Discovery Health - Gap Comprehensive: Executive & Classic Gap Cover
Discovery’s Comprehensive gap cover provides in-hospital cover for medical expense shortfalls at up to 500% of the medical scheme tarriff.
It also offers extended gap cover benefits for hospital admission (including gap cover for private ward fees); oncology; scopes and scans; and medical emergencies while travelling.
Discovery's Gap Comprehensive: Executive and Classic gap cover is available to existing members of Discovery Health Executive or Classic medical aid plans.
Gap Cover Benefits
| Co-payment benefit |
Cover for co-payments or deductibles on hospital account for endoscopies (gastroscopy, sigmoidoscopy, proctoscopy and colonoscopy). Includes cover on copayments that applies to out-of-hospital MRI and CT scans |
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| Dental benefit |
No Benefit |
| Diagnosis benefit |
Medical Breakthrough Funder available through Supplementary Gap Cover benefit, at an additional cost Refer to member guide for details |
| Emergency/casualty benefit |
No Benefit |
| Full time students over 21 |
Covered, as long as they are registered as medical scheme dependants |
| Gap cover limits |
An overall annual limit of R160,000 per beneficiary per year |
| Gap cover percentage benefit |
In-hospital Specialist Gap Cover gives cover of up to 500% of the medical scheme rate. This amount is over and above what the medical scheme pays |
| Lives Covered |
Main medical scheme member of Discovery (excl KeyCare); All family members registered as medical scheme dependants 24 month waiting period applies when; Join date is after 1 March 2017 OR Option downgrade is done after 1 March 2017 |
| Maximum entry age |
There is no maximum entry age applicable |
| Oncology benefit |
Cover up to R100,000 available. OBE: Once registered on schemes oncology benefit is reached, up to R40,000 additional cover relating to approved cancer related claims |
| Oncology supplementary benefit |
No Benefit |
| PMB cover |
Prescribed Minimum Benefits are covered |
| Sub-limit benefit |
No Benefit |
| Trauma counselling |
No Benefit |
Gap Cover Contributions
| Contributions |
Family - Under 54 yrs R 270 Family - Btw 54-64 yrs R 410 Family - Over 65 yrs R 570 |
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