The Delta Range
The Delta Range offers full cover within the Delta Hospital Network, while also offering the choice of other providers, subject to a deductible.
Key features of the Delta Range
- The Delta Range is an affordable alternative that is available on selected Saver and Core Plans.
- 20% lower contribution than comparable Saver and Core Plans
- Full cover for emergencies in all hospitals
- Full cover for elective procedures in the Delta Hospital Network; R3 500 deductible applies in other hospitals
- Full cover for chronic medicine through the Delta Courier Pharmacy, 25% co-payment elsewhere
Hospital Benefits
We cover you in hospital for emergency and planned hospital admissions. In an emergency, go straight to hospital but call us or get someone to call us within 12 hours. For planned hospital admissions, please call us 48 hours before you go to hospital to confirm your admission.
| Delta Range | Classic Delta Saver and Essential Delta Saver | Classic Delta Core and Essential Delta Core |
|---|---|---|
| Overall limit | There is no overall hospital limit on the Delta Range Limits apply to some healthcare services and procedures |
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| Choice of hospitals | You are covered in full at hospitals in the Delta Hospital Network. For planned admissions at any other private hospital, you must pay a deductible of R3 500. This deductible applies in addition to any other co-payment listed below. | |
| Procedures and consultations by specialists participating in direct payment arrangements | We pay in full if you consult a specialist who charges the Premier Rate. If you are on a Classic Plan we cover a wider range of specialists in full. | |
| Other healthcare professionals | Classic Delta: We pay up to 200% of the Discovery Health Rate Essential Delta: We pay up to 100% of the Discovery Health Rate |
|
| Radiology and pathology | We cover these expenses in full up to the Discovery Health Rate | |
| Endoscopies (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy | The first R2 000 of your hospital account is paid from your Medical Savings Account. We pay the balance of the hospital account and your related accounts from your Hospital Benefit. | You must pay the first R2 000 of your hospital account. We pay the balance of your hospital account and your related accounts from your Hospital Benefit. |
| MRI and CT scans | As part of an approved hospital admission: no overall limit If admitted for conservative back and neck treatment: We pay the first R1 800 of the scan code from your Medical Savings Account. We pay the balance in full up to the Discovery Health Rate.* | As part of an approved hospital admission: no overall limit If admitted for conservative back or neck treatment: You must pay the full cost of the scan. |
| Dentistry | There is an overall limit of R11 900** for each person. The first R1 800 of your hospital account is paid from your Medical Savings Account. We pay the balance of the hospital account from your Hospital Benefit.* | There is an overall limit of R11 900** for each person. You must pay the first R1 800 of your hospital account. We pay the balance of the hospital account from your Hospital Benefit.* |
| Cochlear implants and auditory brain implants and processors | R115 000 for each person for each benefit | |
| Internal nerve stimulators | R88 000 for each person | |
| Hip and knee joint prostheses | R30 000 for each prosthesis for each event | |
| Prosthetic devices used in spinal surgery |
R18 900 for each level, limited to two levels for each procedure, and one procedure for each person each year |
|
| Mental health benefit | 21 days for each person | |
| Alcohol and drug rehabilitation | 21 days for each person | |
| Terminal care benefit | R21 300 for each person | |
* We pay all related accounts from the available funds in the Medical Savings Account if you have one. A related account is any approved account for expenses you incur during your hospital stay, other than the hospital account itself.
** We pro-rate this benefit according to when you join the medical scheme. Your hospital account is subject to this limit.
The benefits described in this section are subject to clinical guidelines and policies.
For more detailed information on how we cover specific healthcare services go to Do We Cover
Delta Hospital Network
In addition to the above hospitals, there is a list of additional day facilities available in the network.
Please note this list is subject to change.
DiscoveryCare offers specific benefits to help you manage chronic conditions
You have flexible cover for 27 chronic diseases. You have full cover for medicine on Discovery Health’s approved medicine list or up to a set amount for medicine not on our list. We pay medicine up to a maximum of the Discovery Health medication rate. We need to approve your chronic condition before it is covered from the Chronic Illness Benefit.
