Discovery Executive:
dentistry, optometry and wellness (2024)

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
.

Dentistry benefits (2022):

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	PMBs are always covered by the scheme, and cannot have sublimits or co-payments imposed. These include fracture of face bones, orbit and/or jaw. You can see a full list of maxillo facial PMB benefits here.
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
.

Optometry benefits (2022):

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 lenses	from above limit
Bifocals:	from above limit
Multifocals	from above limit
Contacts	from above limit
Refractive Surgery:	from above limit
Notes:	20% discount on frames and lenses at network optometrist

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.

Wellness/Preventative benefits (2022):

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:

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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Discovery Executive:
dentistry, optometry and wellness (2024)

Monthly Costs:

Dentistry benefits (2022):

Optometry benefits (2022):

Wellness/Preventative benefits (2022):

Other 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: dentistry, optometry and wellness (2024)

Monthly Costs:

Dentistry benefits (2022):

Optometry benefits (2022):

Wellness/Preventative benefits (2022):

Other benefits for 2022:

Also see these:

Discovery Executive:
dentistry, optometry and wellness (2024)