Discovery Health has announced a zero increase for member contributions for the first half of 2021.
In addition to providing much-needed relief for healthcare consumers, Discovery Health has announced a basket of new and updated benefits for 2021. It has also strengthened and expanded its digital health ecosystem.
Cash reserves pooled during pandemic
Owing to a marked decline in demand for healthcare during the pandemic, the largest medical scheme in South Africa has pooled substantial cash reserves.
It’s these reserves that are initially cushioning members from an increase in premiums.
The premium freeze is in line with medical inflation, which is expected to retain a low trajectory until mid-year in 2021.
Here’s a brief synopsis of what to expect from Discovery Health Medical Scheme in 2021.
Expanded Connected Care
In recognition of the importance of home-based consultations and care, the scheme has expanded and enriched its on-demand digital health platform.
The integration of wearable devices and diagnostic tools with Discovery Health apps is designed to support end-to-end remote healthcare in 2021.
This will include virtual GP consultations and diagnoses to e-scripts and trackable medicine deliveries.
The Connected Care platform has been expanded to support the scheme’s mental health, diabetes care and cardiac care programmes.
As of 2021, members have access to digitally-enabled clinical content and personalised health coaching to promote the monitoring and self-management of conditions at home.
The platform will play an integral role in the management and care of acute patients in the transition from in-hospital to acute care at home.
Infertility benefits
Women who are struggling to fall pregnant and have been members of the Executive and Comprehensive plans for at least two years have access to infertility benefits in 2021.
The Infertility and Assisted Reproductive Therapy benefit covers up to two cycles of the following assisted reproductive technologies (ART) for women aged between 25 and 42 years:
- in vitro fertilisation (IVF)
- intrauterine insemination (IUI)
- frozen embryo transfer (FET)
- intracytoplasmic sperm injection (ICSI).
Enhanced mental health programme
The Discovery Health mental health programme has been boosted for 2021.
A relapse prevention programme, enhanced out-patient benefits and free access to Vitality Rewards are designed to support and encourage members suffering from major depression to embrace a goal- and rewards-driven approach to wellness.
Updated co-payment and benefit limits
Co-payments and deductibles rise by 3.5% to 4% in 2021.
There’s a 3% increase to benefit limits, with some exceptions.
The exceptions are the Overseas Treatment and International Travel benefits, the Oncology Threshold, Specialised Medicine and Technology benefit and the KeyCare Mobility benefit.
Scrapped or reduced co-payments on scopes
Co-payments for endoscopic procedures have been scrapped altogether in 2021. This is provided the scope is conducted in a doctor’s room or endoscopic suite.
Scopes performed in day clinics attract a co-payment of R3,650 across all Discovery Health options, with the exception of the KeyCare series.
An option-dependent co-payment of between R5,300 and R6,250 applies to procedures performed in acute hospitals.
IFC
At IFC, we offer informed, objective advice about Discovery Health’s 2021 premiums and innovative new benefits, and can assist you in joining the medical aid scheme that best suits your needs and budget. Contact us for more information or to discuss your needs.