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Discovery Health Classic Zero MSA 2017

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Medical Aid Year: 
2017
Day to day Benefits: 

Unlimited private hospital cover Guaranteed full cover in hospital for specialists on a payment arrangement, and up to 200% of the DHR on Classic plans and 100% on Essential plans for other healthcare professionals Full cover for chronic medicine for all CDL conditions plus some additional chronic conditions A choice of a high or no Medical Savings Account and an unlimited Above Threshold Benefit for your day-to-day healthcare needs Additional cover for GP consultation fees and some external medical items. The Classic Comprehensive Plan also covers preferred medicine, blood tests, antenatal consultations, kid’s casualty visits and video call consultations with paediatricians Cover for medical emergencies when travelling

Co-payments: 
You will be required to pay 20% of the cost on all further treatment once costs for cancer treatment go over 400 000. Prescribed Minimum Benefits are covered in full.
In Hospital Benefits
Are you prepared to use designated hospitals?: 
No
Hospitals: 

Unlimited cover

Upfront Payments to hospitals: 

No upfront payment

Specialists: 
Full cover
Other healthcare professionals eg. Physio, Occupational, Dietician: 
200% of the DHR
Radiology and pathology: 
100% of the DHR
Scopes (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy): 
We pay the first R3 150 of the hospital account from your day-to-day benefits and the balance of the hospital account and related accounts from the Hospital Benefit.
MRI and CT scans: 
If done as part of an approved admission, we will pay up to 100% of the DHR from the Hospital Benefit.
Maternity Confinements: 
You have access to antenatal consultations and 2D pregnancy scans, provided you use a gynaecologist/obstetrician who we have a payment arrangement with.
Treatment for Mental Health: 
21 days for admissions or up to 15 outof- hospital consultations for each person for major affective disorders, anorexia and bulimia and up to 12 out-of-hospital consultations for acute stress disorder accompanied by recent significant trauma. 21 days for
International Travel Benefit: 
Up to 500 000 for each person travelling for evidence-based healthcare treatment not available in South Africa. A copayment of 20% and specific rules apply to this benefit.
Day-to-day benefits
GP consultations: 

100% of the DHR

Specialist consultations: 

100% of the DHR

Acute medicine: 

100% of the DHR

Over-the-counter (OTC) Medicine: 

We pay these claims from the available funds in your Medical Savings Account. These claims do not add up to the Annual Threshold and are not paid from the Above Threshold Benefit.

MRI and CT Scans (Out of Hospital): 
We pay the first 2 900 of your MRI or CT scan from your day-to-day benefits. We cover the balance of the scan from the Hospital Benefit, up to the DHR. For conservative back and neck scans, where specific rules apply. On Classic Zero MSA, these are cover
Chronic Conditions
Additional Chronic Conditions: 
You have cover for the 27 CDL conditions according to the Prescribed Minimum Benefits list as well as additional conditions on our Additional Disease List. Your condition needs to be approved for it to be covered.
Total Contributions
Total Contribution Main Member: 
3380.00
Total Contribution Adult: 
3199.00
Total Contribution Child*: 
674.00
Classic Comprehensive Zero MSA
Annual Threshold Amounts
Annual Threshold Main Member: 
15500.00
Annual Threshold Adult: 
15500.00
Annual Threshold Child*: 
2950.00
Risk Contributions
Risk Contribution Main Member: 
3380.00
Risk Contribution Adult: 
3199.00
Risk Contribution Child: 
674.00
Benefit: 
We cover the first 400 000 of approved cancer treatment in full over a 12-month cycle.
How many times per annum do you and your dependants visit a doctor?: 
15
How much do you spend on Acute medication per annum?: 
More than R 5000
How much do you spend on Chronic medication per annum?: 
More than R 5000
Will you or any of your dependants require specialised Dentistry: 
Yes