2026 Rules Active
2026 Validated
Exceptional Cover for Life-Changing Biological Drugs
Actuarial Objective
Designed for members with conditions like severe rheumatoid arthritis or Crohn's disease who require high-cost biologic medicines. The plan offers a very high biologic limit and extensive chronic cover.
Running Actuarial Simulation...
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Discovery Health Medical Scheme
Classic Comprehensive
Strategy: Classic Comprehensive Family with MSA and ATB
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Discovery Health Medical Scheme
Executive Plan
Strategy: Executive Multi‑Chronic Unlimited Day‑to‑Day
Key Terms for this Strategy
- Medical Savings Account (MSA)
- A fund of R16,908 included in your premium. You use this for day-to-day expenses like GP visits and scripts.
People Also Ask
Is there a penalty if I have a gastroscopy in a normal hospital?
Yes. You will be charged a co-payment of R2,872 if you choose to have a day procedure (like a scope) in an acute hospital instead of a Day Hospital.
Does the plan cover MRI scans in full?
No. While covered at 100% of Scheme tariff, you must pay a R1,500 co-payment per scan, unless it is for a Prescribed Minimum Benefit (PMB) condition.
Do I have unlimited cancer cover?
Yes, oncology is covered at 100% of Scheme tariff, but you must strictly adhere to the ICON Network protocols to avoid out-of-pocket costs.
Will the scheme pay for my emergency room visit?
Only if you have funds available. Casualty visits are paid from your Medical Savings Account (Savings) first, not from the Scheme's risk benefit.
Is there a limit on hip or knee replacements?
Yes. Internal prostheses are limited to R147,394 per family, with specific sub-limits of R66,108 for hips and R77,001 for knees.
Does Pace 3 cover depression medication?
Yes. Major depression is covered as one of the 20 Non-CDL chronic conditions, subject to the non-CDL chronic medicine limit of R17,654 (Member) or R35,310 (Family).
How many pregnancy scans can I get?
The plan covers two 2D ultrasound scans: one in the first trimester (10-12 weeks) and one in the second trimester (20-24 weeks).
Do I have to use a specific network for glasses?
Yes. The optometry benefit uses the PPN Network. If you use a non-network provider, your consultation refund is capped at R420 and you may face significant co-payments on lenses.