Discovery Health - Classic Smart Comprehensive Medical Aid Plan

Discovery Health - Classic Smart Comprehensive

Comprehensive Discovery Health medical aid that’s designed to be more affordable than other comprehensive options. This plan features comprehensive hospital cover, an unlimited Above Threshold benefit and day-to-day benefits at Smart network providers. It doesn’t include a Medical Savings Account (MSA).

In Hospital Benefits

Overall Annual Limit

Unlimited at 200% (Discovery Health Rate) (R9,950 co-pay for use of non-network hospital)

Provider

Smart Plan Hospital Network

GP's & Specialists

GP's & Specialists: Unlimited

Radiology & Pathology: Unlimited

Oncology: R300 000 (80% after)

Organ Transplants: Treatment Plan

Dialysis: Treatment Plan

Internal Prosthesis: No limit if you use Discovery Network. Non-network provider attracts a co-payment and limit

Chronic

27 PMB's

Out of Hospital Benefits

Saving / Day to Day / OHEB

Unlimited Network GP consultations R 55 co-payment

Medication (R2 580 single, R4 150 Family) prescribed by Smart GP

Specialist Consultation Limit of R5 150 and R10 300 pfpa, subject to referral by Smart GP

Pooled Day to Day Benefit

Not applicable

Threshhold / Safety Net

Member: R24 850

Adult: R24 850

Child: R850

Self-Payment Gap Before Threshold

Member: R24 850

Adult: R24 850

Child: R850

Above Threshold Limits

Yes, as per limits

Maternity Care

12 consultations, private ward up to R2 220 p/day, certain blood tests

Contributions

Contributions

Member: R4 327

Adult: R3 994

Per Child: R1 378

 

 

 

 

 

 

 

 


Finding it difficult to make sense of all this? Not to worry, you can:

Finding it difficult to make sense of all this? Not to worry, you can:

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