plans and the monthly contribution you have to make depends on your income. Medimed’s Medisave Essential plan is a capitated option and it is unfortunately only available to members in the Nelson Mandela Metropole as this is the area where the aid has specific contracts with the providers.
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.
Medimed offers the option to take out gap cover with Momentum which specifically make provision for clients of Medimed.
Do both schemes offer hospital plans?
Yes, both Discovery Health and Medimed 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 Medimed’s plans give you access to quality care at private hospitals and the Medisave Max plan has no overall annual limit.
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 Saver series has the following plans:
📌 Discovery Health Essential Saver Plan
📌 Discovery Health Essential Delta Saver Plan
📌 Discovery Health Coastal Saver Plan
Who is Medimed?
The Medimed Medical Aid, founded in 1980, focuses on providing healthcare solutions to members in the Nelson Mandela Metropolis. As of the end of 2012, the scheme had just over 5,500 members and reserves of more than R124 million.
Medimed’s primary mission is to give the members of the organisation access to a comprehensive medical care facility that extends to encompass a wide range of additional components.
According to the regulations of the Scheme, the key participants in the plan will consist of those workers who are currently employed by the company as well as the beneficiaries of those workers. Members who have reached retirement age and are still eligible for benefits under the plan are known as retirees and their beneficiaries respectively.
Medimed’s delivery arrangements include a capitated managed care model where comprehensive cover is purchased from the local IPA’s (Independent Practice Associations) and free choice.
Medimed provides four options with comprehensive hospitalisation and chronic medication coverage. Each plan provides a different way to manage the out-of-hospital benefits. The Alpha option is a co-payment plan. Medisave Max and Standard provide out-of-hospital benefits through a savings account with an additional elective benefit. The Medisave Essential option is a managed health care plan provided by contracted service providers with the added flexibility of a savings account.
Medimed Medical Aid has a late joiner fee and also has the following plans to choose from:
Who will benefit from Medimed?
All Medimed’s plans are designed to provide solid cover for what is considered essential to preserve and protect your health. There are 4 plans available that will benefit individuals, couples and families.
FAQ
Which medical aid offers the cheapest medical plan, Discovery Health or Medimed?
Discovery Health has the cheapest medical plan between the two medical aids with its KeyCare Series plan at R1 102.00 per month. Medimed’s cheapest plan is its Alpha plan at R1 680.00 per month.
Which medical aid, Discovery Health or Medimed are the most popular?
Discovery has the most members by far at 3.3 million compared to the 6 000+ of Medimed. It is definitely the most popular of the two.
Do Discovery and Medimed medical aids offer the option of gap cover?
Discovery Health does offer the option to apply for gap cover. With Medimed, members have the option to apply for gap cover with Momentum.
Do Discovery Health and Medimed medical aids have a waiting period?
Yes, both Discovery Health and Medimed 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 Medimed.
Discovery Health was founded in 1992 and provides fair pricing and a variety of packages to meet a variety of budgets and medical needs. Medimed is a fairly young medical aid and was only founded in 1980 and solely focusses on providing healthcare solutions to members in the Nelson Mandela Petropolis.
