Discovery Executive:
cancer, maternity and mental health (2024)

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

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:

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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Cancer/ Oncology benefits for 2022:

Discovery: Executive
Assume scheme pays all these costs, unless otherwise stated
Overall coverage (in and out of hospital):	R500,000, then 20% co-payment applies for non-PMB cancers Extended Oncology Benefit: Certain medicine and treatment is funded without a co-payment, even after R500,000 is reached Certain specialised medicine: 25% 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 2022:

Discovery: Executive
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:	300% scheme rate Up to R2,600 per day for private ward	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:	Consults: 12 consults with GP, Gynae or midwife Nuchal translucency or Non-Invasive Prenatal Test if you meet the criteria Devices: Up to R6,000 for registered devices (breast pumps, etc) with 25% co-payment Antenatal classes: R2,300 per family 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 consult with midwife, GP or gynae; one nutritional assessment; two mental health consults, breastfeeding consultation Savings on stem cell banking Assisted Reproductive Therapy (ART): possible cover for one or two annual cycles of ART. If you are on the oncology program, you might have access to cryopreservation and egg and sperm storage for up to five years. R129,000 per person. and a minimum 25% co-payment.
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 2022:

Discovery: Executive
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:	Major affective disorders, anorexia and bulimia: 21 days for admissions or 15 out-of-hospital consultations Acute stress disorder accompanied by recent significant trauma: 12 out-of-hospital consultations Otherwise, paid from day-to-day benefit. Claims for psychologists and social workers fall into the supplementary benefit ie: Limited to: M= R29,450 M1= R35,400 M2= R41,450 M3+= R49,700
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)

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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)

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Discovery Executive:
cancer, maternity and mental health (2024)

Monthly Costs:

Cancer/ Oncology benefits for 2022:

Maternity benefits for 2022:

Mental Health benefits for 2022:

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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Discovery Executive: cancer, maternity and mental health (2024)

Monthly Costs:

Cancer/ Oncology benefits for 2022:

Maternity benefits for 2022:

Mental Health benefits for 2022:

Also see these:

Discovery Executive:
cancer, maternity and mental health (2024)