Discovery Health - Gap Core: Essential & Coastal Gap Cover

Discovery Health - Gap Core: Essential & Coastal Gap Cover

Discovery Health’s Core gap cover provides in-hospital cover for medical expense shortfalls at up to 250% of the medical scheme tarriff.

It also offers extended gap cover benefits for approved in-hospital specialist claims and oncology claims.

Discovery's Gap Core: Essential and Coastal gap cover is available to existing members of Discovery Health Essential or Coastal medical aid plans.

Gap Cover Benefits

Co-payment benefit

Subject to R7 500 benefit mentioned under Out-patient Cover Benefit listed below. Subject to R185 000 overall limit per insured person per annum

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

250% of the Discovery Health rate over and above what your option covers and with no limit on the number of times you may claim per year.

Lives Covered

Main member and all dependants registered on Main member's medical scheme. Not available to Keycare members.

Maximum entry age

There is no maximum entry age applicable

Oncology benefit

Depending on how many years you have been on Discovery Gap Cover, the following payments will be made to you via the Oncology Benefit Extender, once your oncology benefit limit has been reached - On Executive, Comprehensive Plans and their equivalents - Up to R75 000. On all other plans - up to R30 000

Oncology supplementary benefit

No Benefit

PMB cover

No Benefit

Sub-limit benefit

No Benefit

Trauma counselling

No Benefit

Gap Cover Contributions

Contributions

Individuals (0 – 54 years)

R 265


Individuals (55 - 64 years)

R 600


Individuals (65+ years)

R 899


Families (0 - 54 years)

R 621


Families (55 - 64 years)

R 902


Families (65+ years)

R 1 442

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