Discovery Executive:
dentistry, optometry and wellness (2024)

This page has information on: Costs, Dentistry , Optometry Wellness and Preventative and Other benefits for Discovery Executive

We also have information on: In-hospital, Out of Hospital, Medicine, Maternity, Cancer, Mental Health and Prosthetics benefits.

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Monthly Costs:

Executive 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R10,303
  • R10,303
  • R1,969
  • Only pay for 3 children
Savings:
  • R30,900
  • R30,900
  • R5,904
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R4,330
  • R4,330
  • R776
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Unlimited
  • Unlimited
  • Unlimited
Children Rates:
  • Under 21 yrs old
  • Only pay for 3 children
Note:
  • Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list.
  • All treatments and procedures are subject to authorisation and protocols
  • All benefits are listed as an indication only. Please verify with your broker and scheme
♦️View all the other benefits for this plan:♦️
Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

You can also:
♦️Compare any two plans, side by side | ♦️View all the Discovery plans, with costs and brief summary
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Dentistry benefits (2022):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Discovery: Executive
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:
  • From day-to-day benefit
Specialised Dentistry:
  • R34,500 per person from day-to-day benefit
  • Includes claims for orthognathic surgery, orthodontic treatment, dental appliances and their placements
In-Hospital Dentistry:
  • For severe dental and oral surgery, a defined list of procedures is included, with no upfront payment and no overall limit
  • Dental Trauma Benefit: Paid for sudden and unanticipated injury to teeth and mouth that requires urgent dental treatment after an accident or trauma injury. R65,150 per person
  • Otherwise,
    • <13 yrs: R3,200 co-payment for admission to hospital, or R1,450 co-payment for admission to a day-clinic
    • 13yrs+: R8,250 co-payment for admission to hospital, or R5,300 c0-payment for admission to day-clinic
Orthodontics:
  • See "Specialised dentistry", above
Note:
  • PMBs: Prescribed Minimum Benfits. To read more about PMBs click here
  • DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
♦️View all the other benefits for this plan:♦️
Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

You can also:
♦️Compare any two plans, side by side | ♦️View all the Discovery plans, with costs and brief summary
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Optometry benefits (2022):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Discovery: Executive
Assume scheme pays all these costs, unless otherwise stated
Optometry:
Limit:R10,100 per person. Paid from day-to-day benefit.
Consult:from above limit
Frames:from above limit
Single lensesfrom above limit
Bifocals:from above limit
Multifocalsfrom above limit
Contactsfrom above limit
Refractive Surgery:from above limit
Notes:20% discount on frames and lenses at network optometrist
Note:
  • This section does not apply to opthamology benefits, which fall under "in-hospital" benefits. Some of those are PMBs, and are paid for in full by your scheme. You can read more about PMBs here.
♦️View all the other benefits for this plan:♦️
Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

You can also:
♦️Compare any two plans, side by side | ♦️View all the Discovery plans, with costs and brief summary
.
.
.

Wellness/Preventative benefits (2022):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Discovery: Executive
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • Covered , for 65yrs+
Pneumonia vaccines:
  • Every five years, or once per lifetime for persons over the age of 65
Biometric Screening:
  • Covered
Child Immunisation:
  • Not covered
Pap Smear:
  • Covered , every 3 years
Mammogram:
  • Covered , every 2 years
  • If you qualify, you can get Breast MRI and once-off BRCA test for breast screening
PAS Test:
  • Covered
HIV Test:
  • Covered
Other:
  • Kids' assessment, including height, weight, head circumference and health and milestone tracking
  • Bowel cancer screening
  • Access to the WELLTH Fund. You get up to R10,000 per family for various out of hospital expenses including GP, eye, dental, hearing screenings and medical devices. Find out more .
♦️View all the other benefits for this plan:♦️
Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

You can also:
♦️Compare any two plans, side by side | ♦️View all the Discovery plans, with costs and brief summary
.
.
.

Other benefits for 2022:

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Executive
International Insurance:
  • Up to $1 million per person for emergency costs while travelling outside South Africa, for a period of 90 days. Excludes pre-existing conditions.
  • Second opinion from Cleveland Clinic for life-threatening and life-changing conditions: paid for by scheme
  • R750,000 per person for international treatment not available in South Africa, with 20% co-payment
  • R300,000 to cover voluntary in-hospital treatment outside South Africa, with 20% co-payment
Other:
  • Internal nerve stimulators: R185,550
♦️View all the other benefits for this plan:♦️
Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

You can also:
♦️Compare any two plans, side by side | ♦️View all the Discovery plans, with costs and brief summary
.

    Important!
  • Unless specified, assume that all benefits are paid are paid at 100% scheme rate
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • "Unlimited" benefits are still subject to authorisation, protocols and sublimits
  • Assume that all benefits need to be pre-authorised

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