Discovery Health - Gap Comprehensive: Essential & Coastal Gap Cover
Discovery’s Comprehensive gap cover provides in-hospital cover for medical expense shortfalls at up to 500% of the medical scheme tarriff.
It also offers extended gap cover benefits for hospital admission (including gap cover for private ward fees); oncology; scopes and scans; and medical emergencies while travelling.
Discovery's Gap Comprehensive: Essential & Coastal gap cover is available to existing members of Discovery Health Essential or Coastal medical aid plans.
Gap Cover Benefits
| Co-payment benefit |
Subject to R15 000 benefit mentioned under Outpatient Cover Benefit listed below. Co-payments or Deductibles on hospital account for endoscopic procedures and MRI / CT scans out of Hospital. 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 |
R185 000 overall limit per insured person per annum |
| Gap cover percentage benefit |
500% 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 R100 000. On all other plans - up to R40 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 388 Individuals (55 - 64 years) R 710 Individuals (65+ years) R 943 Families (0 - 54 years) R 885 Families (55 - 64 years) R1 352 Families (65+ years) R1 778 |
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