Discovery Health Product Updates

Oct 1

Discovery Health Medical Scheme Contribution Increase Strategy for 2021

Contribution Freeze for the first 6 months of 2021
Contribution increases for 2021 delayed to 1 July 2021
- The contribution increase for July 2021 will be announced during the second quarter of 2021 with a maximum applicable increase of CPI plus 2% or 5.9% across the scheme

Discovery Health’s ongoing investment in digital technology.

Discovery Health has invested extensively in a digital Healthcare ecosystem to enhance the quality and experience of healthcare for members of Discovery Health Medical Scheme. This investment includes the adoption and funding of digital Healthcare technology, digital tools for members and doctors, integration with health monitoring devices and sophisticated data and analytics.

This digital Healthcare ecosystem allows members to track their health and wellness status based on their interactions with the Healthcare System and the use of interactive wearables and devices for health monitoring purposes

Introducing Discovery Connected Care

Discovery health has consolidated and enhanced the digital Healthcare experience in Connected Care. Connected care can be accessed through the Discovery app or www.discovery.co.za

Connected Care enables a range of appropriate home based healthcare services for all levels of care funded by Discovery Health Medical Scheme.

Connected Care for members at home
Connected Care for members with chronic conditions
Connected Care for acute care at home

Advanced diagnostic care powered by YytoCare

Using the best and latest in medical technology the device sends the doctor a live feed of clinical grade images and sounds during a virtual consultation so that the GP can accurately diagnose and prescribe treatment for common conditions no matter where you are. View more about YytoCare here.

Log on to the Discovery app and access your personalized Healthcare dashboard

View your personalised Healthcare dashboard, find a provider, rate a doctor or view your electronic health record.

View your e-script and order your medicine. The doctor can prescribe the appropriate treatment plan and generate an electronic script during the virtual consult you can choose to get your medication delivered through the connected care medicine delivery partner, Zulzi

Introducing an infertility and Assisted Reproductive Therapy benefit

To support families affected by infertility, in 2021 Discovery Health Medical Scheme is introducing a benefit to provide cover for Assisted Reproductive Technologies (ART) such as in vitro fertilisation (IVF), intra-uterine insemination (IUI), frozen embryo transfer (FET) and intracytoplasmic sperm injection(ICSI).

Co-payments for endoscopic procedures

Currently the scheme applies a co-payment of between R3 750 and R4 552 in-patient gastrointestinal scopes on all of its plans except for the KeyCare plans where endoscopic procedures are only covered as PMBs. No co-payment applies to gastroscopies,colonoscopies, proctoscopies and sigmoidoscopies performed in the doctor's rooms and for confirmed PMB cases.

The following updates to the co-payment structure apply:

DHMS will continue to apply no co-payment where scopes are performed in the doctor's rooms and or endoscopic suites
A reduced co-payment of R3 650 on all plans (except for KeyCare) for scopes performed in day clinics.
A co-payment of between R5 300 and R6 250 depending on the chosen plan will be applied for scopes performed in acute Hospitals
Where an out of network deductible also applies for scopes performed outside of the Day Surgery Network, the higher of the benefits deductible or the out-of-network deductible applies. Where both a colonoscopy and gastroscopy are performed in the same admission a higher co-payment applies

Hospital networks

To ensure continued optimisation of the Delta, Smart and KeyCare hospital networks, in 2021 new hospitals will be added and some existing hospitals will be replaced with region-specific substitutions.

Chronic Illness Benefit

From 1 January 2021 certain Formulary changes and chronic drug amount updates will be applied, Discovery have been communicating these changes with impacted members, these members will have until the end of 2020 to make changes to their treatment to avoid or reduce co-payments

Limits, co-payments, deductibles and thresholds

Co-payments and deductibles will be increased by between 3.5% and 4.0% on 1 January 2021.

Benefit limits will be increased by 3.9% on 1 January 2021 with the exception of the following where there is no increase for 2021

Oncology threshold
Specialised Medicine and Technology Benefit
International Travel Benefit
Overseas Treatment Benefit
KeyCare Mobility Benefit

Thresholds for the Above Threshold Benefit on the Executive, Comprehensive and Priority plans will be increased by 4.0% on 1 January 2021.

Consolidated and enhanced support for mental well-being

Discovery health medical scheme is introducing a Relapse prevention program to identify and support members who are at risk of a relapse or recurrence of a major depressive episode

Introducing Discovery Prepaid Health - making quality healthcare affordable and accessible

Discovery prepaid health is a simple and intuitive digital vouchering solution for purchasing and sharing a variety of accessible healthcare services at a significantly discounted rate supported by a wide distribution network and a free to use digital platform.

For relevant Healthcare options always including medicine available at leading pharmacies and GP practices nationwide.