Discovery Health - Gap Core: Executive & Classic Gap Cover

Discovery Health - Gap Core: Executive & Classic Gap Cover

Discovery Health’s Core gap cover provides in-hospital cover 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 Core: Executive & Classic gap cover is available to individuals and families who are members of Discovery Health Executive or Classic medical aid plans.

Gap Cover Benefits

Co-payment benefit

No Benefit

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 250% 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 201

Maximum entry age

There is no maximum entry age applicable

Oncology benefit

Cover up to R75,000 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
*No cover for emergency or involuntary PMB treatment

Sub-limit benefit

No Benefit

Trauma counselling

No Benefit

Gap Cover Contributions

Contributions

Single - Under 54 yrs

R 100


Single - Btw 54-64 yrs

R 180


Single - Over 65 yrs

R 210


Family - Under 54 yrs

R 175


Family - Btw 54-64 yrs

R 215


Family - Over 65 yrs

R 315

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