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    2014YOUR GUIDE TO THE COMPREHENSIVE SERIES

    ComprehensiveSeries2014

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    Regards

    Milton Streak

    Principal Ofcer:

    Discovery Health Medical Scheme

    Dr Jonathan Broomberg

    CEO:

    Discovery Health

    YOUR HEALTHCARE COVER IN 2014

    Dear Member

    Thank yo fo giving s the oppotnity to ook ae yo heathae ove needs

    O aim is to keep yo heathy and povide yo with the best of ae when yo need it most.

    We design o integated podt soons to make se yo get the most vae fom yo heath pan, and to assist yo in avoiding ot-of-poket payments wheeve possibe,

    espeiay when yo o yo oved ones expeiene a ia iness o majo hospita admission. This integated appoah to yo heathae is made possibe by the ombined

    powe of the Disovey Heath Media Sheme and Disovey Heath (both efeed to as Disovey Heath in this bohe), as we as Disovey Vitaity.

    The Disovey Heath Media Sheme oes the widest ange of heath p ans in the maket. It is Soth Afias agest open media sheme with ove 2, 5 miion membes and

    moe than 50% shae of the oa open media shemes maket. As a membe of the Disovey Heath Media Sheme, a poon of yo monthy ontibons goes into yo

    individa Media Savings Aont (depending on yo hosen pan) to be sed by yo to ove yo day-to-day media expenses. The emainde goes into the Shemes aont,

    and is sed to pay a membes appoved media aims. Whateve is e ove at the end of eah yea emains in the Sheme to be sed to pay aims in fte.

    Disovey Heath is the administato of the Disovey Heath Media Sheme, esponsibe fo many fnons, inding aims poessing and payment, and ient sevie toh

    points sh as the website and a ente.

    Vitaity is a sepaate Disovey ompany that oes a weness pogamme that yo may hoose to join as a Disovey Heath Media Sheme membe. Vitaitys abiity to make

    peope heathie and give them geat ewads has made it the wods eading weness pogamme, with ove ve miion membes on fo onnents.

    This gide gives yo a smmay of the heath pans we oe and the ih benets avaiabe within the dieent pans, so yo an hoose the one that is ight fo yo heathae

    needs and those of yo famiy. Yo wi aso nd infomaon abot the addiona benets and toos povided by Disovey Heath and Vitaity. Pease famiiaise yosef with the

    infomaon we have povided yo with so yo an make the best hoies when it omes to yo heathae.

    Stay in touch with us

    twie.om/disovey_sa

    faebook.om/disoveyheathsa

    www.disovey.o.za

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    TEN REASONS WHY YOUR BEST CHOICE ISTHE DIScOVErY HEAlTH MEDIcAl ScHEME

    Thisboheis onyasmmay ofthe keybenetsandfeatesof theDisoveyHeathMediaS hemepans,awaingfomaappovafom theconifo MediaShemes.Fdetaisan befondin theDisoveyHeathMedia Shemeres.It asosmmaisesotheDisoveypodtsand vae-addedsevies. Whenefeeneismade towe intheontextof benets,membes,paymentsoove inthisbohe,this isefeeneto theDisoveyHeathMedia Sheme. Foompianeqesons,emaiompiane@disovey.

    o.za.DisoveyHeathMediaS heme,egistaonnmbe1125,is administeedby DisoveyHeath(Pty) ltd,egistaonnmbe1997/013480/07,an athoisednaniaseviespovide.Vitaityis notpatof theDisoveyHeathMedia Sheme.Vitaityis asepaatepodtsodand administeedby DisoveyVitaity(Pty)ltd, egistaonnmbe1999/007736/07,anathoisednaniaseviespovide.

    R

    EASON

    SWe oe the widest range of health plansinthe maket, so yo an est assed that theeis one that is exaty ight fo yo and yofamiys heathae needs.

    The widest range of healthplans in the market

    Ove 2,5 miion Soth Afians entst thei

    heathae fnding to s. One of the benets of this

    sae is the abiity it gives s to ontain heathae

    osts and pass these savings on to yo. On a ike-

    fo-ike basis, Disovey Heath Media Sheme

    plan contribuonsae as mh as15% lowerthan

    those of any othe Soth Afian media sheme.

    The most compevecontribuons

    The Disovey Heath Media Sheme has moe

    than r9 biion in eseves. Goba cedit rangs

    has onnay given s the highest possibe

    media sheme ang (AA+) fo o abiity to

    pay yo aims.

    The Discovery Health MedicalScheme has the highest credit rang

    We believe in giving you every opportunity

    to engage and interat with us and with your

    heath pan, and to get the most out of it.

    Our Discoveryappand our websitehave

    both been ppose-bit to do exaty that.

    Discovery HealthID, o awad-winning

    tabet appiaon fo dotos, aows yodoto to digitay aess yo heath

    eods ae yo have given pemission.

    Your dotor an gain insight into your

    benets, study your bood test resuts and

    write eetroni presripons, a with the

    touh of a nger.

    Our technology unlocksthe best of care

    We beieve that pevenon is bee than

    e, and so we avey enoage yoto detet and teat any iness as eay aspossibe. Thats why we ove a ange ofpevenve tests fom hoesteo to HIVseening withot sing the money inyo Media Savings Aont.

    We help you to stay healthy

    Yo have the best ove among Soth

    Afian media shemes fo aneteatment. In addion, with an Exeve

    o compehensive Pan, yo get exta ove

    for new and expensive medicinesand for

    etain teatments that ae avaiabe ony

    otside Soth Afia.

    We give you access to themost advanced medical care

    Emegeny HeathID enabes emegeny

    pesonne to seey aess yo essenainfomaon when yo ae not abe to give it

    to them, by sanning yo niqe Qr ode

    on yo a ske.

    We provide you withlife-saving emergency support

    Disovey Heath oes yo p to 25% ash bak on

    ove-the-onte mediines (shede 1 and 2) atciks, essena honi ae items at Dis-chem, and

    mbiia od bood and sse stem e banking at

    Netes. Yo an enjoy moe savings of p to 20% on

    fames and enses at an optometist in the Disovey

    netwok of optometists.

