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Discovery Health Changes 2. The average increase for 2. Executive and Comprehensive plans. Priority, Saver (excl Coastal), Smart,Core (excl Coastal), and Key. Care plans. 7. 8% Coastal Saver (with 5% Savings reduction to 2. Coastal Core plan. Coastal plans: New hospitals in the coastal regions have increased admissions in these areas.

This has resulted in increased hospital claims on these plans, by 2. The Coastal Saver contribution increase has been offset against a reduction in Savings contribution, but if not for this it would be as high as Coastal Core. Executive and Comprehensive plans: These are typically chosen by members who anticipate high claims. The number of members on these plans who claim 2. The Smart Plan 2. The Smart plan launched in January 2. It has been renamed to the Classic Smart Plan, and a new option, the Essential Smart Plan, will be introduced in January 2.

The Smart plans offer members benefits with defined co- payments at network providers, including digital consultations. New benefits for Classic Smart Plan in 2. More acute medicines have been added to the medicine list with a R1. One dental check- up per year has been added, with a R1. One eye test per year at Mellins Optometrists has been added, with a R5. A sports injury benefit has been added, when referred by a Smart Network GP, including basic x- rays, two specialist visits and 4 visits per annum to physiotherapists, biokineticists or chiropractors, with a R1. The Smart hospital network has been expanded and the Smart GP network has doubled in size since inception.

New Essential Smart plan from January 2. Full hospital cover within the Smart Hospital Network. Admissions outside the network have a R8. Full cover for specialists with a payment arrangement with Discovery, or payment up to 1. Classic Smart is 2. Full cover for Chronic medication at Med.

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Xpress, Clicks, Dis- chem. One dental check- up per year, with a R1. One eye test per year at Mellins Optometrists, with a R5. Targeted Benefits in 2. Diabetes. Care. In 2.

Premier Plus GP Network will be the designated service provider (DSP) for all members registered on Chronic Benefits for Diabetes (excluding the Executive and Comprehensive plans who use the CDE). Enrolment on the Diabetes. Care program will give members access to a biokineticist visit and dietician visit per year. Members are motivated to engage in the program by a Diabetes. Care dashboard on their Discovery App, the Discovery website, or by email. The program scores their management of the disease and highlights areas that require attention.

Vitality members can enrol in personal health programs to manage their weight and their physical activity. Major Joints Network. In 2. 01. 7, members can use a national network of doctors and hospitals for elective hip and knee replacements. The providers have been chosen based on the quality of outcomes (recovery time and complications or readmissions).

Members using the network are guaranteed full cover, while those using non- network providers will have a 2. Key. Care and Essential Smart plans exclude major joint replacements. Specialised in- hospital Psychiatry Network.

To improve the quality of care for psychiatric hospital admissions, Discovery has introduced network providers for 2. The network includes facilities with separate psychiatric wards, full time psychiatrists and trained psychiatric nursing staff. Admission to a facility in the network will be covered at 1. Individualised Screening Benefits. The Screening Benefit has been updated in 2. For example, members with out of range results for glucose and cholesterol screenings will be covered for a Lipogram and Hb. A1c test as part of the screening process.

Breast Cancer and Cervical Cancer. All members will be covered for one mammogram every two years and one pap smear every three years, from 2. At- risk members will be covered for one mammogram or breast MRI once a year, a once- off BRCA test and an annual pap smear.

General 2. 01. 7 Updates. Limits, Co- Payments, Deductibles, Thresholds. All co- payments and deductibles are increased by 9. Threshold increases are plan specific. All benefit limits are increased by 9.

Oncology Threshold, External Medical Items Limit and Spinal Devices Limit. International prosthesis limits are increased by surgical inflation. Premier Plus GP Network. GP consultations will be covered from the Day- to- day Extender Benefit (previously the Insured Network Benefit) in the new Premier Plus GP Network. A Premier Plus GP is a network GP that has contracted with Discovery on quality- based metrics. Chronic Illness Benefit. The CIB medicine list has been updated, as well as the Chronic Drug Amounts (the monthly amount paid for approved medication that is not on the list).

These changes will take effect on 1st January for new members with inception dates of 1st January or later, and from 1st July 2. December 2. 01. 6 or earlier. Designated Service Providers for Chronic medication: Delta and Core plans: Med. Xpress or Med. Xpress partner pharmacies.

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Smart Plans: Med. Xpress or Med. Xpress partner pharmacies, Clicks and Dis- Chem. Key. Care: Your allocated GP or a Key.

