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

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

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