    We help you save on over-the-countermedicines, chronic care items,optometry and stem cell banking

    By being a Disovey Heath Media Sheme

    membe, yo have the oppotnity to joinVitaity, the wods eading siene-based

    weness pogamme that both enoages

    and ewads heathy behavio.

    Vitality

    Our extensive network of heathare providers,

    ombined with our unique toos, mean you an

    avoid o-payments when vising a speiaist or

    GP, on day-to-day preferenay pried mediines,

    bood tests or when going to hospita. look out for

    the Fu cover choie stamp on our website and

    in our guides to point you in the zero o-paymentdireon.

    We give you thechoice of full cover

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    THE DISCOVERY HEALTH MEDICAL SCHEMEPrODucT PlATFOrM

    The Disovey Heath Media Sheme oes a ange of opons to ate fo evey need fom the Exeve Pan to the Keycae

    Seies. Eah pans ove anges fom hospitaisaon to honi mediine, with many pans oeing day-to-day ove as we.

    Hospital coverThee is no ovea imit fo hospita ove on any DisoveyHeath Media Sheme pan. Yo an go to any pivate hospitaon most pans. The Deta, coasta and Keycae Pans oe

    hospita ove in a dened netwok of hospitas.If yo se a speiaist who we have a payment aangementwith, we ove yo in f fo yo appoved poedein hospita.

    Chronic illness cover

    A Disovey Heath Media Sheme pansove appoved mediine fo the choniDisease list ondions. We pay appovedhoni mediines that ae on theShemes mediine ist in f, o p to aset monthy and amont fo mediinesnot on the mediine ist.The Exeve and compehensive Pansoe ove fo addiona ondions.On the Exeve Pan yo aso have exsiveaess to a dened ist of band mediines whih weove in f.

    Screening and prevenon

    The Seening and Pevenon Benet oves bood

    gose, bood pesse, hoesteo and body mass indexmeasements at a Disovey Weness Netwok povide. Thebenet aso pays fo a mammogam, Pap smea, PSA (postateseening test) and HIV seening tests. If yo ae 65 yeas oode o ae egisteed fo etain honi ondions, we asoove a seasona vaine.

    Discovery Vitality oers the worlds leading science-based programme with a personalised approach to wellness

    Vitaity heps yo get heathie by giving yo the knowedge, toos and movaon to impove yo heath its been iniay poven that Vitaitymembes ae heathie, ive onge and have owe heathae osts.

    Disovey Vitaity (Pty) ltd is an athoised nania sevies povide. registaon nmbe: 1999/007736/07.

    The Above Threshold Benet further extends your

    day-to-day coverThe Exeve, compehensive and Pioity Pans inde an Above TheshodBenet that gives fthe day-to-day ove one yo aims add p to aset amont (yo Anna Theshod). On the Exeve and compehensiveSeies, the Above Theshod Benet is nimited. On the Pioity Seies, theAbove Theshod Benet has an ovea imit.

    Your Medical Savings AccountWe pay yo day-to-day media expenses fom yo Media Savings

    Aont on Exeve, compehensive, Pioity and Save Pans. Anynsed fnds ae aied ove to the next yea nike tadiona

    pans whee nsed ove is ost.

    The Insured Network Benet extends

    your day-to-day cover for essenal healthcare

    servicesWe extend yo day-to-day ove thogh the Insed

    Netwok Benet. When yo have spent yo annaMedia Savings Aont aoaon and befoe yoaims add p to the Anna Theshod, we ove

    sevies sh as GP onstaon fees, bood tests,day-to-day ost-eeve mediine, matenity osts and

    dabe extena media items fom a povide in o netwok.The heathae sevies oveed depend on the heath pan yo have

    hosen.

    Day-to-day cover

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    A FULL COVER CHOICEEXISTS ON EVErY PlAN

    O extensive netwoks of heathae povides, ombined with o niqe sef-sevie toos, mean yo an aways

    avoid o-payments. These ps wi gide yo to f ove. remembe to ook ot fo the f ove stamp thoghot this gide.

    Use our extensive hospital networksYo ae oveed in f when yo se a netwok hospitaon pans that oe a dened netwok of hospitas. use

    o onine MaPS too to nd a hospita in o netwok.

    1

    Go for prevenve screening testsWe ove pevenve seening tests sh as mammogams, bood pesseand hoesteo tests whih ae geat at deteng eay waning signs of seiosiness. Having these tests done heps yo to stay heathy, bease pevenon is

    bee than e.

    5

    Use our preferred medicine

    A Disovey Heath Media Sheme

    pans oe a ompehensive ist ofmediine whih we ove in f.The Exeve Pan oes addionaove fo an exsive ist of bandmediines. unde the InsedNetwok Benet, we ove pefeedmediine one yo have spent theanna fnds in yo Media SavingsAont. use Disovey MedXpesso ask yo phamaist abot yoopons to avoid a o-payment.

    3

    Use a GP or specialist who we have a

    payment arrangement with

    We oe the boadest ange of GP and speiaistpayment aangements, whih povides f ove

    both in and ot of hospita. Amost 90% of omembe inteaons ae with a GP o speiaistin o payment aangements. use o MaPS tooto nd a heathae pofessiona who we have anaangement with.

    2

    Use a network provider to access the

    Insured Network Benet when you have

    used up your Medical Savings AccountOne yo have spent yo anna Media Savings Aont(MSA) aoaon and befoe yo aims add p to theAnna Theshod, we extend yo day-to-day ovethogh the Insed Netwok Benet. Yo have ove fonimited GP onstaon fees, bood tests, ost-eeveday-to-day mediine, matenity osts and etain dabe

    extena media items. cove fo these heathae seviesdepends on the heath pan yo have hosen. use MaPS tond a netwok povide.

    4

    Yo an aess MaPS and MedXpess at www.discovery.co.zao on the Disovey app.Disovey Vitaity (Pty) ltd is an athoised nania sevies povide. registaon nmbe: 1999/007736/07.

