Discovery Coastal Saver:
prosthetic benefits (2024)

This page has information on: Costs and Prosthetics for Discovery Coastal Saver

We also have information for: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Maternity, Cancer, Mental Health, Other/Extra Benefits and Wellness and Preventative

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Monthly Costs:

Coastal Saver 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R3,423
  • R2,574
  • R1,382
  • Only pay for 3 children
Savings:
  • R6,144
  • R4,632
  • R2,484
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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Prosthetics benefits (2024):

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

Discovery: Coastal Saver
Overal Limit:
  • Covered, subject to authorisation
Prosthetics required for PMB conditions are always paid paid in full by scheme, with no co-payment, if you follow the protocols. More info here
Sub-limits:
  • Shoulder joint prostheses: no limit, unless you use non-network supplier, then R45,550 limit applies
  • Hip and knee joints surgery: no limit, unless you use non-network supplier, then 80% scheme rate and R30,900 per prosthesis limit applies
  • Prosthetic devices used in spinal surgery: no limit, unless you use non-network supplier, then R26,250 limit for first level and R52,500 for two or more levels. Limited to one procedure per person per year.
  • Spinal surgery: no limit, unless you use non-network supplier, then 80% scheme rate
Note:
  • PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs 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
.
.
.
Always consult with your broker before making final decisions regarding your healthcare cover.

    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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