Here's what you get:
- Personal Health Fund for engaging in Personal Health Pathways
- Unlimited hospital cover in the Smart Hospital Network
- Full in-hospital cover for specialists with a payment arrangement with us. Up to 200% of the Discovery Health Rate for other specialists
- Day surgery for defined conditions at a facility in the Smart Day Surgery Network
- Day-to-day cover for your GP consultations, acute medicine cover for over-the counter (OTC) medicine, eye and dental check-up and sports-related injuries, with fixed co-payments and/or limits
- Maternity cover for pre- and post-natal healthcare
- Full cover for Chronic Disease List conditions
- Comprehensive cancer treatment including the Oncology precision medicine at a Network Provider or designated service provider
- Cover depends on the plan you choose
Our Smart Plan
| Classic | Essential | Essential Dynamic | Active Smart | |
| Hospital cover | ||||
| Unlimited private hospital cover at a network hospital. | ||||
| 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% | 100% | 100% |
| Other healthcare professionals are covered at a percentage of the Discovery Health Rate | 200% | 100% | 100% | 100% |
| Chronic illness cover | ||||
| Cover for 27 Chronic Disease List conditions (once approved) according to the Prescribed Minimum Benefits. | ||||
| 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. On Essential Smart we cover cancer treatment in our network. | R250 000 | R250 000 | R250 000 | Covered at a network provider, limited to Prescribed Minimum Benefits |
| Cancer care, including access to Oncology precision medicine, at a designated service provider. | ||||
| Day-to-day cover | ||||
| Personal Health Fund | ||||
| Unlimited GP consultations with a fixed co-payment for each consultation. | R70 | R125 | R125 | R125 |
| One eye test at an optometrist with a fixed co-payment for the test. | R70 | R125 | R125 | R125 |
| One dental check-up with a fixed co-payment for the check-up. | R125 | R190 | R190 | R190 |
| Cover for acute medicine categories, up to an annual limit. | ||||
| Cover for over-the-counter (OTC) medicine obtained from a network pharmacy. | ||||
| Cover for over-the-counter (OTC) medicine obtained from a network pharmacy | ||||
| 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 R125 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.