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    5 5

    Discovery Health Rate (DHR)

    This is a ate set by the Disovey Heath Media Sheme at whih aims and sevies fo heathae povides

    (hospitas, phamaies and heathae pofessionas) wi be paid.

    Hospital cover

    We ove yo in hospita fo emegeny and panned hospita admissions. Yo have to get

    athoisaon fom s fo yo hospita stay. Yo hospita ove is made p of yo hospita

    aont and eated aonts. A eated aont is an aont fom yo teang doto,

    anaesthest and any othe appoved heathae sevies ike pathoogy o adioogy sans.

    Networks

    Some pans, benets and heathae sevies eqie yo to se the Shemes netwok povides. If yo se

    these povides we ae abe to keep yo ontibons as aodabe as possibe whie ensing f ove.

    Limits

    Most in- and ot-of-hospita heathae benets ae nimited bt thee ae some heathae sevies

    sh as densty and optomety that ae sbjet to anna imits. It is impotant fo yo to famiiaise

    yosef with these imits and to tak yo sage by ogging onto www.disovey.o.za o heking

    yo statements.

    DHR

    Payment arrangements

    The Sheme has enteed into payment aangements with vaios heathae pofessionas that haveageed to be eimbsed at the Disovey Heath rate. This enses no o-payments fo yo. Yo

    benet fom aess to the boadest ange of GPs and speiaists, whih epesents amost 90% of

    membes inteaons with these heathae pofessionas.

    Day-to-day cover

    Day-to-day ove indes yo visits to heathae pofessionas ot of hospita, adioogy, pathoogy and mediines phased

    fo eveyday se. We ove yo day-to-day heathae sevies fom the Media Savings Aont, Insed Netwok Benet and

    Above Theshod Benet. The eve of day-to-day ove depends on the pan yo hoose.

    Medical Savings Account (MSA)This is an amont that gets set aside fo yo at the beginning of the yea o when yo join the Sheme.

    Yo an se it fo day-to-day heathae expenses ike doto visits, optomety, mediine, pathoogy and

    adioogy as ong as yo have money avaiabe. Money not sed at the end of the yea wi be aied

    ove to the next yea.

    Above Threshold Benet (ATB)The Above Theshod Benet gives yo exta ove at the Disovey Heath rate o a peentage of it

    when yo aims add p to a set amont aed the Anna Theshod. The ATB appies to the Exeve

    Pan, compehensive Seies and Pioity Seies. The ATB has a imit on Pioity Seies.

    Insured Network Benet (INB)

    This niqe benet gives yo nimited day-to-day ove fo a set of heathae

    sevies at a netwok povide when yo have spent the anna fnds in yo

    Media Savings Aont. These heathae sevies inde GP onstaon fees

    day-to-day ost-eeve mediines, bood tests, matenity osts and dabe

    extena media items. The eve of ove depends on the pan yo hoose.

    Chronic Illness Benet (CIB)

    The choni Iness Benet oves a ompehensive ist of honi ondions that indes asthma,

    diabetes, high hoesteo and high bood pesse. The choni Disease list (cDl) is a dened ist of

    honi ondions we ove aoding to the Pesibed Minimm Benets. Exeve and compehensive

    Pans oe ove fo addiona honi ondions. Yo have f ove fo appoved mediine on the

    Shemes mediine ist o p to a set monthy choni Dg Amont fo mediine not on the mediine ist.

    The choni Dg Amont is a monthy maximm amont we pay fo a ass of mediine.

    Medicine list

    This is a i st of appoved honi mediines that the Sheme oves in f. The

    ist indes an extensive ange of high-qaity mediines fo a oveed honi

    ondions to ense yo aways have an opon of f ove.

    IMPORTANT CONCEPTS TO HELP YOUuNDErSTAND YOur HEAlTH PlAN

    PMB

    Prescribed Minimum Benet (PMB) condions

    These ae ondions whih a media shemes ae eqied to ove as set by the coni fo Media Shemes aoding

    to inia gideines. Yo may be eqied to se a Designated Sevie Povide (DSP). A DSP is a hospita o heathae

    povide who has an ageement with the Disovey Heath Media Sheme to povide teatment o sevies at a

    ontated ate and withot any o-payments by yo.

    Self-payment Gap (SPG)

    This is a tempoay gap in ove when yo n ot of fnds in yo MSA bt have not yet eahed yo Anna

    Theshod. Yo wi have to pay fo day-to-day aims fom yo own poket ding this peiod. Yo mst s

    sbmit aims to s so that we know when to stat paying fom yo Above Theshod Benet.

    use these handy denions to hep yo ndestand impotant onepts disssed in this gide.

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    cassi | cassi Deta | cassi Zeo MSA | Essena | Essena DetaPlan range

    COMPREHENSIVE SERIESKEY FEATurES

    unimited pivate hospita ove

    Gaanteed f ove in hospita fo speiaists on a payment

    aangement, and p to 200% of the Disovey Heath rate fo

    othe heathae pofessionas

    F ove fo honi mediine fo a cDl ps some addiona

    honi ondions

    A high savings aont and an nimited Above Theshod Benet

    fo yo day-to-day heathae needs

    Addiona ove fo GP onstaon fees, pefeed mediine,

    bood tests, matenity osts and some dabe extena media

    items

    Aess to speiaised, advaned media ae in SA and aboad

    cove fo media emegenies when taveing

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    COMPREHENSIVE SERIESHOSPITAl cOVEr

    Yo hospita ove is made p of:

    cove fo the aont fom the hospita

    cove fo the aonts fom yo adming doto, anaesthest o any othe appoved heathae pofessiona.

    Cover for your hospital accountWe ove yo in any pivate hospitas fo emegeny and peathoised hospita admissions. We ove yo hospita aont

    (the wad and theate fees) at the ate ageed with the hospita. Yo have nimited ove fo genea wads.

    Network hospitals on Delta

    OnClassic DeltaandEssenal Delta, yo ae oveed in f at pivate hospitas and day-inis in the Deta Hospita Netwok.

    Fo panned admissions at hospitas otside the netwok, yo mst pay an amont of r5 450 pfont to the hospita. This does

    not appy in an emegeny.

