Plan Comparison

20 13
Executive Plan
Executive Classic Comprehensive

Comprehensive Series

Classic Delta Comprehensive Classic Comprehensive Zero MSA Essential Comprehensive Essential Delta Comprehensive

Priority Series

Classic Priority Essential Priority

Classic Saver

Saver Series

Classic Delta Saver Essential Saver Essential Delta Saver Coastal Saver

Classic Core

Core Series

Classic Delta Core Essential Core Essential Delta Core Coastal Core

Critical hospital care Planned hospital care Chronic Illness Benefit Day-to-day medical care Screening and prevention

KeyCare Plus

KeyCare Series

KeyCare Access KeyCare Core

KeyFIT

This brochure is intended for intermediary use. It is only a summary of the key benefits and features of the Discovery Health Medical Scheme plans, awaiting formal approval from the Council for Medical Schemes. Full details can be found in the Discovery Health Medical Scheme Rules on www.discovery.co.za/portal/rules. It also summarises other Discovery products and value-added services. For compliance questions, email compliance@discovery.co.za. Discovery Health Medical Scheme, registration number 1125, is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider. Vitality is not part of the Discovery Health Medical Scheme. Vitality is a separate product sold and administered by Vitality Healthstyle (Pty) Ltd, registration number 1999/007736/07, an authorised financial services provider.

EXECUTIVE
THE MOST EXTENSIVE COVER FOR IN-HOSPITAL AND DAY-TO-DAY BENEFITS

COMPREHENSIVE
CLASSIC ZERO MSA CLASSIC ESSENTIAL COMPREHENSIVE COVER FOR IN-HOSPITAL AND DAY-TO-DAY BENEFITS Unlimited private hospital cover A choice of a high or no Medical Savings Account and an unlimited Above Threshold Benefit Comprehensive cover for chronic medicine Cover for medical emergencies when travelling in and outside South Africa

SUMMARY

Unlimited private hospital cover and private ward cover Highest Medical Savings Account and an unlimited Above Threshold Benefit, which covers both in- and out-of-hospital claims Full cover for an exclusive list of chronic medicine Cover for medical emergencies when travelling in and outside South Africa

HOSPITAL COVER Hospitals Upfront payments to hospitals Specialists we have an agreement with Specialists we do not have an agreement with Other healthcare professionals Radiology and pathology
If done as part of an approved admission, we pay the hospital account from your Hospital Benefit and all related accounts from the Medical Savings account or Above Threshhold benefit Scans not related to your admission will be paid from your day-to-day benefits at 100% of the Discovery Health Rate Unlimited cover at any private hospital and private ward cover of up to R1 300 each day Unlimited cover at any private hospital Unlimited cover Full cover on Delta when using the Delta Hospital Network of private hospitals For planned admissions outside of the Delta Hospital Network, an upfront payment of R5 000 must be paid to the hospital

No upfront payments

Cover is subject to funds in Medical Savings Account or Above Threshold Benefit

Full Cover

300%

200%

100%

200% 100% 100%

100%

MRI and CT scans

If done as part of an approved admission, we will pay up to 100% of the Discovery Health Rate from the Hospital Benefit Covered once you reach your Annual Threshold If not related to your admission or if for conservative back or neck treatment, we pay the first R2 450 of the scan from your day-to-day benefits. We pay the balance of the scan from your Hospital Benefit, up to 100% of the Discovery Health Rate

CHRONIC ILLNESS BENEFIT Conditions Medicine cover

You have cover for conditions according to the Prescribed Minimum Benefits list and on our Additional Disease List. Your condition needs to be approved in order to be covered Full cover for approved medicine on Discovery Healths most extensive medicine list. If you choose to use medicine that is not on our list, you have a set monthly amount available that is higher than that of our other plans. Full cover for an exclusive list of medicines only available on this plan. Full cover for approved medicine on Discovery Healths medicine list. If you choose to use medicine not on our list, we will pay it up to a set monthly amount.

ONCOLOGY Benefit Co-payments Healthcare professionals Medical Savings Account Self-payment gap Insured Network Benefit Above Threshold Benefit MRI and CT scans Screening and Prevention Benefit Trauma Recovery Extender Benefit Specialised Medicine and Technology Benefit Overseas Treatment Benefit Allied, Therapeutic and Psychology Extender Benefit
Covers first R400 000 of approved cancer treatment in full over a 12-month cycle

You will be required to pay 20% of the cost on all further treatment once costs for cancer treatment go over R400 000 Paid up to 100% of the Discovery Health Rate

DAY-TO-DAY BENEFITS
Covers day-to-day medical expenses like GP visits, radiology and pathology at the rate the healthcare professional charges If you run out of money in your Medical Savings Account before your claims add up to the Annual Threshold, you will have to pay for your medical expenses This plan does not offer this benefit Pays for day-to-day medical expenses like GP visits, radiology and pathology as long as you have money available

