Here's what you get:
- Unlimited private hospital cover in the Smart Hospital Network
- Guaranteed full cover in hospital for specialists who we have a payment arrangement with, and up to 200% of the Discovery Health Rate (DHR) on Classic plans and up to 100% of the DHR on Essential plans for other healthcare professionals.
- Full cover for chronic medicine on our medicine list for all Chronic Disease List (CDL) conditions when you use a network pharmacy.
- Cover for extensive pre and postnatal healthcare services for maternity and early childhood.
- Day-to-day cover for your GP consultations, acute medicine cover for over-the-counter (OTC) medicine, eye and dental check-up, Kids injury Benefits and sports-related injuries, with fixed co-payments and/or limits. This cover depends on the plan you choose.
- A Medical Savings Account and Personal Health Fund for your day-to-day healthcare needs.
Our two plans in the Smart Saver Series
| Classic | Essential | ||
| Hospital cover | |||
| Unlimited private hospital cover in any facility approved by the Scheme. | |||
| Full cover with a specialist we have a payment arrangement with. | |||
| Specialists we don't have a payment arrangement with are covered at a percentage of the Discovery Health Rate | 200% | 100% | |
| Other healthcare professionals are covered at a percentage of the Discovery Health Rate | 200% | 100% | |
| Chronic illness cover | |||
| Chronic condition: Cover for 27 Chronic Disease List conditions (once approved) according to the Prescribed Minimum Benefits | |||
| Chronic medicine: Full cover for approved medicine on our medicine list at a designated service provider pharmacy. | |||
| Cancer cover | |||
| We cover a set amount in full over a 12-month period. Costs above this amount attract a 20% co-payment. Prescribed Minimum Benefit conditions are covered in full | R250 000 | R250 000 | |
| Day-to-day cover | |||
| Medical Savings Account: Percentage of your contribution that goes into an MSA | 7% | 7% | |
| Personal Health Fund for engaging in Personal Health Pathways | Up to R20,000 | Up to R12,000 | |
| Unlimited GP consultations with a fixed co-payment for each consultation. | R75 | R130 | |
| One eye test at an optometrist with a fixed co-payment for the test. | R75 | R130 | |
| One dental check-up with a fixed co-payment for the check-up. | R130 | R195 | |
| Cover for acute medicine categories, up to an annual limit. | |||
| Cover for over-the-counter (OTC) medicine obtained from a network pharmacy. | |||
| Kids Injury Benefit with a fixed co-payment for your consultation. | R75 | ||
| Cover for sports-related injuries: basic X-rays, two specialist visits and a total of four visits to either a physiotherapist, biokineticist or chiropractor when referred by a Smart Network GP. You will have to pay R130 for each visit. | |||
This is only a summary of the key benefits. Please consult the health plan guide for more details. Discovery Health Medical Scheme Rules apply.
The Smart Saver series is subject to approval of the Council for Medical Schemes.