DISCOVERY HEALTH MEDICAL SCHEME SAVER SERIES

2019D I S C O V E R Y H E A LT H M E D I C A L S C H E M ESAVER SERIES

For completepeace of mindThe benefits explained in this brochure are provided by Discovery Health Medical Scheme, registration number 1125, administered by Discovery Health (Pty) Ltd,registration number 1997/013480/07, an authorised financial services provider. This brochure is only a summary of the key benefits and features of Discovery HealthMedical Scheme plans, awaiting formal approval from the Council for Medical Schemes. In all instances, Discovery Health Medical Scheme Rules prevail. Please consultthe Scheme Rules on www.discovery.co.za. When reference is made in this brochure to “we” in the context of benefits, members, payments or cover, this refers toDiscovery Health Medical Scheme. We are continuously improving our communication to you. The latest version of this guide as well as detailedbenefit information is available on www.discovery.co.za.Discovery Health Medical SchemeJoin SA’s leading medical aidDiscovery Health Medical Scheme gives you complete peace of mind thatyour healthcare is in good hands at every stage of your health journeyWidest range of plansto choose from01Rich benefits tailoredto your health needs02Choose from 23 health plan optionsdesigned to suit your individual healthand financial needsUnmatched benefits with unlimitedprivate hospital cover and full coverin our networksReal value throughaffordable contributions03Highest financialstability ratingContributions are on average16.4% lower than otherSouth African medical aidsOur industry-leading financialstability means you can havecomplete peace of mindAccess to the most advanceddigital health technology05Get rewardedfor being healthySeamless support is just oneclick away for you at every stepof your healthcare journeyYou have access to the world’sleading science-basedwellness programme, Vitality0406Vitality is a separate wellness product sold and administered by Discovery Vitality (Pty) Ltd, registration number 1999/007736/07,an authorised financial services provider.Reference to the lower cost analysis is a comparison of our contributions with those of open scheme competitors, based on aninternal analysis of publicly available marketing material.

DISCOVERY HEALTH MEDICAL SCHEMEA world of digital support is one click awayManage your health plan anywhere, anytime, in the palm of your handEasily find doctors and hospitalsTrack your healthGet the best careGet rewarded for managing your health Fully interactive, real time technology that helps you find doctors and hospitals,on our networks, near you Follow personalised health checks, recommended for you,to help you track and manage your health Give your doctor consent to view your health records before your consultationAsk Discovery Choose a doctor that suits your needs, view the doctor’s practice informationto schedule your appointment Our chat bot powered by artificial intelligence is available 24/7to provide instant answers online Book a follow-up video consultation with yourdoctor at your convenience If you need an important document or need to know aboutyour benefits, start a conversation by saying Hello, and AskDiscovery will process your request or answer your questionManage your healthDownload key documentsProactive supportHassle free admin Understand your health riskswith MyFamilyHistory andaccess progress dashboardsfor specific chronic conditions Download your tax certificatesand international travel documentswhen you need them Unlock additional benefits whenyou are pregnant and after yourbaby is born View information on hospitalprocedures for your authorisedhospital admissions You will also get tips on how you can improve your weight,nutrition and exercise levels and get rewarded along the wayDoctor advice on your deviceAnywhere anytimeYour medicine comes to you When it’s simply not possible tosee your doctor, get trusted advicefrom doctors on the Discovery Appat no additional costNo queues, no fuss Order your medicine on the Discoveryapp from MedXpress and have itdelivered to your door, or collectat a network pharmacy near youManage benefits and track claimsNever forget to take your medicineReal time, on the goGet reminders on your phone Submit and track your claims and benefitsreal time Stay on track with your prescribed medicine Get monthly reminders to refill your prescriptionDownload the Discovery app or visit www.discovery.co.za06Discovery Health Medical Scheme, registration number 1125, administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider and administrator of medical schemes. Vitality is a separate wellness product sold and administered by Discovery Vitality (Pty) Ltd,registration number 1999/007736/07, an authorised financial services provider. Ask Discovery, DrConnect, HealthID, MedXpress, MyFamilyHistory and the Discovery app are brought to you by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider and administratorof medical schemes. Visit www.discovery.co.za or click on find a provider in the Discovery app to find hospitals or providers in our network.Track your health and associated rewards are brought to you by Discovery Health (Pty) Ltd, registration number 1997/013480/07,an authorised financial services provider and administrator of medical schemes.

DISCOVERY HEALTH MEDICAL SCHEMESaver SeriesKey benefitsUnlimited private hospital coverCover for comprehensive pre- and postnatalhealthcare services for maternity and early childhoodGuaranteed full coverin hospital for specialistswho we have a paymentarrangement with,and up to 200% of theDiscovery Health Rate(DHR) on Classic plansand up to 100% of theDHR on Essential andCoastal plans for otherhealthcare professionalsFull cover for chronic medicine on ourformulary for all Chronic Disease Listconditions when you use MedXpressor a MedXpress network pharmacyAdditional cover through theDay-to-day Extender Benefit (DEB)for GP consultation fees and kidscasualty visits when your MedicalSavings Account (MSA) runs outA savings account for yourday-to-day healthcare needsCover for medical emergencieswhen travelling itality is not part of Discovery Health Medical Scheme. Vitality is a separate wellness product, sold and administered by Discovery Vitality (Pty)VLtd, registration number 1999/007736/07, an authorised financial services provider. MedXpress is brought to you by Discovery Health (Pty) Ltd,registration number 1997/013480/07, an authorised financial services provider.07

