Benefit Checker 2026
Gastroscopy and Colonoscopy (bi-directional)
on Discovery Health Executive Plan
Your Co-payment
Payable to the provider at time of service.
Understanding this Cost
Although Executive Plan is a premium plan, this procedure attracts a co-payment of R5 700. This is typically a deductible applied when using a specific setting (e.g., Hospital vs. Day Clinic) or a provider outside the plan's network. You may be able to use your Medical Savings Account (MSA) to fund this co-payment, provided you have funds available.
Co-payment
A fixed amount you must pay upfront for a medical service. The scheme pays the rest.
PMB (Prescribed Minimum Benefit)
A set of conditions that medical schemes must cover in full by law, provided you use a Designated Service Provider (DSP).
Network Hospital
A hospital that has an agreement with Discovery Health to charge an agreed rate. Using a non-network hospital may result in a higher co-payment.
PMB Status
This procedure is listed as a Prescribed Minimum Benefit (PMB) condition. It may be covered in full if specific clinical criteria are met.
Patient Guide
Financial Readiness
Medical Savings Account
Ensure you have sufficient funds in your MSA. Your generic annual allocation is R34 284 (varies by family size).
Administrative Timeline
See your Doctor
Consult your GP or Specialist to confirm the need for the procedure.
Get a Quote
Ask for a detailed quote. Check if it falls within the 100% Discovery Health Rate covered by Executive Plan.
Pre-authorize
Submit your quote to Discovery Health. Mention you are on the Executive Plan plan.
Admission
Ensure you choose a hospital from: Any Scheme-approved private hospital to avoid co-payments.
Important Notes
R5,700 if both scopes performed same admission. R0 if value-based network doctor.
Frequently Asked Questions
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