Your 6-step guide to choosing a Discovery Health Medical Scheme plan option

How do you choose the right Discovery Health Medical Scheme plan option? How do you know which plan meets your needs, and your family's? Have you been asking yourself these questions? Choosing which plan option is right for you is an important decision to make from both health and financial points of view.

The good news is that once you understand a few simple concepts, choosing the right Discovery Health Medical Scheme plan option becomes much easier to do.

Here's your 6-step guide to choosing a Discovery Health Medical Scheme plan option

1. Understand your health needs before choosing a medical aid plan

Your cover needs depend on your life stage and health status. Choosing the right plan starts with understanding what you and your family's healthcare needs are.

Ask yourself:

• How often do I visit a GP or specialist?
• Do I have chronic conditions that need ongoing medicine or treatment?
• Am I planning to have children or add dependants to my policy in the near or distant future?

Some people may want healthcare cover only for planned or unexpected hospital admissions. Others may want healthcare cover that also funds their out-of-hospital care, such as paying for GP visits, chronic medicine or specialist consultations.

For example: If you visit a doctor often or live with a chronic condition, a plan with broader day-to-day benefits can help reduce what you pay yourself (which is called 'paying out-of-pocket'). If you're young, healthy and rarely see a doctor, a plan focused on hospital cover may be all you need at this stage of your life. Like everyone, even young and healthy people can face unexpected and expensive hospital admissions, and this is where having medical scheme cover in place is really important.

Life happens! Read more on how joining a medical scheme early protects young members from unpredictable, high-cost health events, like expensive admissions to hospital.

2. Think beyond the monthly contribution when choosing medical aid

Choosing the right medical aid isn't just about your monthly payment. It's about:

• Having access to quality care when you need it
• Reducing the financial impact of unexpected medical events
• Supporting your long-term health through preventive care and wellness programmes.

Discovery Health Medical Scheme plans are designed to support people at different life stages - whether you're starting out, raising a family or planning for the years ahead.

3. Set a realistic budget for your medical aid plan

Choosing the right medical aid plan ensures your cover works as a financial safety net, helping protect your budget rather than adding strain.

Before comparing plans, take time to understand what you can afford. Ask yourself:

• What monthly contribution (your premium) can I comfortably manage?
• Will this plan still fit my budget in a year or two?

While cheaper plans can be appealing, choosing on price only can cost you more in the long run. If a plan doesn't meet your healthcare needs, you may end up paying significant out-of-pocket expenses. Aim for a balance between affordability and the level of cover you need.

3. Know what each type of medical aid plan covers

Medical aid plans differ in the level of cover they provide and how you access care. Understanding these differences helps you choose a plan that matches your needs:

• Hospital-focused plans: These are generally more affordable and cover major medical events and hospital admissions.
• Comprehensive plans: These include hospital cover plus out-of-hospital benefits, such as GP visits, chronic medication and specialist consultations.

If you're healthy and rarely need medical care, a hospital-focused plan may be enough for now. If you or your family need regular care, a comprehensive plan can offer better value and peace of mind over time.

Explore Discovery Health Medical Scheme health plan categories

Discovery Health Medical Scheme offers a range of 25 plan options designed to suit different healthcare needs and budgets:

• Executive and Comprehensive plans
  This range of plans presents the most extensive cover, including hospital benefits, generous day-to-day cover, higher medical savings and extended benefits for chronic conditions.
• Priority and Saver plans
  This range of plans offers solid in-hospital cover and structured day-to-day benefits at an affordable monthly contribution.
• Network plans such as KeyCare and Smart plans
  This plan range features cost-effective options that use selected networks of doctors and hospitals to keep contributions lower while maintaining quality care. This includes our new Active Smart Plan with young professionals in mind which offers cover for hospital and emergency care, valuable day-to-day benefits and access to Personal Health Pathways - all at a compelling contribution of R1,350 per month. Starting or have a family? The Classic Smart Saver and Essential Smart Saver is designed around the healthcare and financial needs of young, growing families.

All Discovery Health Medical Scheme plans include unlimited private hospital cover (subject to Scheme rules). Some plans also feature a Medical Savings Account and Above Threshold Benefits, which we explain in the next section.

4. Understand key medical aid terms before you choose a plan

It helps to understand some terms when talking about medical aid. Here are the most important ones:

• Medical Savings Account
  Part of your monthly contribution is allocated to an account for everyday healthcare expenses, such as GP visits or medicine. Once these savings run out, you pay from your own pocket unless your plan offers extra cover.
• Above Threshold Benefits
  These benefits may apply after you've used all your medical savings. They help cover certain out-of-hospital expenses, depending on your plan.
• Out-of-pocket costs
  This refers to the healthcare expenses you pay yourself when your plan doesn't cover the full amount or when you've used up your available benefits.

5. Check if your doctors or hospitals are in your medical aid plan option's network

Some Discovery Health Medical Scheme plans use specific networks of doctors, specialists and hospitals. Choosing a plan within these networks often means lower costs and better cover. Before you decide, check:

• Are your preferred doctors and hospitals part of the network?
• Will the plan still suit your needs if you travel or move to a different area?

These factors can make a big difference to both convenience and what you pay when you're choosing which doctors to see and where to go for treatment.

6. Understand how 'waiting periods' work on medical aid plans

When you join a medical aid, waiting periods may apply - especially if you're signing up for the first time or have pre-existing health conditions. During this time, some benefits may be limited or unavailable.

Knowing about waiting periods upfront helps you avoid unexpected surprises later. Always review the plan rules or speak to a consultant to understand how waiting periods could affect your cover.

Ready to take the next step?

Compare Discovery Health Medical Scheme plans online and get a personalised quote in minutes. Find the option that fits your healthcare needs and budget today.