You pay all day-to-day If you run out of money in your Medical Savings Account before medical expenses until your claims add up to the Annual Threshold, you will have to pay you reach your Annual for your day-to-day medical expenses Threshold Pays for certain day-to-day benefits after you have run out of money in your Medical Savings Account and before you reach the Annual Threshold This plan does not offer this benefit GP consultations, day-to-day generic medicines (above schedule 3)* and blood tests* will be covered if you use a provider in our network *On Classic and Classic Delta only

GP consultations, day-to-day generic medicines (above schedule 3) and blood tests will be covered if you use a provider in our network

The Above Threshold Benefit is unlimited We pay the first R2 450 of your MRI or CT scan from your day-to-day benefits. We cover the balance of the scan from your Hospital Benefit, up to the Discovery Health Rate (except for conservative back and neck scans, where specific rules apply).

Paid from your available Medical Savings Account or Above Threshold Benefit

Covered once you reach your Annual Threshold

ADDITIONAL BENEFITS
Covers certain tests at a Discovery Wellness Network provider, like blood glucose, blood pressure, cholesterol and body mass index. We also cover a mammogram, Pap smear, PSA (a prostate screening test) and HIV screening tests. Members 65 years or older and members registered for certain chronic conditions are also covered for a seasonal flu vaccine. Out-of-hospital claims for recovery after certain traumatic events are covered on this benefit for the rest of the year in which the trauma took place, and a year after the trauma

Out-of-hospital claims for recovery after certain traumatic events are covered on this benefit for the rest of the year in which the trauma took place, and a year after the trauma

This plan does not offer this benefit

Cover up to R200 000 for each person for a defined list of the latest and most advanced treatments

Up to R500 000 for each person if they travel to seek evidence-based healthcare treatment not available in South Africa. A co-payment of 20% and specific rules apply to this benefit.

Provides unlimited cover for a list of allied healthcare services, like physiotherapy. This unlimited cover is for a defined list of conditions, for example quadriplegia and cerebral palsy. Cover depends on your condition and the criteria for it.

PRIORITY
CLASSIC ESSENTIAL

SAVER
CLASSIC ESSENTIAL COASTAL ECONOMICAL IN-HOSPITAL AND DAY-TO-DAY BENEFITS
Unlimited private hospital cover Essential cover for chronic medicine A Medical Savings Account Cover for medical emergencies when travelling in and outside South Africa

SUMMARY

COST-EFFECTIVE IN-HOSPITAL AND DAY-TO-DAY BENEFITS Unlimited private hospital cover Essential cover for chronic medicine A Medical Savings Account and a limited Above Threshold Benefit Cover for medical emergencies when travelling in and outside South Africa

HOSPITAL COVER Hospitals Upfront payments to hospitals Specialists we have an agreement with Specialists we do not have an agreement with Other healthcare professionals Radiology and pathology MRI and CT scans
If not related to your admission, we pay the first R2 450 of the scan from your day-to-day benefits. We pay the balance of the scan from the Hospital Benefit up to 100% of the Discovery Health Rate. If for conservative back and neck treatment, you have to pay the first R1 950 of the hospital account and we pay the first R2 450 of the scan from your day-to-day benefits. We pay the balance of the scan from the Hospital Benefit up to 100% of the Discovery Health Rate Unlimited cover at any private hospital Unlimited cover at any private hospital Full cover on Delta when using Delta Hospital Network of private hospitals For planned admissions at hospitals outside of the Delta Hospital Network, an upfront payment of R5 000 must be paid to the hospital Unlimited cover at any coastal private hospitals If a coastal hospital is not used, a payment of up to 70% of the hospital account is paid and you must pay the difference

An upfront payment of between R1 950 and R9 500 must be paid to the hospital when you are admitted for a defined list of procedures

Full cover

200%

100%

200%

100%

200%

100%

200%

100%

100% If done as part of an approved admission, we will pay up to 100% of the Discovery Health Rate from the Hospital Benefit

If not related to your approved admission or if for conservative back or neck treatment, we pay the first R2 450 of the scan from your day-to-day benefits. We pay the balance of the scan from your Hospital Benefit, up to 100% of the Discovery Health Rate.

CHRONIC ILLNESS BENEFIT Conditions Medicine cover Benefit Co-payments Healthcare professionals Medical Savings Account Self-payment gap Insured Network Benefit
You have cover for conditions according to the Prescribed Minimum Benefits list. Your condition needs to be approved in order to be covered Full cover for approved medicine on Discovery Healths medicine list. If you choose to use medicine not on our list, we will pay it up to a set monthly amount.