    Cover for related accountsWe gaantee f ove when yo se heathae pofessionas who we have a payment aangement with. If yo ae on

    a cassi Pan yo benet fom aess to the boadest ange of speiaists, whih epesents ove 90% of o membes

    speiaist inteaons.

    On the cassi Pans we ove speiaists who we dont have a payment aangement with and othe heathae pofessionas

    p to 200% of the Disovey Heath rate.

    On the Essena Pans we ove speiaists who we dont have a payment aangement with and othe heathae

    pofessionas p to 100% of the Disovey Heath rate.

    radioogy and pathoogy ae oveed p to 100% of the Disovey Heath rate on a pans.

    Invesgaons are covered dierently

    Cover for scopes (gastroscopies, colonoscopies, sigmoidoscopies and proctoscopies)

    We pay the st r2 500 of yo hospita aont fom yo avaiabe day-to-day benets. We pay the baane of the hospita

    aont and yo eated aonts fom yo Hospita Benet.

    We ove yo in hospita fo emegeny and panned hospita admissions. Thee is no ovea imit fo hospita ove.

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    8

    COMPREHENSIVE SERIESHOSPITAl cOVEr

    Cover for MRI and CT scans

    If yo MrI o cT san is done as pat of an appoved hospita admission, we pay fo it fom yo Hospita Benet at 100% of the Disovey

    Heath rate.

    If yo ae admied fo onsevave bak o nek teatment, o if the san is not eated to yo hospita admission, we pay the st r2 450

    of the amont fo the san fom yo avaiabe day-to-day benets. We pay the baane of the san fom yo Hospita Benet, p to 100%of the Disovey Heath rate. Spei es and imits appy to onsevave bak and nek sans.

    On the cassi Zeo MSA, MrI and cT sans ae oveed one yo eah yo Anna Theshod.

    Cover for dental treatment

    Severe dental and oral surgery

    The Sevee Denta and Oa Sgey Benet oves a dened ist of poedes, with no pfont payment and no ovea imit. This benet is

    sbjet to athoisaon and the Shemes inia es.

    Dental treatment in hospital

    Yo need to pay a poon of yo hospita o day-ini aont pfont fo denta admissions. This amont vaies, depending on yo age

    and the pae of teatment:

    Hospital

    Younger than 13 R1 550

    Day-clinic

    Younger than 13 R750

    13andolder R4 000 13andolder R2 600

    We pay the baane of the hospita aont fom yo Hospita Benet, p to 100% of the Disovey Heath rate. We pay the eated

    aonts, whih inde the denta sgeons aont, fom yo Hospita Benet, p to 100% of the Disovey Heath rate.

    On cassi Pans, we pay anaesthests p to 200% of the Disovey Heath rate.

    We ove one, onsevave densty, sh as pevenve teatments, simpe ings and oot ana teatments fom yo avaiabe

    day-to-day benets.

    No overall dental limit

    Thee is no ovea imit fo denta teatment. Howeve, a denta appianes, thei paement, and othodon teatment (inding eatedaonts fo othogna sgey) ae paid at 100% of the Disovey Heath rate fom yo day-to-day benets, p to an anna imit of

    r20 900 a peson. If yo join the Sheme ae Janay, yo wont get the f imit bease it is aated by onng the emaining

    months in the yea.

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    9

    COMPREHENSIVE SERIESHOSPITAl cOVEr

    Dental appliances, their

    placement and orthodoncsr20 900 fo eah peson fom yo day-to-day benets. If yo join the Sheme ae Janay, yo wontget the f imit bease it is aated by onng the emaining months of the yea.

    Cochlear implants, auditory

    brain implants andprocessors

    r170 000 fo eah peson fo eah benet

    Internal nerve smulators r124 000 fo eah peson

    Hip, knee and shoulderjoint prostheses

    Thee is no ovea imit if yo get yo posthesis fom o pefeed sppies. If yo hoosenot to, a imit of r35 000 appies to eah posthesis.

    Prosthec devices used inspinal surgery

    r24 500 fo the st eve, r49 000 fo two o moe eves, imited to one poede fo eah peson

    Mental health 21 days fo eah peson

    Alcohol and drug

    rehabilitaon21 days fo eah peson

    Compassionate care r40 000 fo eah peson in thei ifeme

    Some healthcare services have an annual limit

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    10

    COMPREHENSIVE SERIEScHrONIc IllNESS, cANcEr AND HIV cOVEr

    Cover for chronic condions

    Yo have extensive ove fo a ompehensive ist of honi ondions whih indes the choni Disease list and the

    Addiona Disease list. We need to appove yo appiaon befoe we ove yo ondion fom the choni Iness Benet.

    Cover for condions on the Chronic Disease List

    Yo have f ove fo appoved mediine on o mediine ist. If yo se mediine that is not on the mediine ist, yo an

    se p to a set monthy amont fo eah ass of mediine.Cover for condions on the Addional Disease List

    Yo an se p to a set monthy amont fo eah ass of mediine.

    How we pay for medicine

    We pay fo mediine p to a maximm of the Disovey Heath rate fo mediines. The Disovey Heath rate fo mediines

    is the pie of mediine as we as a fee fo dispensing it. The Disovey Heath Media Sheme has negoated ontats with

    ove 2 000 phamaies, who have ageed to hage no moe than this ate. If yo se a phamay otside of this netwok, yo

    may have a o-payment on the dispensing fee haged by the phamaist.

    On Classic Deltaand Essenal Delta, yo have ove fo appoved honi mediine, if yo se MedXpess. If yo dont seMedXpess a 20% o-payment appies.

    Cover for diabetes

    If yo ae egisteed on the choni Iness Benet fo diabetes, yo have aess to a f ange of sevies fo the ongoing

    management of yo ondion thogh the cente fo Diabetes and Endoinoogy. We aso ove appoved betooth enabed

    gose monitoing devies and test stips that hep yo and yo doto with ea-me management of yo ondion.

