Discovery Health - Essential Delta Comprehensive Network
A comprehensive plan that offers day-to-day benefits, full cover for private hospitalisation subject to use of hospitals in the Delta network and full cover for chronic medication, subject to use of a designated pharmacy. The plan includes cover up to 100% of the scheme rate for in-hospital specialists.
15% of contributions are paid to a medical savings account, for managing day-to-day expenses.
In Hospital Benefits
| Overall Annual Limit |
Unlimited at 100% (Discovery Health Rate) |
|---|---|
| Provider |
Delta network hospitals |
| GP's & Specialists |
GP's & Specialists: Unlimited Radiology & Pathology: Unlimited Oncology: R500 000 (80% after) Organ Transplants: Treatment Plan Dialysis: Treatment Plan Internal Prosthesis: Procedure based, limits apply |
| Chronic |
PMB's + Additional |
Out of Hospital Benefits
| Saving / Day to Day / OHEB |
SAVING Member: R9960 Adult: R9408 Child: R1983 GP NETWORK ADVISABLE |
|---|---|
| Pooled Day to Day Benefit |
Not applicable |
| Threshhold / Safety Net |
Member: R25 740 Adult: R25 740 Child: R4 910 |
| Self-Payment Gap Before Threshold |
Yes |
| Above Threshold Limits |
Yes, as per limits. |
| Maternity Care |
12 consultations, private ward up to R2 460 p/day, certain blood tests, X2D scans |
Contributions
| Contributions |
Member: R5667 Adult: R5352 Per Child: R1134
|
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