Benefit Checker 2026
Arthroscopy
on Discovery Health Priority Essential
Your Co-payment
Understanding this Cost
Good news! On the Priority Essential, Arthroscopy is fully covered. This means you won't have to pay any upfront fees if you use a provider in the scheme's network. Make sure to obtain pre-authorization to secure this benefit.
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 not typically covered as a PMB, meaning standard scheme rules and co-payments apply.
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 200% Discovery Health Rate covered by Priority Essential.
Pre-authorize
Submit your quote to Discovery Health. Mention you are on the Priority Essential plan.
Admission
Ensure you choose a hospital from: Any private hospital approved by the Scheme to avoid co-payments.
Important Notes
Functional knee procedures, hysteroscopy (except for pre-ovulatory diagnostics/lysis), scopes for nasal sinuses, ankle and wrist. R11,500 upfront payment if admitted to hospital
Frequently Asked Questions
Ready to Join Priority Essential?
Speak to an accredited broker who can help you switch or sign up.