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Comprehensive benefits
and cover

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Benefits and cover

Tools to check and manage your benefits and cover

Track the usage of your benefits

Check your cover for treatments, procedures, medical devices and medicine

Find out more about your cover for chronic conditions

Benefits and cover overview

 

You get unlimited hospital cover - network plans require that you visit a hospital in your network to enjoy full cover. For planned or non-emergency admission you need to call us to confirm your admission.

Going to hospital?

For planned procedures, it is necessary that you inform Discovery Health before being admitted to hospital. Understand what we need to know before we can authorise your hospital admission.

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In an emergency, you can go straight to hospital. Alternatively in the event of an emergency medically equipped transport can be arranged by calling Discovery 911 on 0860 999 911.

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Hospital cover

All members have access to private hospitals. We cover the costs of planned hospital admissions from your Hospital Benefit. There is no overall limit of hospitalisation. You can have peace of mind that Discovery Health places you first with a focus on giving you comprehensive benefits, value for money and services to improve the quality of care available to you.

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General
Consultations

Cover for consulting GPs and other healthcare professionals.

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Optometry

Cover for frames, contact lenses, surgery and treatments.

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Dental treatment

Members have access to dental treatment - both in the dentist's or dental specialist's rooms, in hospital or a day clinic. Cover for dentistry also depends on the member's plan type.

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Maternity benefit

Members have access to comprehensive maternity and post-birth benefits supported by access to 24/7 support, advice and guidance through the My Pregnancy and My Baby programmes on the Discovery Health app and website.

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Assisted Reproductive Therapy benefit

The Executive and Comprehensive plans offer cover for assisted reproductive therapy, such as in vitro fertilisation (IVF) and embryo transfer through our approved network of specialists and facilities.

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International travel

Offers medical emergency cover outside borders of the Republic of South Africa.

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Trauma cover

The Emergency Services and Trauma Support includes dedicated support and benefits to trauma related to gender-based violence or crime-related violence. The Trauma Recovery Extender Benefit extends your cover for out-of-hospital claims related to certain traumatic events.

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Tests and scans

You have cover for in- and out-of-hospital tests and screening, including investigations, radiology and blood tests.

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Screening and prevention

You and your children have access to screening and prevention benefits that cover tests to detect early warning signs of serious illness.

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WHO Global Outbreak Benefit

You have cover for relevant healthcare services, as well as a defined basket of care for out-of-hospital healthcare services, related to global World Health Organization (WHO) recognised disease outbreaks such as COVID-19.

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Cover for in-rooms procedures

You have cover for certain procedures done in the specialist's rooms, including surgical procedures and investigative procedures. You must preauthorise the procedure with us beforehand.

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Health Check

You get access to a yearly Health Check covered in full that empowers you to proactively manage your health risks through lifestyle changes and suitable treatments.

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Cover for chronic conditions and cancer
Oncology

If you're diagnosed with cancer and once we have approved your cancer treatment, you are covered by the Oncology Care Programme.

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Chronic Illness Benefit

All our plans cover approved medicine for the Prescribed Minimum Benefit Chronic Disease List conditions. Certain plans cover additional conditions.

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Kidney disease

The Kidney Care Programme focuses on members with chronic kidney disease who need dialysis.

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Diabetes Care

Our Diabetes Care Programme, together with your Premier Plus GP, will help you actively manage your diabetes.

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Cardio Care

The Cardio Care Programme, together with your Premier Plus GP, will help you actively manage the conditions affecting your heart and blood vessels.

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HIV Care

When you register for our HIV Care Programme, you are covered for the care that you need. You can be assured of confidentiality at all times.

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Mental Health Care

The Mental Health Care Programme, together with your Premier Plus GP, will help you actively manage episodes of major depression.

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Advanced illness care

Member who have an illness in an advanced stage have access to a comprehensive palliative programme. 

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Disease Prevention Programme

This programme will help you actively manage your risk of developing a chronic condition.

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Cover for medicine and medical items
Medicine cover

Cover for chronic, acute and day-to-day prescribed medicine.

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External medical items

Cover for medical appliances and devices.

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TytoHome Device

Cover for TytoHome device per plan.

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Extra benefits to enhance your cover
International second opinion

Through your specialist you have access to second opinion services from Cleveland Clinic for life-threatening and life-changing conditions.

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Stem cell banking

Save on stem cell banking with Netcells.

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Health Pay

You can integrate payments for out-of-pocket medical expenses with Health Pay from Discovery Pay. You can do this for your medical scheme benefits and other funding sources for healthcare, including gap cover, using your savings and credit facilities with Discovery Bank.

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See more extra services and savings

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