    Cover for cancer

    If yoe diagnosed with ane, we ove yo fom the Disovey CareOnoogy Pogamme one we have appoved yo

    ane teatment. We do not imit yo ane teatment osts. We ove the st r400 000 of yo appoved ane

    teatment ove a 12-month ye in f. If yo teatment osts moe than r400 000, yo wi need to pay 20% of theaddiona osts. cane teatment that is a Pesibed Minimm Benet is aways oveed in f.

    A ane-eated heathae sevies ae oveed p to 100% of the Disovey Heath rate. Yo might have a

    o-payment if yo heathae pofessiona hages above this ate.

    Cover for HIV and AIDS

    When you register for our HIVCarePogamme yo ae oveed fo the a-insive ae that yo need. Yo get aess

    to iniay sond and ost-eeve teatment and yo an be assed of ondenaity at a mes. We ove fo GP

    onstaons, a speiaist visit, bood tests, sans and x-ays at a netwok povide. Appoved mediines on o mediine ist

    ae oveed in f. Mediines not on o ist ae oveed p to a set monthy amont. Yo wi need to get yo mediine

    fom a Designated Sevie Povide to avoid a 20% o-payment.

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    11

    COMPREHENSIVE SERIESDAYTODAY cOVEr

    How we cover your day-to-day healthcare expenses

    Yo ove is made p of thee eements:

    Yo Media Savings Aont

    The Insed Netwok Benet

    The Above Theshod Benet

    We pay fo day-to-day media expenses ike visits to heathae pofessionas, adioogy and

    pathology from your Medical Savings Account, as ong as yo have money avaiabe.

    When yo have spent yo anna Media Savings Aont aoaon and befoe yo aims

    add p to the Anna Theshod, we extend yo ove fo essena heathae sevies thogh

    the Insured Network Benet.

    Yo wi have to pay fo othe day-to-day media expenses n yo aims add p to the

    Anna Theshod. One yo have eahed the Anna Theshod, we pay the est of yo aims

    from the Above Threshold Benet.

    The Insured Network BenetYo have aess to a niqe set of heathae sevies that ae aways paid in f when yo se a netwok povide, even when yo MSA is

    sed p. We ove:

    Your GP consultaon fees

    at a GP in our GP network

    Classic, Classic Delta, Essenal, Essenal Delta

    A dened ist ofdurable external

    medical items at a network ofdesignated suppliers

    Classic, Classic Delta, Essenal, Essenal Delta

    Blood tests

    at any of the foowing phamaies

    Classic, Classic Delta

    Preferenally priced generic and brand

    medicines(schedule 3 and above)at our independent pharmay network or from:

    Classic, Classic Delta

    Antenatal consultaons and two

    2D pregnancy scans

    at a gynaeoogist o obstetiian who

    we have a payment arrangement with

    Classic, Classic Delta

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    12

    COMPREHENSIVE SERIESDAYTODAY cOVEr

    Classic Essenal

    Professional services

    Allied, therapeuc and psychology healthcare services*

    (acouscians, biokinecists, chiropractors, counsellors, dieans, homeopaths,nurses, occupaonal therapists, physiotherapists, podiatrists, psychologists,psychometrists, social workers, speech and language therapists and audiologists)

    Singe membe:With one dependant:With two dependants:With thee o moe dependants:

    R11 950R16 180

    R19 770R22 870

    R 7 190R10 180

    R13 180R15 580

    Antenatal classes R 1 200for your family

    Dental appliances and orthodonc treatment* R20 900fo eah peson

    Medicine

    Prescribed medicine*(over schedule3)

    Singe membe:With one dependant:With two dependants:With thee o moe dependants:

    R20 250

    R23 800R27 650

    R31 550

    R13 100

    R15 900R19 150

    R20 900

    Over-the-counter medicine(including prescribed medicineunder schedule 3 and lifestyle-enhancing products)

    We pay these aims fom the avaiabe fnds in yo MediaSavings Aont.

    Appliances and equipment

    External medical items* Fo yo famiy: R53 000 R35 500

    Hearing aids Fo yo famiy: R19 600 R15 700

    Opcal*(includes cover for lenses, frames, contact lenses and surgery or anyhealthcare service to correct refracve errors of the eye, like excimer laser)

    R3 500fo eah peson

    * If you join the Scheme aer January, you wont get the full limit because it is calculated by counng the remaining months in the year.

    The Above Threshold Benet oers extra day-to-day cover

    One yo aims add p to the Anna Theshod, we pay the est of yo aims fom the Above Theshod Benet, at the Disovey

    Heath rate. The compehensive Seies has an nimited Above Theshod Benet.

    Some day-to-day healthcare services have limits

    These imits appy to aims paid fom yo Media Savings Aont, Insed Netwok Benet (whee appiabe) and Above Theshod

    Benets. These ae not sepaate benets.

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    13

    COMPREHENSIVE SERIESBENEFITS THAT ENHANcE YOur cOVEr

    We make your Medical Savings Account last longer

    Prevenve screening

    The Seening and Pevenon Benet oves etain tests ike bood gose, bood

    pesse, hoesteo and body mass index when done at any one of the Disovey

    Weness Netwok povides. We aso ove a mammogam, Pap smea, PSA (a postate

    seening test) and HIV seening tests. Membes 65 yeas o ode and membes

    egisteed fo etain honi ondions ae aso oveed fo a seasona vaine.

    Addional allied,

    therapeuc and

    psychology services

    The Aied, Theape and Psyhoogy Extende Benet gives yo aess to nimited

    iniay appopiate ove fo biokineists, aosians, physiotheapists o

    hiopatos, psyhoogists, opaona theapists and speeh and heaing theapists.

    This ove is fo a dened ist of ondions. Yo may need to appy to make se of

    this benet.

    Claims related to

    traumac events

    The Tama reovey Extende Benet oves ot-of-hospita aims eated to etain

    tama events. caims ae paid fom the Tama reovey Extende Benet fo the est

    of the yea in whih the tama oed, as we as the yea ae the event oed.

    Yo may need to appy to make se of this benet.

    Access to the most advanced medical cover

    Specialised medicine and

    technology

    Yo have ove fo a dened ist of the atest teatments thogh the Speiaised

    Mediine and Tehnoogy Benet, p to r200 000 fo eah peson eah yea. A

    o-payment of p to 20% appies.

