Discovery Classic Priority:
cancer, maternity and mental health (2024)

This page has information on: Costs, Maternity, Oncology, Mental Health for Discovery Classic Priority

We also have information on: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Other/Extra Benefits, Wellness and Preventative and Prosthetics

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Monthly Costs:

Classic Priority 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R5,272	R4,158	R2,108 Only pay for 3 children
Savings:	R15,792	R12,456	R6,312
Self Payment Gap: (What you need to pay out of pocket before you can access the "Above Threshold" benefit)	R7,098	R4,754	R1,308
"Above Threshold" benefit (ATB): Additional cover the scheme makes available to you, once you've paid* the self payment gap.*	R19,370	R13,820	R6,770
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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Cancer/ Oncology benefits for 2024:

Discovery: Classic Priority
Assume scheme pays all these costs, unless otherwise stated
Overall coverage (in and out of hospital):	R250,000, then 20% co-payment applies for non-PMB cancers Innovative cancer medicine: Certain "innovative cancer medicine" is covered with a 50% co-payment Palliative Care: Unlimited cover for approved care at home	Treatment required for PMB conditions is always paid by scheme, with no co-payment, if you follow the protocols. Most cancers are PMBs! More info here Most schemes require use of specific providers (DSPs) for oncology treatment.
♦️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
.

Maternity benefits for 2024:

Discovery: Classic Priority
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:	200% scheme rate for specialists	Usually covered for 2 nights* for natural birth, and 3 nights for C-sections. All newborns receive immediate full medical aid cover at birth, even if parents are on a waiting period.*
Consultations:	8 consults with GP, Gynae or midwife Nuchal translucency or Non-Invasive Prenatal Test if you meet the criteria Certain blood tests Five antenatal or postnatal classes or consultations with a registered nurse up until two years after you have given birth After birth: One six week post-birth consult with midwife, GP or gynae; one nutritional assessment; two mental health consults, breastfeeding consultation Savings on stem cell banking
Scans:	2 x ultrasound scans
Note:	If you are pregnant and don't have medical aid, your pregnancy will most likely be excluded for new cover, but your baby will be covered from birth. Read more about pregnancy cover if you don’t have medical aid.
♦️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
.

Mental Health benefits for 2024:

Discovery: Classic Priority
Assume scheme pays all these costs, unless otherwise stated
In-hospital:	Major affective disorders, anorexia and bulimia: 21 days for admissions or 15 out-of-hospital consultations Attempted suicide or detoxification: 3 days admission Other mental health admissions: 21 days in-hospital Alcohol and drug rehab: 21 days in-hospital All admissions are covered in full at a network facility, or at 80% scheme rate at a non-network facility
Out-of-hospital:	See above Otherwise, paid from day-to-day benefit. Claims for psychologists and social workers fall into the supplementary benefit ie Limited to: M =R14,500 M1 =R19,850 M2 =R25,700 M3+ =R30,350
Trauma:	Traumatic event claims: 6 counselling sessions per person per year, for the year in which the trauma event occurred and the year after
Note:	PMBs: Prescribed Minimum Benefits. Here is a list of PMB conditions: Mental Illness. 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
.

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

All the medical aid jargon explained (2024)

Medical aid and PMBs? DSPs? PPNs? We decipher the medical aid jargon in plain English so that you are not as confused 🙂

How do I make a medical aid plan change (2024)?

A quick guide to how you can change your medical aid plan, including the resignation procedure, and things to look out for, such as imposed waiting periods from your new scheme

Medical Aid waiting periods: what you need to know (2024)

Waiting periods can prevent you from getting the cover that you need – but they are not always applied. Find out rules here.

Discovery Classic Priority:
cancer, maternity and mental health (2024)

Monthly Costs:

Cancer/ Oncology benefits for 2024:

Maternity benefits for 2024:

Mental Health benefits for 2024:

All the medical aid jargon explained (2024)

How do I make a medical aid plan change (2024)?

Medical Aid waiting periods: what you need to know (2024)

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cancer, maternity and mental health (2024)

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prosthetic benefits (2024)

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in-and-out of hospital benefits (2024)

Sizwe Value Core:
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Sizwe Silver Hospital:
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Discovery Classic Priority: cancer, maternity and mental health (2024)

Monthly Costs:

Cancer/ Oncology benefits for 2024:

Maternity benefits for 2024:

Mental Health benefits for 2024:

Also see these:

Discovery Classic Priority:
cancer, maternity and mental health (2024)