The Core Series
The Core Plans cover you in hospital
- Unlimited hospital cover in any private hospital or our network of hospitals on the Delta network options
- Essential cover for chronic medicine
- Cover for up to 90 days up to R5 million for each person for medical emergencies when travelling outside South Africa
Comprehensive hospital cover
We cover you in any private hospital for emergencies and for planned hospital admissions that you have authorised with us. There is no overall limit.
Emergency cover when you need it most
In an emergency, go straight to hospital.
If you need medically-equipped transport in a medical emergency, call 0860 999 911. This line is managed by highly qualified emergency personnel who will send the most appropriate air or road emergency evacuation transport. It is important that you, your loved one or the hospital let us know about your admission as soon as possible.
Cover for planned hospital admissions
Please call us at least 48 hours before you go to hospital to confirm your admission.
Limits, clinical guidelines and policies apply to some healthcare services and procedures in hospital.
Going to hospital can be a stressful experience. Discovery’s HospitalXpress makes your admission to hospital convenient and seamless. This service offers you express pre-admissions and online tools to authorise your admission and confirm your cover. HospitalXpress also connects you to select partners, bringing you a range of value-added services at the reduced prices you’re accustomed to as a Discovery member.
Use a network hospital on the Delta network and Coastal options
Delta network options
On the Classic and Essential Delta network options, you are covered in full at hospitals in the Delta Hospital Network. For planned admissions at any other private hospital, you must pay an amount of R4 550 upfront to the hospital.
The Delta Hospital Network
- Arwyp Medical Centre
- Life Bedford Gardens Hospital
- Netcare Bougainville Private Hospital
- Life Brenthurst Clinic
- Life Carstenhof Clinic
- Clinix Private Hospital – Lesedi
- Clinix Private Hospital – Sebokeng
- Emfuleni Medi-Clinic
- Genesis Clinic (Saxonwold)
- Life Fourways Hospital
- Legae Private Hospital
- Lenmed Clinic Limited
- Life Little Company of Mary
- Louis Pasteur Hospital
- Midvaal Private Hospital
- Morningside Medi-Clinic
- Life Robinson Private Hospital
- Life Roseacres Clinic
- Suikerbosrand Clinic
- The Donald Gordon Medical Centre
- Life Wilgeheuwel Hospital
- Bagleyston Day Clinic
- Benoni Day Clinic
- Birchmed Day Clinic
- Boksburg Medical & Dental Centre
- Brooklyn Surgical Centre
- Centurion Eye Hospital
- Constantia Clinic
- Constantia Park Medical & Dental Centre
- Cure Day Clinics-Midstream
- Cure Day Clinics - Erasmuskloof
- Eastmed Day Clinic
- Edenvale Day Clinic
- Fauchard Clinic
- Fordsburg Clinic
- Gauteng Surgical Eye Centre Facility
- Germiston Medical and Dental Centre
- Hasson & Lubbert Theatre
- Intercare Day Hospital Hazeldean
- Johannesburg Clinic
- Johannesburg Eye Hospital
- Karibu Day Clinic
- Kilnerpark Narko Clinic
- Mayo Clinic
- Medi Dent Day Clinic
- Medgate Day Clinic
- Medkin Clinic
- Mercidoc Day Clinic
- Peniston N T Theatre
- PJ Schutte Theatre Unit
- Pretoria Narkokliniek
- Pretoria North Day Clinic
- Protea Day Clinic
- Randburg Medical & Dental Centre
- Sandton Surgical Centre
- Sandhurst Eye Centre
- Silverton Medical & Dental Centre
- South Day Clinic (Pty) Ltd.
- The Berg Day Theatre
- The Healthy Eye
- Visiomed Eye Laser Clinic
- Wierda Park Clinic
- Wilgeheuwel Day Clinic
- Life New Mercantile Hospital
- Bloemfontein Eye Centre
- Life Rosepark Hospital
- Universitas Private Hospital
- Bethlehem Medical Centre
- CityMed Theatre
- Medovs Day Clinic
- Welkom Medical Centre
- Life Chatsmed Garden Hospital
- Life Entabeni Hospital
- Ethekwini Hospital
- Midlands Medical Centre
- Life Westville Hospital
- Bluff Medical & Dental Centre
- Care Clinic
- Lorne Street Anaesthetic Clinic
- Malvern Medical And Dental Centre
- Mandeni Medical Services
- Pinetown Clinic (Pty) Ltd
- Pinetown Medicross Theatre
- Shelly Beach Day Clinic
- Cape Town Medi-Clinic
- Gatesville Medical Centre
- Life Claremont Hospital
- Life Kingsbury Hospital
- Mitchells Plain Medical Centre
- Panorama Medi-Clinic
- Vergelegen Medi-Clinic
- Cango Medicentre
- Cape Dental Theatres
- Cure Day Clinic - Paarl
- George Surgical Centre
- John Hill Eye Laser Centre
- Khangella Eye Theatre
- Kraaifontein Medical And Dental Centre
- Medi Paarl Kliniek
- Monte Vista Clinic
- Paarl Medi-Clinic
- Panorama Laser Clinic
- Parow Medical & Dental Centre
- Renaissance Surgical Clinic
- Somerset Aesthetic Clinic
- Strathmed Paediatric Dental Theatre
- The Surgical Institute - Durbanville
- Tokai Medical & Dental Centre
- Wesfleur Private Clinic
- Emalahleni Day Hospital
On the Coastal Plan, you must go to a hospital in one of the four coastal provinces for a planned hospital admission. If you don’t use a coastal hospital, we pay up to a maximum of 70% of the hospital account and you have to pay the difference.