    Overseas treatment

    Yo have ove fo teatment not avaiabe in Soth Afia. The teatment mst be at a

    egisteed heathae pofessiona and is paid p to a imit of r500 000 fo eah peson.

    Yo wi need to pay and aim bak fom s when yo etn to Soth Afia. A o-payment of 20% appies.

    Travel and evacuaon cover

    Internaonal travel

    Yo have ove of p to r5 miion fo eah peson on eah joney fo emegeny

    media osts whie yo tave otside Soth Afia. This ove is fo a peiod of 90 days

    fom yo depate fom Soth Afia. Pe-exisng ondions ae exded.

    Africa evacuaon coverYo have ove fo emegeny media evaaons fom etain sb-Sahaan Afian

    onties bak to Soth Afia. Pe-exisng ondions ae exded.

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    14

    COMPREHENSIVE SERIESCONTRIBUTIONS

    Tota ontibons (inding MediaSavings Aont amonts)

    Anna Media Savings Aontamounts**

    Anna Theshod amonts**

    Main member Adt Child* Main member Adt Child* Main member Adt Child*

    Classic r3 362 r3 180 r670 r10 080 r9 540 R2 004

    r11 350 r11 350 r2 150

    Classic Delta r3 028 r2 864 r602 r9 084 r8 592 r1 800

    Classic Zero MSA r2 522 r2 385 r503 No Media Savings Aont

    Essenal r2 825 r2 670 r568 r5 076 r4 800 R1 020

    Essenal Delta r2 544 r2 403 r509 r4 572 r4 320 r912

    * We count a maximum of three children when we work out the monthly contribuons, annual Medical Savings Account and Annual Threshold.

    ** If you join the Scheme aer January, you wont get the full amount because it is calculated by counng the remaining months in the year.

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    15

    AddionalInformaon

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    16

    UNIQUE SAVINGSONlY WITH DIScOVErY HEAlTH

    Disovey Heath has patneed with ciks, Dis-chem and Netes to hep yo save p to 25% on heathae-eated spend. Weve aso set p a netwok of

    pefeed optometists whee yo an save p to 20% on fames and eyegass enses.

    If yo ae egisteed on the choni Iness Benet yo get p to 25% ash

    bak on a ange of speiaised podts at Dis-chem Phamaies ontywide.

    Yo get ash bak on a seeon of monitoing devies, speiaty food, heath

    edaon, footwea and aessoies as we as tness and webeing items.

    Go to www.discovery.co.za/info/chronicareto egiste, view the ataoge of

    podts and fo moe infomaon.

    Yo get p to 25% ash bak with MedSave on ove-the-onte (shede 1

    and 2) mediines at ciks Phamaies. Go to www.discovery.co.za orwww.medsaver.co.zato avate MedSave now and stat eaning yo ash bak.

    Yo get an exsive disont of 25% when yo pay pfont fo mbiia

    od bood and sse stem e banking with Netes Biosienes. When

    yo hoose to se a payment pan, yo get a disont of 20%. Go to

    www.discovery.co.za fo moe infomaon.

    Yo get p to 20% disont on fames and eyegass enses when vising an

    optometist in the Disovey Heath Optomety Netwok. To view a ist of a

    optometrists in our network go to www.discovery.co.za

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    17

    MEDXPRESSDOOrTODOOr MEDIcINE DElIVErY

    Home

    Work

    Holid

    ay

    Have your monthly

    meds delivered to

    your door.

    Delivering wherever you are2014

    Delivering the best of care

    MedXpress, Discovery Healths convenient medicine delivery service

    Now yo an take standing in a ong qee at the phamay o yo aeady-oveowing to-do ists. MedXpess ets yo ode mediine

    onine o ove the phone and have it deiveed diety to yo doo. MedXpess is aso the onvenient way to ode epeatabe mediine

    pesipons. Yo have f ove fo mediines on the Disovey Heath mediine ist (fomay). This means that yo wont have to make

    any o-payments and yo wont be haged above the Disovey Heath rate fo mediines.

    What Discovery MedXpress oers you

    Convenience

    Deivey to yo doo Thees no need

    to wait in qees o eave home to get

    yo mediine.

    A simpe poess thee ae no

    ompiated foms to ompete. A we

    need is a vaid sipt and a phone a.

    rega pdates we keep yo p to

    date on any hanges that may aetyo ove fo honi mediine when

    yo a s to ode thei mediine.

    Advice to help you save

    When sing MedXpess, Disovey Heaths

    qaied sevie agents an aso advise yo

    on the most ost-eeve atenaves. And

    yo wi aways be haged at the Disovey

    Heath rate fo mediines o ess in eet

    geng id of a those sma o-paymentsthat add p ove me.

    Important points to remember

    Delivery

    choni o epeatabe pesipon mediine

    will be delivered to your preferred address

    anywhee in Soth Afia.

    One-o pesipon mediine deivey

    odes ae enty ony avaiabe in

    Johannesbg, Petoia and cape Town

    metopoitan aeas.

    Delta membersIn 2014 a Deta beneiaies need to ode

    thei appoved honi mediine thogh

    MedXpess, to avoid a 20% o-payment on

    the ost of thei mediine.

    How you can order medicine

    If yoe paing yo ode fo the st

    me, yo need to eay mak yo

    pesipon with the wods MedXpess

    and yo Disovey Heath Media Sheme

    membeship nmbe. Yo an emai yo

    pesipon to [email protected]

    o fax it to 011 539 1020 and yo wi

    eeive an SMS fom Disovey Heath

    MedXpess. One yove paed yo st

    ode fo honi mediine yo an se the

    Disovey smatphone app (downoadabein the App stoe o Googe Pay) o yo an

    log in to www.discovery.co.zato have your

    monthy epeat mediine odes deiveed

    to an addess of yo hoie.

    Thee is no addiona administaon o

    deivey ost, so yo an take bak the

    me spent in the phamay by paing

    yo ode now.

