Discovery Health: How to get tested for Covid-19 and have it covered by the scheme

Step by step process to ensure that Discovery pays for your Covid-19 test, including details of assessment, consultations and pre-admission tests
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Covid-19 tests are covered by Discovery Health under their new WHO Global Outbreak benefit, but you need to follow the guidelines and meet the clinical criteria. You can read more about how Discovery pays for Covid-19 claims here.

How must I get tested?

Step 1: Complete the Discovery COVID-19 risk assessment
If you suspect that you have contracted COVID-19, you must complete the COVID-19 risk assessment available via www.discovery.co.za, the Discovery app or by calling Discovery ( 0860 99 88 77). The assessment is a set of questions which determines if you may be presenting with symptoms suggestive of COVID-19 disease or may have been exposed to COVID-19 infection and need a consultation with a doctor.

Step 2: Consult with a network doctor
You are covered for COVID-19 screening consultations and personal protective equipment (PPE) used during the consultation, where you have successfully completed and were referred from the screening risk assessment. You can choose to do either access a virtual consultation with a DrConnect healthcare provider, or a telephone or face-to-face
screening consultation with a Discovery network GP. Based on the outcomes of your screening, you may be referred for testing.

After completing the risk assessment, if you are “at-risk” you should consult with a doctor for a screening consultation within 72 hours.

Step 3: Testing:
All Discovery Health Medical Scheme members have access to 2 PCR tests per beneficiary per year, regardless of the outcome of the test, subject to completion of the Discovery risk assessment where the outcome showed onward referral to be necessary or appropriate referral from the doctor who screened you. This includes pre-admission PCR testing for
approved hospital admissions, subject to referral by a doctor. Registered healthcare professionals, that are members of Discovery Health Medical Scheme, have access to 4 PCR tests per year.

What if I didn’t do the assessment first?

If your COVID-19 test is positive, the WHO Global Outbreak Benefit will cover the consultation and test up to the Discovery Health Rate if referred by a doctor, even if you have not competed the risk assessment.

If the test results are negative and you did not complete a COVID-19 risk assessment prior to the screening consultation or you were not appropriately referred for testing by a doctor, the cost of the test will be covered from your available day-to-day benefits or for your own expense.

How do I access virtual consultations?

  • Select ‘Start your COVID-19 risk assessment’ on the COVID-19 information hub home page, via the Discovery app or website
  • You will be prompted to log in using your online account details
  • Accept the terms and conditions and complete the risk assessment
  • If classified at high risk of contracting COVID-19, you will be advised to conduct a virtual consultation. Select the ‘consult virtually with a doctor’ button
  • You will be able to book an appointment or consult directly with your doctor or a doctor from the COVID-19 Care Team via video, voice or text.

If the hospital requests a test before I get admitted, how will this be covered?

Discovery Health Medical Scheme members are covered for pre-admission COVID-19 testing for approved hospital admissions. Cover for pre-admission testing is subject to referral by a doctor and the screening PCR test limit of 2 tests per person per year. You do not have to complete the risk assessment for the pre-admission PCR test. Details of the referring doctor must be included on the laboratory test form.

Other links about Discovery Health and Covid-19:

This information was sourced directly from a Discovery Health publication, and does not reply on our own independent research. Always consult your scheme and broker to confirm benefits and regulations, and do not treat any information on rehealth.co.za as a “final say” on any matter.

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