Assisted reproductive therapy (ART) - supporting your fertility journey
We know that the journey to parenthood can be deeply personal, and that it does not always follow the path you expected. If you need additional support, members on the Executive Plan and Comprehensive Series, who meet the criteria, have access to cover through the Assisted Reproductive Therapy Benefit.
This benefit is designed to help ease some of the financial pressure by providing access to quality care for specific fertility treatments at a SASREG-accredited facility.
Your experience is personal, and so is the support you may need. We are here to help you navigate the emotional, physical and financial realities of this journey.
What we cover
Starting or growing your family is a meaningful journey and we're able to assist you by navigating the next steps.
The Assisted Reproductive Therapy Benefit covers you at 75% of the Discovery Health Rate up to the benefit limit of R140,000 per person per year, subject to clinical guidelines, treatment protocols, and the use of a SASREG-accredited facility. You'll have access to comprehensive cover for up to two defined cycles of assisted reproductive therapy. Each cycle includes a thoughtfully curated basket of care, designed to give you the medical support you need during this important time.
Assisted reproductive therapy (ART) consultations and medicine
A defined list of pathology
Oocyte (egg) retrieval
Embryo transfer and freezing
Ultrasound scans
Admission costs, including the laboratory fees
Embryo and sperm storage relating to the approved assisted reproductive therapy procedures.
For additional information such as entry criteria and PMB access, please refer to the Assisted Reproductive Therapy benefit guide for more details.
Members registered on the Oncology Programme who meet the Scheme's benefit entry criteria, have access to cryopreservation and egg and sperm storage of up to five years. Egg cryopreservation is covered for female members up until the age of 42. If you are not registered on the Oncology Programme or do not meet the criteria, you will be responsible for all costs related to egg or sperm cryopreservation (freezing) as these are not covered from the Assisted Reproductive Therapy Benefit.
Cover is up to 75% of the agreed Discovery Health Rate up to a limit of R140 000 per year. You will have to pay a co-payment of 25% of the costs for assisted reproductive therapy and any other costs not covered by the benefit.
We pay up to two cycles of assisted reproductive therapy (ART), including egg donated cycles, if you are 25 to 39 years old and one cycle from the age of 40 up to and including 42 years of age, per year. If you are 43 years of age up to and including 50 years of age, we will cover one egg donated IVF cycle per year, including the egg donor matching fee.
Although Assisted Reproductive Therapy is not part of the Prescribed Minimum Benefits (PMB), infertility is classified as a PMB condition by the Council for Medical Schemes (CMS). This means that all schemes must provide funding for the diagnosis, treatment and care of infertility, subject to a defined basket of care, regardless of a member's chosen plan type. You can read more about PMB cover in the Assisted Reproductive Therapy benefit guide.
Once your Assisted Reproductive Therapy Benefit has been successfully activated, this cover will automatically be made available to you.
If a semen analysis is needed for a male partner, this may also qualify for cover under the Prescribed Minimum Benefits. To activate this part of the benefit, please send the membership details of the member undergoing treatment, together with the male partner's details if they are on a different policy, to PMB_APP_FORMS@discovery.co.za
We will carefully review the application and share the outcome with you by email within 2 to 3 working days.
How to get the benefit
If you meet the benefit and clinical entry criteria, you can activate the Assisted Reproductive Therapy (ART) Benefit below. If you still meet the benefit and clinical entry criteria the following years, you do not need to activate the benefit again.
ACTIVATE ASSISTED REPRODUCTIVE THERAPY BENEFIT