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    18

    THE DIGITAL WORLD OF DISCOVERY

    www.discovery.co.za and the Discovery appO website has been designed to dispay opmay, whethe yo ae aessing it on a desktop,

    aptop, tabet o smatphone. The Disovey app avaiabe on the App stoe and Googe Pay

    pts yo heath pan in yo poket. Togethe they povide a weath of sef-sevie toos and

    infomaon to hep yo to manage yo heath pan and yo heath.

    Translate your travel cover

    into one of ve languages

    Watch our educaonal

    videos

    Access your health

    records

    Check medicine price

    and alternaves

    View other Discovery

    products you have

    View informaon on

    hospital procedures

    Track your benets and

    medical spend

    Plan and authorise

    hospital admission

    Find a healthcare

    professional

    Access important

    documents

    Order medicine for

    home delivery

    Submit and track

    your claims

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    19

    HealthID PUTTING YOUR MEDICALINFOrMATION IN YOur DOcTOrS HANDS

    With Disovey Heaths HeathID tabet app dotos an:

    To benet fom HeathID, yo doto wi need yo pemission to aess yo heath eods. Yo wi need to give onsent to eah doto

    yo visit befoe that doto an aess yo heath eods on HeathID. Yo an og onto www.disovey.o.za to give yo onsent.

    No nathoised peson wi have aess to yo pesona media infomaon.

    Apply for chronic cover

    If yo ae diagnosed with a honi ondion, yo doto an ompete an

    eetoni choni Iness Benet appiaon sing the HeathID app. This appiaonis easy and onvenient, bease yo doto gets the infomaon they need fo

    yo spei ondion when ompeng the appiaon and yo an get immediate

    appova fo etain ondions.

    Access medical histories and electronic health records

    A doto an go into yo eetoni heath eods and aess yo heath

    infomaon to see yo media histoy. So, if yo ae having tobe emembeing

    paa mediines yove taken, this infomaon is avaiabe to yo doto

    immediatey. Yo an save me and money by not having to epeat tests and

    invesgaons, bease the ests of thei pevios tests ae avaiabe fo yo

    doto to see.

    View benet informaon

    Yo doto aso has instant aess to yo heath benet infomaon to hep yo

    get the most ot of yo benets. A these fnons ae designed to make dotos

    visits easie and moe podve.

    Write electronic scripts

    Yo doto an pesibe mediine ding a onstaon with yo sing eetoni

    sipng. Yo doto an aso see mediines on thei appoved mediine ist, as we as

    the ost of those mediines. Yo an nd ways to ede o even avoid o-payments onyo mediines befoe yo even eah the phamay.

    HealthID puts your health records in your doctors hands. This is the rst electronic health recordapplicaon of its kind in South Africa.

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    20

    HOSPITAL NETWORKSDElTA HOSPITAl NETWOrK

    Appiabe to cassi Deta compehensive, Essena Deta compehensive, cassi Deta Save, Essena Deta Save, cassi Deta coe andEssena Deta coe netwok opons.

    Yo ae oveed in f at hospitas in the Deta Hospita Netwok. Fo panned admissions to any othe pivate hospita, yo mst pay anpfont amont of r5 450. This does not appy in an emegeny.

    Gauteng

    Awyp Media cente

    life Bedfod Gadens Hospita

    Netae Bogainvie Pivate Hospita

    life Benthst cini

    life castenhof cini

    cinix Pivate Hospita lesedi

    cinix Pivate Hospita Sebokeng

    cinton cini

    Emfeni Medi-cini

    Netae Femina Hospita

    life Foways Hospita

    legae Pivate Hospita

    lenmed cini

    life lie company of May

    lois Paste Hospita

    Midvaal Private Hospital

    Moningside Medi-cini

    life robinson Pivate Hospita

    life roseaes cini

    Sikebosand cini

    The Donad Godon Media cente

    life Wigehewe Hospita

    Plus 42 day-clinics

    Free State

    life rosepak Hospita

    Universitas Private Hospital

    Plus 3 day-clinics

    KwaZulu-Natal

    life chatsmed Gaden Hospita

    life Entabeni Hospita

    Ethekwini Hospital

    Midands Media cente

    life Westvie Hospita

    Plus 8 day-clinics

    Western Cape

    cape Town Medi-cini

    life caemont Hospita

    life Kingsby Hospita

    Mithes Pain Media cente

    Panoama Medi-cini

    Vegeegen Medi-cini

    Plus 13 day-clinics

    Eastern Cape

    life New Meane Hospita

    Delta network

    Pease note that these ists ae sbet to hange. Go to www.discovery.co.zafo the atest ist of hospitas.

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    21

    GENERALEXcluSIONS

    The benets outlined in this guide are a summary of the plans registered in the medical scheme rules. These benets are reviewed annually and amended in line with the

    requirements of the Medical Schemes Act and also take into account the requirements of the Consumer Protecon Act where it relates to the business of a medical scheme.

    The Disovey Heath Media Sheme has etain exsions. We do not pay fo heathae sevies eated to the foowing,exept whee spated as pat of a dened benet o nde the Pesibed Minimm Benets.

    General exclusion list

    cosme poedes and teatments

    Otopasty fo bat eas, pot-wine stains and bephaopasty

    (eyeid sgey)

    Beast edons o enagements and gynaeomasa

    Obesity Fai ae

    Infeity

    Wify sef-inited iness o injy

    Aoho, dg o sovent abse

    Wif and mateia vioaon of the aw

    Wif paipaon in wa, teoist avity, iot, ivi

    ommoon, ebeion o pising

    Injies sstained o heathae sevies aising ding tave too in a onty at wa

    Expeimenta, npoven o negisteed teatments o paes

    Seah and ese

    Any osts fo whih a thid paty is egay esponsibe

    We aso do not ove the ompiaons o the diet o indiet

    expenses that aise fom any of the exsions isted above,

    exept whee spated as pat of a dened benet o nde the

    Pesibed Minimm Benets.Waing periods

    If we appy waing peiods bease membes have neve beonged

    to a media sheme o have had a beak in membeship of moe

    than 90 days befoe joining the Disovey Heath Media Sheme,

    they wi not have aess to the Pesibed Minimm Benets ding

    thei waing peiods. This indes ove fo emegeny admissions.