No additional co-payments apply when you get your chronic medicine at the designated Delta Courier Pharmacy. However, an additional 25% co-payment will apply if you don’t use the designated pharmacy.
Cover for day-to-day medical benefits (Classic Delta Saver and Essential Delta Saver)
We pay for your day-to-day medical expenses, like GP visits, x-rays and blood tests, from your Medical Savings Account as long you have money available.
Discovery Health pays claims for some day-to-day expenses to make the money in your Medical Savings Account last longer.
- GP network – If you go to a GP in our network, you will only pay a portion of the consultation fee from your Medical Savings Account. We pay the balance of the consultation fee.
- Screening Benefit– The Screening Benefit covers a range of preventive screening tests, including the following tests at a Discovery Wellness Network provider: blood glucose, blood pressure, cholesterol and body mass index. The benefit also covers a mammogram, Pap smear, PSA and HIV screening tests.
- Trauma Recovery Extender Benefit– We will cover out-of-hospital claims for your recovery after certain traumatic events. The cover applies for the rest of the year in which the trauma takes place.
Day-to-day medical benefits (Classic Delta Saver and Essential Delta Saver)
| Professional services | |
|---|---|
| General practitioners* | These expenses are limited to available funds in your Medical Savings Account |
| Specialists | |
| Allied healthcare professionals (for example physiotherapists, chiropractors, occupational and speech therapists) | |
| Radiology and pathology | |
| Mental health benefit (including psychologists and psychiatrists) | |
| Private nursing | |
| Antenatal classes | |
|
Pregnancy scans (Up to two 2D scans for each pregnancy. 3D scans covered as 2D scans) |
|
| Dentistry | |
| Endoscopies (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy) in your doctor’s rooms** | There is no limit on these health services. Discovery Health pays for these claims without using your Medical Savings Account. |
| MRI and CT scans | There is no overall limit. The first R1 800 of your scan code is paid from available funds in your Medical Savings Account. We cover the balance in full at the Discovery Health Rate. |
| Medicine | |
| Prescribed medicine (schedule 3 and above) | The claims for these expenses are limited to available funds in your Medical Savings Account. |
| Over-the-counter medicine, including prescribed schedule 0, 1 and 2 medicine and lifestyle enhancing products | |
| Appliances and equipment | |
| External medical items | The claims for these expenses are limited to available funds in your Medical Savings Account. |
| Hearing aids | |
| Optical (includes cover for spectacles, frames, contact lenses and surgery to correct refractive errors of the eye, eg excimer laser) | |
* Any time that you have no day-to-day benefits available and you visit a GP in our network, you will only pay a portion of the consultation fee from your pocket, while Discovery Health pays the balance.
** Also available on Classic Delta Core and Essential Delta Core.
For more detailed information on how we cover specific healthcare services go to Do We Cover
Annual Medical Savings Account amounts
| Main member | Adult | Per child (to a maximum of three) | |
|---|---|---|---|
| Classic Delta Saver (25%*) | 3 060 | 2 412 | 1 224 |
| Essential Delta Saver (15%*) | 1 452 | 1 092 | 576 |
2009 Monthly contributions
| Family size | Classic Delta Saver | Essential Delta Saver | Classic Delta Core | Essential Delta Core |
|---|---|---|---|---|
| Main member | R1 022 | R812 | R762 | R654 |
| Adult dependant | R805 | R609 | R599 | R490 |
| Child * | R409 | R324 | R304 | R262 |
* We count a maximum of three children when we work out the monthly contribution.
General exclusions
Discovery Health does not cover certain healthcare services. You can find a full list of these exclusions here.
How to join Discovery Health
We market our Discovery Health Plans through independent and accredited financial advisers. If you want a financial adviser to help you choose a Health Plan to suit the needs of your family, please send us your contact details and we will contact you.
