Discovery: All the 2027 medical aid plans

Discovery has 26 plans grouped into 8 “series”. (Executive, Comprehensive, Priority, Saver, Core, Smart, Smart Saver, KeyCare).

Hospital cover is unlimited on every plan. Plans differ mostly on what hospitals you can use and how out of hospital claims are paid.

What the plan names mean

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Which series should I start with?

EXECUTIVE

Discovery’s top plan, with the most cover in and out of hospital. It has the largest savings account, unlimited extra cover once you’ve paid your self-payment gap, and the best cancer and specialist cover. It’s for people who want the best and can afford it.

COMPREHENSIVE Series:

These plans have a savings account, a self payment gap and a generous Above Threshold Benefit (ATB). There are also generous “extra” benefits paid for by Discovery.
The Smart version is cheaper, but you get less savings, higher self payment gap and must use a smaller list of hospitals.

PRIORITY Series:

These middle-ground plans also have a savings account, a self payment gap and an Above Threshold Benefit (ATB). There are substantial co-payments required for certain surgeries (could be covered with a gap cover).

SAVER Series:

These plans have a Savings Account to fund out of hospital expenses. Once that runs out, claims are paid out of pocket. Five variations of the series let you trade hospital choice and choose rate of specialist cover for a lower price.

SMART SAVER Series:

A small savings account combined with set everyday benefits, such as Smart GP visits and dental and eye check-ups. You must use the Smart hospital list, and the plans will require you to use State facilities for kidney dialysis.

SMART Series:

No savings account. Instead you get a fixed set of everyday benefits, mostly through virtual and Smart GP care. Premiums are low, but you must use a smaller hospital list, and on most versions children cost the same as adults. Some of the plans will require you to use State facilities for certain procedures.

CORE Series:

These plans are the “hospital” plans. You pay GP visits, medicine and scans out of hospital yourself (unless PMB). Six variations of the series let you trade hospital choice and choose rate of specialist cover for a lower price.

KEYCARE Series

Premiums are adjusted to your income level. These plans have (varying) cover for out of hospital benefits, and require you to use a limited network of hospitals and providers. You use a nominated GP, with some treatment at state facilities on the Start and Start Regional plans.

Note:

• Classic Plans pay specialists at 200% scheme rate.
• Essential plans pay specialists at 100% scheme rate.
• Delta Plans require you to use a Delta Network hospital for overnight procedures. Almost all plans require network hospitals for day procedures.
• Coastal Plans limit you to usage of hospitals in coastal provinces only, unless an emergency