Care network pharmacy. Medical Scheme Contribution Rates. Annual Savings Account. Thresholds. Executive and Comprehensive Plans: Priority Plans: Key. Care changes in 2. Income Bands: Key.

Care income band thresholds have increase by 7. Key. Care Plus has been removed. Key. Care Hospital Network: A two- tier network is being introduced in 2. Members will have full cover for admissions in the Full Cover Network, and will be covered for 7.

Partial Cover Network. Co- ordinated care for those with multiple Chronic conditions: Key. Care members suffering from complex medical conditions can be enrolled in the Care Coordination Program in 2.

The program will provide members with additional out- of- hospital benefits. Members will be contacted if they meet the criteria for participation. If they don’t register, a 2. Vitality and Key. Fit Contribution Rates. Members on any plan may join Vitality.

Members on Key. Care plans may join Key. Fit. Members on any plan wanting Vitality and also wanting the funeral benefits included in Key. Fit, can join both Vitality and Key.

Fit. The funeral cover is available to members where the principal member is age 6. Key. Fit 2. 01. 7The Key.

Fit benefits in 2. They are as follows: Access to a Vitality Health Check (blood pressure, glucose, cholesterol, weight assessment) at pharmacies in the Vitality Wellness Network (such as Dis- Chem and Clicks). This is paid from the Screening Benefit. Healthy. Food cash back on healthy items at Pick n Pay, increased to 1. Vitality Health Check.

Healthy. Care cash back on personal and family care products at Clicks, increased to 1. Vitality Health Check. Healthy. Gear cash back on sports gear at Totalsports, increased to 1. Vitality Health Check. Main member and spouse save up to 6. Virgin Active, and adult dependants over age 1.

New and expecting parents can activate Vitality Baby and receive a gift pack from Discovery, and earn 1. Healthy. Care at Clicks. R7. 50. 0 for up to 5 children (depending on age at time of death). This is increased to R1. R1. 1,2. 50 for children once you and your spouse(s) have completed a Vitality Health Check.

Statistics from Vitality. Average Age: The average age of South Africans is 6.

The average age of insured South Africans is 6. The average age of Vitality members is 8. The average age of Vitality members on Gold and Diamond status is 8. Vitality members: Have completed over 2.

Health Checks. Have gone to gym over 1. Vitality Active Rewards. Have bought over 2. Healthy. Food baskets with over R1 billion paid out in cash back. Have watched 2. 5 million discounted movies and booked 1 million discounted flights. Have claimed 1. 5 million Vitality Active Rewards drinks, with 1.

Team Vitality runners and cyclists, and 2. Apple i. Watch users. Have swiped Discovery.

Cards 3. 3. 8 million times and earned 1. Discovery Miles. Vitality Active Rewards 2. New partnersvida e caff. The monthly cash back percentage is applied to the cost of your shoes (maximum R2. Each member can purchase one pair of shoes per year with this benefit.

From January to March 2. Sportsmans Warehouse.

Thereafter the preferred choice of brand will be determined and members will be limited to a few select brands. Vitality Points in 2. The points structure has been changed drastically to focus primarily on activity and screening. There will be only one online questionnaire in 2. Your Vitality Health Check is based on 5 results - glucose, cholesterol, blood pressure, weight assessment and non- smoker’s declaration. You earn 2,5. 00 points for 1 result in normal range, 5,0.

You can also earn 2,5. HIV test, 1,0. 00 points for a dental check up, and 1,0. Senior members (over age 6. Vitality Active Rewards. Earn 2. 0 points for each healthy item you buy on Healthy. Food and deduct 2.

Vitality Weight Loss Rewards and various points to achieving goals, and 1. Weight Watchers. Earn points for being active: 1. Curves, or Bootcamp, up to 3.

Run/Walk for Life or with your fitness device, 3. Discovery. Card in 2. The current cash back and Miles Multiplier partners remain in force until 3.

December 2. 01. 6 and new partners will be announced in January 2. There are two new benefits next year for Discovery.

Card members with Vitality, a Discovery Health Plan, and Discovery Miles: Points to Miles: Engage in Vitality by earning points and improving your status. Manage your health to reduce claims. Use your Discovery.

Card. At the end of 2. Vitality points will be paid to you in Discovery Miles, with the payment in February 2. Boosted Travel Savings: The usual discount is 1. Blue, 2. 0% on Bronze, 2.

Silver and 3. 0% on Gold. Pay for your travel with your Discovery. Card and boost your savings up to 5.

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