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How many claims does Discovery health pays every day? You’re about to find out…

Here are a few interesting titbits about Discovery Health which you might not know:

  • 7.9% – That’s the increase at Discovery Health across all plans.
  • Across 23 plans the increases ranged from 7.27% to 8.48%.
  • Executive plan – 7.35%one plan on offer
  • Comprehensive range – 8.31% to 8.36%5 different plans on offer
  • Priority range – 8.30% to 8.35%2 plans on offer
  • Saver range – 7.60% to 7.68% 5 plans on offer
  • Smart range – 7.27% to 7.36%2 plans on offer
  • Core range – 7.60% to 7.69%5 plans (These are hospital only options) on offer
  • KeyCare Plus range – 8.32% to 8.36%1 plan with 3 cost options based on income
  • KeyCare Access range – 8.37% to 8.48% 1 plan with 4 cost options based on income
  • KeyCare Core range – 8.25% to 8.36%1 plan with 3 cost options based on income

But isn’t Discovery Health expensive and are they any good at paying claims?

There’s no such thing as cheap medical aid, and if anyone tells you otherwise, run for the hills.

According to Discovery Health:

  • Their contributions are on average 15.1% below the market average.
  • Expect to have 96.5% of all your in hospital medical costs covered across all 23 plans. In other words, R96.50 out of every R100 is paid by Discovery Health while in hospital.
  • They have R14. 2 billion set aside in member reserves. That’s your money – not Discovery Health’s – and its there to take care of unexpected costs.
  • R1,3 billion was their net surplus in 2016 alone
  • 26.3% solvency ratio versus the 25% required by the Council of Medical Schemes
  • AA+ credit rating which is the highest a South African medical scheme can achieve

So how often is the scheme used by its members?

  • 6, 906, 000 GP visits took place in 2016
  • 703, 000 hospital admissions in the same year

What kind of staffing so they need to handle a scheme this big?

Okay, so they’ll need more than one or two at the switchboard:

  • 36, 600 telephone calls a day
  • 250, 900 claims processed every day
  • 115 social media chats on a daily basis
  • 87, 000 Discovery app logins every day

Are they the biggest?

In terms of open medical schemes, YES!!!
Open” meaning anyone can join the scheme as opposed to a “closed” scheme such as GEMS where only government employees can join.

  • 800, 000 new members were added in the 10 years from 2006 to 2016.
  • Their share of the market grew from 36.9% to 55.3% during that time

Which are their most popular plans?

If you’re on one of the more unpopular plans it’s one of two things – you’re either a high income earner or very smart:

  • Executive – 1% (That takes care of the high income element)
  • Comprehensive – 12%
  • Priority – 8%
  • Saver – 45%
  • Smart – 2% (Here’s where the smart fit in)
  • Core – 13%
  • KeyCare – 19%

What’s new at Discovery Health in 2018?

Four things that weren’t here last year are:

  • Discovery Purple Collection
  • Young Families
  • Smart Suite for Young Professionals, and
  • Discovery for Corporates

Let’s bang through each of them very briefly, shall we?

Discovery Purple Collection

Unless you’re the CEO of a listed company, the owner of a large business, or a super high income earner, this might make you see purple.
Ever been into the Mercedes Benz customer lounge area with everyone sipping cappuccinos as they wait for their lifts? Kind of reminds me of the same thing – an exclusive club, and why not if you qualify?

It consists of:

  • The Purple Life Plan
  • The Purple Insure Plan
  • Discovery Purple Card
  • Purple Investments
  • Vitality Purple, and
  • The Discovery Health Medical Scheme Executive Plan

Are you also seeing the colour purple? Speak to your advisor if you’d like to join.

Young families

The big thing with young families is having kids, right?

Basically, regardless of your plan choice, Discovery Health is offering you access to comprehensive maternity and post birth benefits up to 2 years after birth. And none of this comes out of your medical savings account.

During and after pregnancy:

  • 12 Gynaecological, GP, or midwife visits prior to birth depending on plan type
  • Blood tests
  • Up to 5 antenatal and postnatal classes with a registered nurse
  • 2 2D ultrasound scans
  • 1 NIPT screening (I’m too lazy to write the full name of this one)
  • R5, 000 cover for essential devices (Breast pumps, that kind of thing) on the Executive and Comprehensive options
  • R1, 880 per day cover for private maternity ward on the Executive and Comprehensive options
  • 1 six week post birth consultation with a gynaecologist, GP, or midwife

Other benefits:

  • The Global Education Protector takes care of your child’s education needs from creche to university if you die, become disabled, or suffer a dreaded disease. This is added to your life insurance at a cost so don’t think it’s a freebie. But get this…as soon as you sign up you automatically get 10% of your child’s university tuition paid for.
  • Vitality points for antenatal classes, clinic visits and vaccinations
  • A 25% discount on your child car seat bought through one of their partners

Joining Young Families doesn’t happen automatically. You need to activate your status by way of:

  • Discovery app
  • Discovery online
  • When authorising the delivery (Sounds confusing, right? That baby is coming, authorisation or not!) by booking your bed.

Smart Suite for Young Professionals

This one’s all about giving the young person just starting out a jump start.

  • Join the Discovery Health Smart plan managed through the Discovery app
  • Vitality active rewards offering up to 25% discount on gym fees. Don’t forget the weekly and dream surprise rewards
  • Then there’s the Smart Life plan offering life insurance for as little as R100 a month and 100% of your payments back. Only the under 30’s need apply.
  • And what about the 20% discount on your car insurance cost at DiscoveryInsure? Or the up to 25% discount on Uber? All you need to be is a responsible driver and avoid late night driving.
  • Start a smart investment at DiscoveryInvest from as little as R300 a month

Discovery for Corporates

This one’s all about looking after your employees and in so doing reducing absenteeism.

The Healthcare benefits on offer are:

  • The Discovery Health Medical Scheme with a plan which will suit each and every staff member
  • Discovery PrimaryCare is a primary and emergency healthcare service aimed at the low income employee
  • Discovery Gap Cover which makes sure there aren’t any complaints from your staff for unpaid medical costs

The Wellness benefits being offered are:

  • Vitality offers 3 options in 2018 – There’s the baseline Vitality Move which is free or upgrade to Vitality Active or, better yet, upgrade to Purple Vitality.
  • Discovery Health will also arrange wellness days at your premises. Each employee will receive personalised feedback on their health while the employer gets an overview on the health of their staff as a whole.


The one thing we’ve learned is that Discovery seldom sits on their laurels. You can bet your bottom Dollar that next year this time they’ll jazz things up again.

The big highlight for us was the lower than expected increase. Stay tuned because we’re about to run through each of the plans in more detail – the good and the bad.

Can we help you with anything? Leave your details below and we will be in touch.

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