ONCOLOGY
Covers first R200 000 of the approved cancer treatment in full over a 12-month cycle You will be required to pay 20% of the cost on all further treatment once costs for cancer treatment go over R200 000 Paid up to 100% of the Discovery Health Rate

DAY-TO-DAY BENEFITS
Pays for day-to-day medical expenses like GP visits, radiology and pathology as long as you have money available If you run out of money in your Medical Savings Account before your claims add up to the Annual Threshold, you will have to pay for your day-to-day medical expenses Pays for certain day-to-day benefits after you have run out of money in your Medical Savings Account and before you reach the Annual Threshold GP consultations, on Classic and Essential. Blood tests on Classic only. You must use a provider in our network The Above Threshold Benefit* is limited Main member R7 800 Adult R5 550 Child dependant R2 680 We pay the first R2 450 of the scan from your day-to-day benefits. We pay the balance of the scan from the Hospital Benefit up to 100% of the Discovery Health Rate Covers GP consultations in our network up to a limit depending on your plan type and family size Pays for day-to-day medical expenses like GP visits, radiology and pathology as long as you have money available You need to pay claims when your Medical Savings Account runs out

Above Threshold Benefit MRI and CT scans Screening and Prevention Benefit Trauma Recovery Extender Benefit Specialised Medicine and Technology Benefit Overseas Treatment Benefit Allied, Therapeutic and Psychology Extender Benefit

These plans do not offer this benefit We pay the first R2 450 of MRI or CT scan from your available Medical Savings Account. We cover the balance of the scan from your Hospital Benefit, up to the Discovery Health Rate. For conservative back and neck scans, specific rules and limits may apply.

ADDITIONAL BENEFITS
Covers certain tests at a Discovery Wellness Network provider, like blood glucose, blood pressure, cholesterol and body mass index. We also cover a mammogram, Pap smear, PSA (a prostate screening test) and HIV screening tests. Members 65 years or older and members registered for certain chronic conditions are also covered for a seasonal flu vaccine.

Out-of-hospital claims for recovery after certain traumatic events are covered on this benefit for the rest of the year in which the trauma took place, and a year after the trauma

These plans do not offer these benefits

* If you join the medical scheme after January, you wont get the full amount because it is calculated by counting the remaining months in the year.

CORE

KEYCARE

CLASSIC

ESSENTIAL VALUE-FOR-MONEY HOSPITAL PLAN

COASTAL

CORE

PLUS AFFORDABLE MEDICAL AID COVER

ACCESS

SUMMARY
Unlimited private hospital cover Essential cover for chronic medicine Cover for medical emergencies when travelling in and outside South Africa

Unlimited emergency and trauma cover in our KeyCare network of hospitals and planned hospital cover on KeyCare Core and KeyCare Plus Essential antenatal care Cover in our network when you need to see a specialist Cover for medical emergencies in South Africa

HOSPITAL COVER
Unlimited cover at any private hospital Unlimited cover for in the KeyCare Access Hospital and KeyCare Hospital networks for emergencies and trauma and Unlimited cover in the KeyCare Hospital Network. A list of procedures in the KeyCare Access Hospital are covered in the day surgery network. Network for childbirth and care for newborns. Other conditions are covered in contracted network of state facilities. If you do not use hospitals in your plans networks, you will have to pay all costs

Hospitals

Full cover on Delta when using Delta Hospital Network of private hospitals

Unlimited cover at any coastal private hospitals

Upfront payments Specialists we have an agreement with Specialists we do not have an agreement with Other healthcare professionals Radiology and pathology MRI and CT scans

For planned admissions at hospitals outside of the Delta Hospital Network, an upfront payment of R5 000 must be paid to the hospital

If a coastal hospital is not used, a payment of up to 70% of the hospital account is paid and you must pay the difference Full cover

200%

100%

100%

200%

100%

100%

100% If your MRI or CT scan is done as part of an approved hospital admission, we cover your scan up to 100% of the Discovery Health Rate from your Hospital Benefit If not related to your admission or if for conservative back or neck treatment, we do not pay for it If not related to your admission, we pay it from the Specialist Benefit up to a limit of R2 550 each person each year.

CHRONIC ILLNESS BENEFIT Conditions Medicine cover

You have cover for conditions according to the Prescribed Minimum Benefits list. Your condition needs to be approved in order to be covered. Full cover provided for approved medicine on Discovery Healths medicine list. If you choose to use medicine not on our list, we will pay it up to a set monthly amount. Approved medicine must be purchased from one of our network pharmacies or from your chosen GP. If medicine is purchased elsewhere, you will have to pay a 20% co-payment. Chosen GP must prescribe the chronic medicine. Cancer treatment is covered according to the Prescribed Minimum Benefits in a network of contracted state Facilities

