Discovery Health vs. Sizwe Hosmed Medical Scheme
Discovery Health versus Sizwe Hosmed Medical Scheme 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 Sizwe Hosmed Medical Scheme 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 Sizwe Hosmed Medical Scheme?
So if you’re ready to go “all in” with Discovery Health versus Sizwe Hosmed Medical Scheme in South Africa, this guide is for you.
Let’s dive right in…
Discovery Health vs. Sizwe Hosmed Medical Scheme Summary
Overall Comparison
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Sizwe Hosmed Medical Fund |
| General comparison | 5/5 | 4/5 |
| Number of plans | 7 | 14 |
| Lowest premium | R1,102 (KeyCare Series) | R1 870.00 (Essential Copper) |
| Highest premium | R10,303 (Executive Plan) | R8 415.00 (Titanium Executive) |
| Student Plan | No | No |
| Gap Cover | Yes | Yes |
| Hospital plans | Yes | Yes |
| Maternity benefits | Yes | Yes |
| Number of members | 3.3 million | 172 000 |
Plan benefits
| ℹ️ Feature | 🥇 Discovery Health | 🥈 Sizwe Hosmed Medical Fund |
| Name of Plan | • Executive Plan • Comprehensive Series • Priority Series • Saver Series • Core Series • Smart Series • KeyCare Series | • Essential Copper (3X) • Access Core • Access Saver 25 • Silver Hospital • Gold Ascend • Gold Ascend EDO • Value • Value Core EDO • Plus • Platinum Enhanced • Platinum Enhanced EDO Titanium Executive |
| 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 | • Essential copper: R1 870.00 – R2 839.00 (depending on your income) • Access Core: R2 418.00 • Access Saver 25: R3 092.00 • Silver Hospital: TBC • Gold Ascend: R3 418.00 • Gold Ascend EDO: R3 250.00 • Value: R4 401.00 • Value Core EDO: R4 051.00 • Plus: R7 227.00 • Platinum Enhanced: R4 747.00 • Platinum Enhanced EDO: R4 511 • Titanium Executive: R8 415.00 |
| 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 with pre-authorization |
| Basic optometry | Yes, 100% of Discovery Health Rate | Yes depending on the plan you choose |
| HIV benefit | Yes | Yes |
| Maternity benefit | Yes | Yes |
| Road accident claims | Yes, full cover | No |
Discovery Health vs. Sizwe Hosmed Medical Scheme
Both Discovery Health and Sizwe Hosmed Medical Scheme 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 Sizwe Hosmed Medical Scheme?
Of the two medical aids, Discovery Health offers the lowest premium on its KeyCare Series. However, Sizwe Hosmed Medical Scheme offers a bigger choice between different plans. Overall both medical aids offer a choice between affordable plans which 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.
Sizwe Hosmed Medical Fund does not make provision for gap cover.
Do both schemes offer hospital plans?
Yes, both Discovery Health and Sizwe Hosmed Medical Scheme 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 Sizwe Hosmed Medical Fund’s plans come with hospital plans that will pay for the costs of your care if you are admitted to the hospital, including ward costs, theatre fees, and accounts from other in-hospital providers like anesthesiologists or radiologists.
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.
✅ Discovery Health – Priority Series
Who is Sizwe Hosmed Medical Fund? 
Sizwe Medical Fund was founded in 1978. The Fund is essentially a South African company that in many ways mirrors a South African story. Hosmed Medical Scheme was founded in 1998. The two medical aids merged to form Sizwe Hosmed Medical Fund.
The Group’s goals in creating the Fund were to lead the black people in healthcare issues and to offer medical aid coverage for blacks. Black specialists can now launch their own private practises because to this. Additionally, it allowed black private patients and their doctors access to pricey drugs, X-rays, and other investigations that were beyond of reach for almost everyone without medical aid coverage.
Sizwe Hosmed Medical funds’ footprint stretches nationwide and itis accepted by all service providers. It guarantees unlimited hospitalisation on all options for PMB conditions. The collective value of Hosmed day-to-day benefits per option compares well with the rest of the industry.
It offers optometry, dentistry, pathology and radiology benefits per person, no matter how big your family is. Additionally, it includes a wellness benefit for all beneficiaries on all options as well as access to a 24-hour call centre, including telephonic nurse advice emergency and nonemergency transfer.
Overall the scheme offers a traditional, sound healthcare solution for all South Africans.
Sizwe Hosmed offers 12 medical aid plans
- ✅ Sizwe Hosmed Value Core
- ✅ Sizwe Hosmed Titanium Executive
- ✅ Sizwe Hosmed Silver Hospital
- ✅ Sizwe Hosmed Plus
- ✅ Sizwe Hosmed Platinum Enhanced
- ✅ Sizwe Hosmed Platinum Enhanced EDO
- ✅ Sizwe Hosmed Gold Ascend
- ✅ Sizwe Hosmed Gold Ascend EDO
- ✅ Sizwe Hosmed Value
- ✅ Sizwe Hosmed Essential Copper
- ✅ Sizwe Hosmed Access Saver 25
- ✅ Sizwe Hosmed Access Core
Who will benefit from Sizwe Hosmed Medical Fund?
With Sizwe Hosmed Medical Fund, you have access to a wide range of medical aid options and industry-leading benefits for individuals as well as the whole family.
FAQ
Which medical aid offers the cheapest medical plan, Discovery Health or Sizwe Hosmed Medical Fund?
Discovery Health has the cheapest medical plan between the two medical aids with its KeyCare Series plan at R1,102 per month. Sizwe Hosmed Medical Fund’s cheapest plan is its Essential Copper plan at R1 590.00 per month.
Which medical aid, Discovery Health or Sizwe Hosmed Medical Fund are the most popular?
Discovery has the most members by far at 3.3 million compared to the 172 000+ of Sizwe Hosmed Medical Fund. It is definitely the most popular of the two.
Do Discovery and Sizwe Hosmed Medical Fund medical aids offer the option of gap cover?
Discovery Health does offer the option to apply for gap cover. Sizwe Hosmed Medical Fund does not offer the option of gap cover. However, members do have the option to apply for gab cover with an independent insurer.
Do Discovery Health and Sizwe Hosmed Medical Fund medical aids have a waiting period?
Yes, both Discovery Health and Sizwe Hosmed Medical Fund 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 Sizwe Hosmed Medical Fund?
Discovery Health was founded in 1992 and provides fair pricing and a variety of packages to meet a variety of budgets and medical needs. Sizwe Hosmed Medical Fund was formed with the merger between Sizwe Medical Fund and Hosmed Medical Scheme. The Fund’s main aim is to provide affordable medical aid coverage for Black South Africans.