    KeyCare Series exclusions

    In addion to the genea exsions that appy to a pans, the Keycae

    Seies does not ove the foowing, exept if the Pesibed Minimm

    Benets say shemes mst:

    1. Hospita admissions eated to:

    Densty

    Nail disorders

    Skin disorders

    Invesgaons and diagnos wok-p

    Fnona nasa sgey

    Eeve aesaean seon, exept if mediay neessay

    Sgey fo oesophagea ex and hiats henia

    Bak and nek teatment o sgey

    Joint epaements, inding bt not imited to hips,

    knees, shodes and ebows

    cohea impants, aditoy bain impants and intena neve

    smatos this indes poedes, devies and poessos

    Heathae sevies that shod be done ot of hospita

    and fo whih an admission to hospita is not neessay

    2. coeon of Hax Vags/Bnion and Taios Bnion/Bnionee

    3. Athosopy

    4. remova of vaiose veins

    5. refave eye sgey

    6. Non-aneos beast ondions

    7. Heathae sevies otside Soth Afia

    We aso do not ove the ost of teatment fo any ompiaons

    o the diet o indiet expenses eated to any of these exdedondions and teatments.

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    KNOW YOUR HEALTH | IMPROVE YOUR HEALTH | GET REWARDED

    Disovey Vitaity (Pty) ltd is an athoised nania sevies povide. registaon nmbe 1999/0077.

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    Discovery Vitality: The wellness programme that rewards you for geng healthier

    Vitaity heps yo to get heathie by giving yo the knowedge, toos, pesonaised weness pogammes and movaon to impove yo

    heath. Apat fom the fat that a heathy ifestye is geneay moe ewading, its been iniay poven that Vitaity membes have owe

    heathae osts than non-Vitaity membes. So join today and stat the joney to a heathie yo and a moe ewading ifestye.

    To join Vitalityo to nd ot moe, visitwww.discovery.co.za, a 0860 99 88 77, o ontat yo nania advise o yo ompanys Hr epesentave.To apply for your DiscoveryCard, a 0860 11 22 73. Pease note that a infomaon dispayed hee is ony a smmay of the Vitaity benets. Spei

    tems and ondions appy to eah benet. *Sbjet to a fai sage poiy.

    Disovey Vitaity (Pty) ltd is an athoised nania sevies povide. registaon nmbe 1999/0077.

    Find ot yo

    Vitaity Age

    Online health tools

    and assessments

    lean moe abot

    yo eang habits

    Do a Vitality

    Heath chek

    Find ot yo

    tness eves

    lean abot

    hidens heath

    Get p to 25% ash

    bak on pesona

    ae podts and

    on adidas gear

    Get ave

    and save p to 80%

    at gym partners

    use the Disovey app

    and tness devies

    to monito tness

    Save at

    weight-osspartners

    Save on

    stopping smoking

    Get p to 25% ash

    bak on HeathyFood

    at Pik n Pay and

    Woolworths

    Blu

    es

    tatus

    Bronzes

    tatu

    s

    Silverstatus

    Goldstatus

    Diamondstatus

    Enjoy the ewadsof impoving yo heath.

    Get heathie, eanVitaity points, inease yo

    Vitaity stats and expeiene

    ihe ifestye ewads.

    Join the Vitaity liveWellPogammes, and se the

    Vitality partners and

    digital tools to get

    great savings and

    tak yo heathand wellness

    avity.

    Enjoytherewards

    Imp

    rovey

    ourh

    ea

    lth

    Know

    you

    rhea

    lth

    Do heath, tness

    and ntionassessments to

    understand how

    heathy yo ae.

    Vitality Age

    up to 35% savings

    on oa and

    intenaona ights

    Fee as* and

    boosted data with

    VitalityMobile

    Even more

    rewards with a

    Disoveycad

    Wide variety of

    shopping rewards

    up to 25% savingson a enta

    Movies at less

    than haf pie

    up to 50% savings on a

    wide range of hotelaommodaon

    LOSEWEIGHT

    MANAGEHEART HEALTH GET FIT

    EATHEALTHILY

    MANAGEDIABETES

    The Vitaity liveWell Programmes are tailored to support

    individual health needs

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    Start at Blue status

    35 000 points

    45 000 points

    Maintain Gold for 3consecuve years

    15 000 points

    Start at Blue status

    70 000 points

    90 000 points

    Maintain Gold for 3consecuve years

    30 000 points

    Fo eah addiona membe aged 18 yeas and ode, add: 10 000 (Bonze), 20 000 (Sive), 30 000 (God).

    Single member Member plus onedependant aged 18 yeas and ode

    DIAMOND STATUS

    GOLD STATUS

    SILVER STATUS

    BRONZE STATUS

    BLUE STATUS

    The Vitality points guide

    Stat at Be stats and move p the Vitaity adde as yo impove yo heath and ean Vitaity points thogh heathy avies.

    Yo move fom Be stats to Bonze, Sive, God and nay to the highest Diamond Vitaity stats.

    Disovey Vitaity (Pty) ltd is an athoised nania sevies povide. registaon nmbe 1999/0077.

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    The benets expained in this bohe ae povided by the Disovey Heath Media Sheme, egistaon nmbe 1125, administeed by Disovey Heath (Pty) ltd, egistaon nmbe 1997/013480/07,

    an athoised nania sevies povide. This bohe is ony a smmay of the key benets and feates of the Disovey Heath Media Sheme pans, awaing foma appova fom the coni fo

    Media Shemes. When efeene is made to we in the ontext of benets, membes, payments o ove, in this bohe this is efeene to the Disovey Heath Media Sheme. Fo ompiane

    qesons, emai [email protected]. Vitaity is not pat of the Disovey Heath Media Sheme. Vitaity is a sepaate podt sod and administeed by Disovey Vitaity (Pty) ltd.

    registaon nmbe 1999/007736/07, an athoised nania sevies povide.

    GM_23227DHl_11/09/13_V3