ONCOLOGY Benefit Co-payments Healthcare professionals Medical Savings Account Self-payment gap Insured Network Benefit Above Threshold Benefit MRI and CT scans ADDITIONAL BENEFITS Screening and Prevention Benefit Trauma Recovery Extender Benefit Specialised Medicine and Technology Benefit Overseas Treatment Benefit Allied, Therapeutic and Psychology Extender Benefit
Covers certain tests at a Discovery Wellness Network provider, like blood glucose, blood pressure, cholesterol and body mass index. We also cover a mammogram, Pap smear, PSA (a prostate screening test) and HIV screening tests. Members 65 years or older and members registered for certain chronic conditions are also covered for a seasonal flu vaccine. Covers first R200 000 of the approved cancer treatment in full over a 12-month cycle You will have to pay 20% of the cost on all further treatment once costs for cancer treatment go over R200 000 Paid up to 100% of the Discovery Health Rate Paid up to 100% of the Discovery Health Rate Cancer treatment is covered according to the Prescribed Minimum Benefits and if you go to a cancer specialist in our network

DAY-TO-DAY BENEFITS
This plan does not offer this benefit These plans do offer this benefit but they cover primary care through your chosen GP and day-to-day medicine from our medicine list. We pay for basic radiology and pathology at a network provider.

These plans do not offer these benefits

These plans do not offer these benefits

Scans paid from the Specialist Benefit up to a limit of R2 550.

These plans does not offer this benefit

Out-of-hospital claims for recovery after certain traumatic events are covered on this benefit for the rest of the year in which the trauma took place, and a year after the trauma

These plans do not offer this benefit.

Contributions
Series Executive
Executive Classic Comprehensive Classic Delta Comprehensive

2013
Contributions to Medical Savings Account Total contributions
Main member 3 764 3 086 2 780 2 315 78 70 207 106 181 145 86 69 143 2594 2335 2069 1778 1814 1449 1442 1152 1428 1350 1081 No Medical Savings Account 1 160 927 998 1330 893 638 1300 No Medical Savings Account 865 600 450 982 636 511 Adult 3 764 2 918 2629 2 189 2451 2207 1629 1397 1428 1141 1078 864 1070 1062 849 869 695 748 1330 893 638 1300 865 600 450 982 636 511 Child* 714 616 553 462 520 467 828 710 725 581 576 460 574 539 432 464 372 398 356 250 230 350 245 215 195 222 158 129 No Annual Threshold No Annual Threshold No Annual Threshold 178 154 138

Plan

Contributions
Main member 2 823 2 315 2 085 2 315 2205 1985 1552 1512 1361 1087 1226 980 1071 1350 1081 1 160 927 998 1330 893 638 1300 865 600 450 982 636 511 Adult 2 823 2 189 1 972 2 189 2084 1876 1222 1188 1071 856 917 735 803 1062 849 869 695 748 1330 893 638 1300 865 600 450 982 636 511 Child* 536 462 415 462 442 397 621 604 544 436 490 391 431 539 432 464 372 398 356 250 230 350 245 215 195 222 158 129

Annual thresholds
Main member 11 280 10 375 10 375 10 375 10 375 10 375 9 170 9 170 Adult 11 280 10 375 10 375 10 375 10 375 10 375 6 890 6 890 Child* 2 125 1 950 1 950 1 950 1 950 1 950 3 000 3 000

Main member 941 771 695 389 350 517 266 453 362 216 172 357

Adult 941 729 657 367 331 407 209 357 285 161 129 267

Child*

Comprehensive

Classic Comprehensive Zero MSA Essential Comprehensive Essential Delta Comprehensive

No Medical Savings Account

Priority

Classic Priority Essential Priority Classic Saver

Saver

Classic Delta Saver Essential Saver Essential Delta Saver Coastal Saver Classic Core Classic Delta Core

Core

Essential Core Essential Delta Core Coastal Core KeyCare Plus (8 301+) KeyCare Plus (6 251 8 300) KeyCare Plus (0 6 250) KeyCare Access (8 301+) KeyCare Access (6 251 8 300) KeyCare Access (3 901 6 250) KeyCare Access (0 3 900) KeyCare Core (8 301+) KeyCare Core (6 251 8 300) KeyCare Core (0 6 250)

KeyCare

*  We count a maximum of three children when we calculate family contributions, Annual Thresholds and Above Threshold Benefit limits. We pro-rate the Annual Thresholds according to when you join the medical scheme. All amounts are in rands.

Vitality and KeyFIT contributions

Single member Vitality KeyFIT Vitality and KeyFIT 155 33 165 Member with one dependant 179 39 195 Member with two or more dependants 199 49 229

Discovery Health offers a range of options to meet the individual needs of our members For detailed information visit www.discovery.co.za

Discovery Health Medical Scheme | 16 Fredman Drive | Sandton | 0860 99 88 77 | www.discovery.co.za

Discovery Health Medical Scheme, registration number 1125, is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider.

GM_17407DHM_29/10/2012