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In part twenty four of this series we looked at what the Classic Delta Core plan offers. Now we look at the Essential Core in terms of cost and where it fits into the big picture.

The difference between Core plans and the rest

I think if you had to boil it down to one major difference, it has to do with the medical savings account and above threshold benefits.

  • The Executive plan has no self-payment gap and an unlimited above threshold benefit
  • The Comprehensive range has a self-payment gap and an unlimited above threshold benefit
  • The Priority range has a self-payment gap and a limited above threshold benefit
  • The Saver range has no above threshold benefit but a day-to-day savings benefit
  • The Core range only pays for chronic medication and hospital

The Essential Core Plan

This plan is less comprehensive than the Classic options:

  • It allows you to use any private hospital, but
  • It only pays 100% of the DHR for those expenses. Think of Discovery Health deciding that a procedure should cost R1, 000. This is known as the Discovery Health rate. On the Classic Core plan Discovery Health is willing to pay R2, 000 for that procedure. On the Essential Core range they only pay R1, 000.

Let’s start off with the cost:

  • Main member – R1, 648 monthly
  • Adult dependants – R1, 234 per adult
  • Children – R661 per child (A maximum of three children are charged for)

Here’s how the cost compares to Classic Smart:

Classic SmartEssential CoreDifference
Main memberR1, 535R1, 648R113
Discovery Health Rate200%100%
Choice of Private HospitalSmart plan hospital onlyAny
GP ConsultationsR50
MedicinesR10
Eye TestR50
Dental CheckupR100
Sports Related InjuriesR100

You can find our Discovery Health 2017 pillar articles by clicking on the links below:

If you’d like to drill down in more detail, here are the links to each and every plan:

Do you need any assistance with your medical aid? Leave your details below and we will get in touch.

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Until next time.

The InsuranceFundi Team

 

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