Discovery Health Medical Scheme (DHMS) is one of South Africa’s largest and most well-known medical schemes, offering a range of plans to suit different budgets and healthcare needs. Below is a comprehensive breakdown of the current plans, prices, and contact information.
Discovery Medical Aid Plans, Prices, and Contact Details
Overview of Discovery Medical Aid Plans for the Current Year
Discovery offers a range of plans, from entry-level options to comprehensive cover. The scheme has received approval for a weighted average contribution increase, with most plans seeing adjustments effective from 1 April of the current year. A key highlight is the Active Smart plan, which has seen a zero increase, remaining at an affordable entry-level price.
| Plan Name | Plan Type | Monthly Contribution (Principal Member) | Key Features |
|---|---|---|---|
| Active Smart | Entry-Level (Digital-first) | R1,350 | Unlimited hospital cover in Smart Network; Personal Health Fund (up to R1,000); Smart GP consults |
| KeyCare | Entry-Level (Income-based) | Linked to income level | Affordable cover; designed for lower-income earners; specific provider networks |
| Essential Smart Saver | Mid-Range | Contact Discovery for Quote | New plan for families; Medical Savings Account; Guaranteed hospital cover |
| Essential Delta Core | Core | ~R2,700 | Hospital cover in specific “Delta” network; Limited day-to-day benefits |
| Classic Saver | Mid-Range (Comprehensive) | From R4,535 | Unlimited private hospital cover; Medical Savings Account; Day-to-day Extender Benefit |
| Classic Priority | Mid-Range (Comprehensive) | From R5,796 | Unlimited private hospital cover; Savings account + Above Threshold Benefit; Maternity benefits |
| Classic | Comprehensive | From R9,298 | Unlimited private hospital cover; High savings account; Chronic medicine cover; Travel cover |
| Executive / Comprehensive | Premium | Contact Discovery for Quote | Top-tier cover; Private hospital network; Advanced medical care; International cover |
Detailed Plan Breakdown
Active Smart Plan (Entry-Level, Digital-First)
This plan is designed specifically for young professionals starting their careers. It is currently the most affordable plan in the market for this demographic.
– Monthly Cost: R1,350 per principal member
– Hospital Cover:
– Unlimited cover in the Dynamic Smart Hospital Network with a standard deductible of R7,500 for non-PMB admissions.
– Day surgery for defined conditions covered in the Smart Day Surgery Network.
– Day-to-Day Benefits:
– Unlimited Smart GP consults (subject to co-payments).
– Benefits for dentistry, eye care, and medicine.
– Personal Health Fund: Members can earn up to R1,000 per adult by engaging in personal health pathways. This fund can be used for day-to-day expenses like contraceptives and prescription medicine.
This plan has seen a 0% increase for the current year, meaning the price remains R1,350. It is described as the “fastest-growing new plan” in the scheme’s history, with tens of thousands of lives covered.
KeyCare Plans (Entry-Level, Income-Based)
KeyCare plans are aimed at making medical aid accessible to lower-income earners. Contributions are linked to the member’s income level.
– Increase: The weighted average increase for these plans is approximately 7.9%.
Essential Smart Saver (Mid-Range, New for Families)
Launched recently, this plan targets young families by combining essential hospital cover with a medical savings account.
– Key Features: Guaranteed risk-funded benefits for universal healthcare needs, plus a savings account for more unique or specialised care.
Essential Delta Core (Core Hospital Plan)
This plan focuses primarily on hospitalisation within a specific network of “Delta” hospitals.
– Premium Example: Users have reported paying approximately R2,700 per month for this plan.
– Note: While premiums are lower, out-of-pocket costs for GP visits can be higher (members pay the full consultation fee). Upgrading to a “Smart” version of this plan often reduces GP co-payments significantly.
Classic Saver, Priority, and Classic (Comprehensive)
The Classic series is Discovery’s flagship range, offering comprehensive hospital and day-to-day cover. All Classic plans include:
– Unlimited cover in any private hospital.
– Guaranteed full cover for specialists on a payment arrangement (up to 200% of the Discovery Health Rate).
| Feature | Classic Saver | Classic Priority | Classic |
|---|---|---|---|
| Monthly Cost (From) | R4,535 | R5,796 | R9,298 |
| Hospital Cover | Unlimited private | Unlimited private | Unlimited private |
| Savings Component | Medical Savings Account (MSA) | Savings Account + Above Threshold Benefit (ATB) | High Savings Account + ATB |
| Day-to-Day Extender | Yes (DEB) | Yes (DEB) | Yes (DEB) |
| Chronic Medicine | Network Pharmacy cover | Network Pharmacy cover | Full cover for CDL conditions |
Comprehensive / Executive Plans
These are the top-tier plans offering the widest access and benefits, including international travel cover and access to specialised advanced medical care.
– Increase: These plans have seen an increase of approximately 7.9%.
Contact Details for Discovery Health
Member Support and General Enquiries
The primary contact number for Discovery Health members is 0860 99 88 77.
– WhatsApp Support: Save 0860 756 756 to your contacts to chat with the “Ask Discovery” service bot.
– Website: www.discovery.co.za
Emergency Medical Services (EMS)
For a medical emergency or medically-equipped transport, call 0860 999 911.
– International Emergency: +27 11 541 1222.
Claims Submission
– Email: claims@discovery.co.za (Remember to put your membership number in the subject line).
Postal and Physical Address
| Detail | Information |
|---|---|
| Postal Address | PO Box 784262, Sandton, 2146 |
| Physical Address | 1 Discovery Place, Sandton, 2196 |
Complaints and Disputes
If you have a complaint, Discovery encourages following a structured process:
Online Complaints Form: Complete the form on the website if initial queries are unresolved.
Escalate to Principal Officer: If still unsatisfied, email principalofficer@discovery.co.za.
Lodge a Formal Dispute: If you want to challenge a final decision, email the completed form to mydispute@discovery.co.za.
Frequently Asked Questions (FAQ)
Q: How do the current Discovery increases work?
A: Discovery has deferred contribution increases for most plans to 1 April of the current year. The weighted average increase across the scheme is approximately 7.2%. However, the Active Smart plan has a 0% increase.
Q: How do Discovery’s “Delta” and “Smart” networks work?
A: These are specific hospital networks. Using hospitals within your plan’s network ensures cover without heavy penalties or deductibles.
– Delta Plans (e.g., Essential Delta Core): You are restricted to a specific list of hospitals. Using a hospital outside this network may require a significant co-payment (e.g., R11,000).
– Smart Plans (e.g., Active Smart): You must use the Discovery app to navigate the Smart Hospital Network. While more restrictive, these plans offer the lowest premiums.
Q: Is the Essential Smart plan better than the Essential Delta Core?
A: It depends on your needs. The Essential Smart plan typically has a lower GP co-payment (e.g., R130) and might include a savings account or more day-to-day benefits, whereas Delta Core often requires you to pay the GP in full. However, the hospital networks differ, so you must ensure your preferred hospital is in the relevant network.
Q: Do I need Gap Cover with Discovery?
A: Discovery offers Gap Cover as an add-on. However, Discovery members have noted that Discovery’s gap cover can be significantly more expensive than competitors, sometimes costing up to 4 times the medical aid premium for older members. It is worth shopping around for Gap Cover; you do not have to buy it from Discovery.
Q: How can I get a quote for Discovery Medical Aid?
A: You can get a quote by calling 0860 000 628 or visiting the Discovery website to compare plans.
Disclaimer: All prices and benefits are subject to change and final approval by the Council for Medical Schemes. Please contact Discovery directly or consult a certified financial advisor for the most current and personalized advice.