Full cover for specialists who we have an agreement with
You can benefit by using healthcare professionals who we have an agreement with because we will cover their approved procedures in full. If you are a Classic Plan member, you benefit from access to the broadest range of specialists whom we pay in full, which represents over 88% of our member’s specialist interactions. These healthcare professionals, appropriate to your plan, are also the designated providers for Prescribed Minimum Benefits.
You may have a co-payment if you use other specialists
If you are treated by a specialist who we do not have an agreement with, we cover you up to a maximum of 200% of the Discovery Health Rate on Classic Plans and at 100% of the Discovery Health Rate on Essential and Coastal Plans.
Other healthcare professionals
We cover GPs and other healthcare services up to 200% of the Discovery Health Rate on Classic Plans and up to 100% of the Discovery Health Rate on Essential and Coastal Plans.
We cover radiology and pathology up to 100% of the Discovery Health Rate on all plans.
Scopes (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy)
You pay the first R2 600 of your hospital account. We pay the balance of the hospital account and your related accounts from your Hospital Benefit. A related account is the account from your admitting doctor, anaesthetist or any approved expense you incur during your hospital admission, other than the hospital account.
MRI and CT scans
If your MRI or CT scan is done as part of an approved admission, we pay it from your Hospital Benefit at 100% of the Discovery Health Rate. If you are admitted for conservative back or neck treatment or if the scan is unrelated to your admission, we do not pay for it.
You need to pay a portion of your hospital or day clinic account upfront for dental admissions. This amount varies depending on your age and the place of treatment.
|Members younger than 13 years||R1 300||R650|
|Members 13 years and older||R3 300||R2 200|
We pay the balance of the hospital account and the related accounts, which include the dental surgeon’s account, from the Hospital Benefit, up to 100% of the Discovery Health Rate.
Dental appliances and orthodontic treatment
You are responsible for paying the costs of all dental appliances, their placement and orthodontic treatment (including the related accounts for orthognathic surgery).
Severe dental and oral surgery
The Severe Dental and Oral Surgery Benefit covers a defined list of procedures, with no upfront payment and no overall limits. This benefit is subject to authorisation and the Scheme’s clinical rules.
Most of your in-hospital healthcare services have no overall limit. These are:
- Allied healthcare professionals, like physiotherapists
- HIV cover
Only the following healthcare services have an annual limit:
|Cochlear implants, auditory brain implants and processors||R140 000 for each person for each benefit|
|Internal nerve stimulators||R106 000 for each person|
|Hip, knee and shoulder joint prostheses||There is no overall limit if you get your prosthesis from our preferred suppliers.
If you choose not to, a limit of R33 000 will apply to each prosthesis.
|Prosthetic devices used in spinal surgery||R21 000 for the first level, R42 000 for two or more levels, limited to one procedure for each person|
|Mental health benefit||21 days for each person|
|Alcohol and drug rehabilitation||21 days for each person|
|Terminal care benefit||R28 000 for each person|
|Chronic dialysis||We cover these expenses in full if we have approved your treatment plan and you use a provider in our network. If you choose not to, you have to make a co-payment.|
Your cover for chronic conditions
You have cover for a list of chronic conditions. You have full cover for approved medicine on Discovery Health’s medicine list or up to a set monthly amount for medicine not on our list.
We pay medicine up to a maximum of the Discovery Health Medicine Rate. We need to approve your chronic condition before it is covered from the Chronic Illness Benefit.
When you use MedXpress, Discovery’s convenient medicine delivery service, you pay no delivery or administration fees. Discovery’s qualified service agents can also advise you on the most cost-effective alternatives and you will always be charged at the Discovery Health Medicine Rate or less – minimizing co-payments. Call us on 0860 99 88 77 to make use of this free service.
The Delta network options
You have cover for approved chronic medicine, with no additional co-payment, if you use a Delta network pharmacy. If you don’t use a Delta network pharmacy, a 20% co-payment applies.
Your cover for cancer treatment
Our Oncology Programme covers the first R200 000 of approved cancer treatment over a 12-month cycle. Cover is unlimited once cancer treatment costs go over this amount, but you will need to pay 20% of the costs of all further treatment.
We cover chemotherapy and oncology-related medicine up to the Discovery Health Medicine Rate. We pay consultations, radiotherapy, radiology, pathology and scans up to 100% of the Discovery Health Rate. You might have to make a co-payment if your healthcare professional charges more than the Discovery Health Rate.
Cancer treatment that is a Prescribed Minimum Benefit is always covered in full. Please call us to register on the Oncology Programme.
You have access to the following day-to-day benefits:
- The Screening and Prevention Benefit covers certain tests at a Discovery Wellness Network provider,like blood glucose, blood pressure, cholesterol and body mass index. We also cover a mammogram, Pap smear, PSA (a prostate screening) and HIV screening tests. Members
- 65 years or older and members registered for certain chronic conditions are also covered for a seasonal flu vaccine.
- We pay for scopes (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy) from your Hospital Benefit if they are done in your doctor’s rooms. We pay up to 200% of the Discovery Health Rate if you are on a Classic Plan and up to 100% of the Discovery Health Rate if you are on an Essential or Coastal Plan. Please call us before you go for your scope to confirm your benefits.
|Family size||Classic Core||Classic Delta Core network option||Essential Core||Essential Delta Core network option||Coastal Core|
|Main member||R1 229||R984||R1 056||R844||R892|
* We count a maximum of three children when we work out the monthly contribution.
Discovery Health does not cover certain healthcare services. You can find a full list of these exclusions here.
We market our Discovery Health Plans through independent and accredited financial advisers. If you want a financial adviser to help you choose a Health Plan to suit the needs of your family, please send us your contact details and we will contact you.