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 |
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 |
No Benefit |
| 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 130 Individuals (55 - 64 years) R 233 Individuals (65+ years) R 271 Families (0 - 54 years) R 225 Families (55 - 64 years) R 278 Families (65+ years) R 407 |
|---|