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In part twenty we looked at the Classic Smart plan. Today we look at the more basic of the two plans – the Essential Smart Plan.

Why would I choose the Essential Smart plan?

MRI and CT scans

If I wasn’t fazed by the possibility of having to pay for a MRI or CT scan out of my pocket then the Essential Smart plan is a definite option.
Scans done as part of an approved admission are paid from the hospital benefit in full, but the problem comes in if:

  • it’s not related to your admission, or
  • the reason for it is because you need conservative back and neck treatment.

The Discovery Health Rate

The Classic Smart plan offers 200% of the Discovery Health rate. 200% is better than the 100% which the Essential Smart plan offers. 100% is fine IF you have medical gap cover. In fact, if we add on gap cover, then the Essential Smart plan is still cheaper than the Classic Smart plan.

How do the day-to-day benefits work on the Essential Smart plan?

GP visits

On the Essential Smart plan you find a Smart plan networked doctor on your smartphone, book an appointment, and pay him or her R100 for the pleasure. That’s double the cost of the Classic Smart plan. You can also see a GP as often as you need to.

Acute medication

On the Classic Smart plan this is paid for. On the Essential Smart plan it isn’t.

Eye test

A R100 co-payment will secure you one eye test at an optometrist in the Smart plan network. That’s double the cost of the Classic Smart plan but it’s still a bargain.

Dental check-up

R150 will pay for one dental check-up at a dentist in the network. That’s R50 more than the Classic Smart plan but what’s R50 between friends?

Sports related injuries

While these are covered on the Classic Smart plan, they aren’t on the Essential Smart plan.

How much does it cost?

  • Main member – R1, 100 monthly
  • Adult dependants – R1, 100 per adult
  • Children – R1, 100 per child (A maximum of three children are charged for)

Quite clearly it’s not aimed at those of us with children who might need to see a GP more often. On the Classic Smart plan children only cost R612 a month.

So how does it compare to the Classic Smart plan?

Classic Smart planEssential Smart planDifference
Main memberR1, 535R1, 100R435
Discovery Health rate200%100% 100%
GP ConsultationsR50R100 R50
MedicinesR10
Eye testR50R100 R50
Dental check-upR100R150 R50
Sports related injuryR100

If this all seems confusing, so if you only want to read the pillar articles relating to Discovery Health 2017, then click 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 assistance with your medical aid? Leave your details below.

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Until next time.

The InsuranceFundi Team

 

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