Discovery Health vs Medshield
Discovery Health versus Medshield 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 Medshield 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 Medshield?
So if you’re ready to go “all in” with Discovery Health versus Medshield in South Africa, this guide is for you.
Let’s dive right in…
Discovery Health vs Medshield Summary
Overall Comparison
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Medshield |
| General comparison | 5/5 | 5/5 |
| Number of plans | 7 | 11 |
| Lowest premium | R1,102.00 (KeyCare Series) | R1 584.00 (MediCurve) |
| Highest premium | R10,303.00 (Executive Plan) | R7 587.00 (MediBonus) |
| Student Plan | No | No |
| Gap Cover | Yes | Medshield members can access gap cover through their brokers |
| Hospital plans | Yes | Yes |
| Maternity benefits | Yes | Yes |
| Number of members | 3.3 million | 250 000 |
Plan benefits
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Medshield |
| Name of Plan | • Executive Plan • Comprehensive Series • Priority Series • Saver Series • Core Series • Smart Series • KeyCare Series | • PremiumPlus • MediBonus • MediSaver • MediPlus Prime • MediPlus Compact • MediCore • MediValue Prime • MediValue Compact • MediSwift • MediPhila • MediCurve |
| 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 | • PremiumPlus: R7 842.00 • MediBonus: R7 587.00 • MediSaver: R4 524.00 • MediPlus Prime: R4 539.00 MediPlus Compact: R4 125.00 • MediCore: R3 474.00 • MediValue Prime: R2 736.00 • MediValue Compact: R2 478.00 • MediSwift: R2 037.00 • MediPhila: R1 851.00 • MediCurve: R1 584.00 |
| 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 | Yes |
Discovery Health vs Medshield
Both Discovery Health and Medishield 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 Medshield?
Although Discovery Health offers the lowest premium on its KeyCare Series plan, both medical aids offer a choice between affordable plans. However, the choice Medshield offers is a bigger variety than Discovery Health. Both are designed for individuals, couples, 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.
Medshield does not offer gap cover through its plans but recommends that members take out gap cover which members can access through its brokers.
Do both schemes offer hospital plans?
Yes, both Discovery Health and Medshield 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 of the plans that Medshield offers include hospital plans that will pay for the expenses associated with your care if you are admitted to the hospital. These expenses may include ward costs, theatre fees, and accounts from other in-hospital providers such as anesthesiologists or radiologists. The conditions of the Scheme, pre-approval, case management, clinical criteria, and the benefit choice you have picked are what regulate all of its hospital plans.
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 Core Series includes the following plans:
Who is Medshield?
Medshield is a well-established medical aid registered in 1968 and, following its merger with Oxygen, covering in excess of 250 000 lives. The Medshield Scheme has a Global Credit rating of AA – and has reserves well in excess of the mandated 25%.
Each of the plans offered by Medshield has advantages that are reasonably priced. They medical aid constantly evaluate and enhance the variety of benefits offered by each option to provide you with what you actually need, namely high-quality healthcare that is reasonably priced and a selection of plans that are tailored to your unique, individual needs.
Medshield boasts a solvency ratio and stable AA- Global Credit rating which is an indication that beneficiaries can rely on it to pay out your claims. As evidence of their dedication to their members, they invite potential clients to check with their healthcare providers about their payment history. For the 12th consecutive year, they have obtained the coveted AA- rating with a stable outlook for their future claim payment performance in recognition of their efforts to make prompt payments.
All the benefit options of plans provide coverage for homes of various income levels, and members even have the choice of controlling their healthcare 24 hours a day using the provided online tools.
MedShield has the following medical aid plans to offer:
- 💙 MedShield MediCurve
- 💙 MedShield PremiumPlus
- 💙 MedShield MediValue Prime
- 💙 MedShield Value Compact
- 💙 MedShield MediSwift
- 💙 MedShield MediSaver
- 💙 MedShield MediPlus Prime
- 💙 MedShield MediPlus Compact
- 💙 MedShield MediPhila
- 💙 MedShield MediCore
- 💙 MedShield MediBonus
Who will benefit from Medshield?
Medshield is your healthcare Partner for Life with an appropriate product offering for every life stage as the requirements and lifestyle of its members evolve from early adulthood to retirement. Medshield’s benefit options include affordable entry-level options to fully comprehensive medical aid cover for individuals, professional individuals, couples, families and corporate employees.
FAQ
Which medical aid offers the cheapest medical plan, Discovery Health or Medshield?
Discovery Health has the cheapest medical plan between the two medical aids with its KeyCare Series plan at R1102.00 per month. Medshield’s cheapest plan is its MediCurve plan at R1 584.00 per month.
Which medical aid, Discovery Health or Medshield are the most popular?
Discovery has the most members by far at 3.3 million compared to the 250 000+ of Medshield. It is definitely the most popular of the two.
Do Discovery and Medshield medical aids offer the option of gap cover?
Discovery Health does offer the option to apply for gap cover. Medshield does not provide gap cover but suggests that members apply for gap cover through the schemes brokers.
Do Discovery Health and Medshield medical aids have a waiting period?
Yes, both Discovery Health and Medshield 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 Medshield?
Discovery Health was founded in 1992 and provides fair pricing and a variety of packages to meet a variety of budgets and medical needs. Medshield has been in operation since 1968 which also makes it an experienced, knowledgeable and reliable medical scheme.