SAVER SERIESThe Saver Series hasfive health plan optionsThe five plan options have differences in benefits, as indicated below.All other benefits not mentioned in the table are the same across all five plan options.ClassicClassic DeltaEssentialEssential DeltaCoastalHospital coverHospital networkAny private hospitalPrivate hospitalsin the Delta NetworkAny private hospitalPrivate hospitalsin the Delta NetworkAny private hospitalin the four coastalprovincesDefined list ofprocedures in aday surgery networkPrivate day surgeryfacility in thedefined list ofnetwork facilitiesPrivate day surgeryfacility in the definedlist of Delta networkfacilitiesPrivate day surgeryfacility in thedefined list ofnetwork facilitiesPrivate day surgeryfacility in the definedlist of Delta networkfacilitiesPrivate day surgeryfacility in the definedlist of Coastalnetwork facilitiesCover for healthcareprofessionalsin hospital200% of the Discovery Health Rate (DHR)100% of the Discovery Health Rate (DHR)Day-to-day benefitsMedical SavingsAccount (MSA)25% of your monthly contribution goes intoyour Medical Savings Account (MSA)15% of your monthly contribution goes intoyour Medical Savings Account (MSA)Day-to-day ExtenderBenefit (DEB)Provides access tocertain healthcareservices once youryearly allocated MSAis used upFace-to-face and video GP consultations Kids casualty visitsFace-to-face and video GP consultations, subject to certain limits08Visit www.discovery.co.za to find hospitals or providers in our network.20% of your monthlycontribution goes intoyour Medical SavingsAccount (MSA)

SAVER SERIESYou have unlimitedhospital coverAll Discovery HealthMedical Scheme plansoffer unlimited hospitalcover. Your hospital coverincludes the accountfrom the hospital andthe accounts fromyour admitting doctor,anaesthetist andany other approvedhealthcare professional.What is the DiscoveryHealth Rate (DHR)?This is a rate set by us.We pay for healthcareservices from hospitals,pharmacies andhealthcare professionalsat this rate.Unlimited coverin private hospitalsperformed outside the networkfacilities.For any planned ornon-emergency admission, youneed to contact us to confirmyour admission.PG 13 FOR T HE DEFIN EDThe Delta and Coastal optionsoffer cover for plannedadmissions in a defined network.On the Delta options, forplanned admissions at hospitalsoutside the Delta HospitalNetwork, you have to pay aportion of the hospital account.On the Coastal options, youmust go to a hospital in one ofthe four coastal provinces for aplanned admission. If you don’tuse a coastal hospital, we payup to a maximum of 70% of thehospital account and you mustpay the difference.You have full cover for a definedlist of procedures in our daysurgery network. An upfrontpayment will apply if you chooseto have these proceduresLIS T OF PROC EDU RESHow we cover yourhospital and relatedaccountsWe cover your hospital accountfrom your Hospital Benefit.Doctors, specialists and otherhealthcare professionals wehave a payment arrangementwith are covered in full forapproved procedures inhospital. You benefit fromaccess to the broadest rangeof specialists, which representover 90% of our members’specialist interactions. If youuse healthcare professionalsthat we don’t have paymentarrangements with, we will payat the rate applicable to yourchosen plan and you may havea co-payment.09 Visit www.discovery.co.za or click on find a provider in the Discovery app to find hospitals or providers in our network.

SAVER SERIESEmergencies arecovered in fullIf you have an emergency,you can go straight tohospital. If you needPrescribed Minimum Benefit (PMB) conditionsIn terms of the Medical Schemes Act 131 of 1998 and its Regulations,all medical schemes have to cover the costs related to the diagnosis,treatment and care of:medically equippedtransport, call Discovery 911on 0860 999 911.An emergency medical condition A defined list of 270 diagnosesWhat is an emergency?A defined list of 27 chronic conditions.An emergency medical condition,also referred to as an emergency,is the sudden and unexpectedonset of a health condition thatrequires immediate medicaland surgical treatment. Failureto provide medical or surgicaltreatment would result inserious impairment to bodilyfunctions or serious dysfunctionof a bodily organ or part orwould place the person’s lifein serious jeopardy.To access Prescribed Minimum Benefits, there are rules that apply: Your medical condition must qualify for cover and be part of thedefined list of Prescribed Minimum Benefit conditions. The treatment needed must match the treatments in the definedbenefits. You must use designated service providers (DSPs) in our network.This does not apply in emergencies. However, even in these cases,where appropriate and according to the rules of the Scheme, youmay be transferred to a hospital or other service providers in ournetwork once your condition has stabilised.If your treatment doesn’t meet the above criteria, we will pay up to80% of the Discovery Health Rate (DHR). You will be responsible for thedifference between what we pay and the actual cost of your treatment.10An emergency does notnecessarily require a hospitaladmission. We may ask youor your treating providerfor additional informationto confirm the emergency.