2026 Rules Active
2026 Validated
Lower Premiums for Members Using Coastal Hospitals
Actuarial Objective
For members living and receiving almost all care in the four coastal provinces, leveraging lower premiums in exchange for a coastal hospital network restriction.
Running Actuarial Simulation...
More Plan Options
Save R-129 pm
Bonitas
BonPrime
Strategy: BonPrime Maternity Risk Transfer with Savings
Upgrade for +R462 pm
Bonitas
Primary
Strategy: Primary Family Day-to-Day Moderate Coverage
Key Terms for this Strategy
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries (like hip/knee replacements) that are not emergencies.
People Also Ask
If I go to a private hospital that is not in the Delta Hospital Network for a planned procedure, will I be penalised?
Yes. Planned admissions outside the Delta Hospital Network can trigger an upfront payment requirement; preauthorisation and using the correct network hospital is essential to avoid large out-of-pocket costs.
If I get cancer treatment, what happens once I reach the Oncology Benefit limit?
The Oncology Benefit covers the first R250,000 in an approved 12-month cycle, and after that the Scheme pays up to 80% of the Discovery Health Rate for subsequent treatment costs (PMB cancer treatment remains covered in full when applicable).
Do I have to use a network provider for cancer treatment on Classic Delta Core?
Yes. On the Classic Delta Core Plan, cancer-related healthcare services are covered at a network provider under the Oncology Benefit rules.
Will I pay extra if my oncologist or hospital charges more than the Discovery Health Rate?
Potentially. The guide notes that cancer-related services are paid up to 100% of the Discovery Health Rate, and members may face co-payments/shortfalls if providers charge above that rate.
Do I need to nominate a GP to get my chronic benefits paid properly?
Yes. You must nominate a GP in the Discovery Health Network as your Primary Care GP to manage your chronic conditions, and full cover for GP consultations depends on visiting your nominated network GP.
If my chronic medicine is not on the formulary, am I still covered?
Cover is limited: medicine not on the medicine list formulary is paid up to the generic Reference Price (where applicable) and up to the monthly Chronic Drug Amount for that medicine class.
If I need a colonoscopy or gastroscopy, will I have to pay upfront?
Often yes, depending on where it is done and whether it qualifies under specific no-upfront-payment scenarios (for example, certain PMB-related or approved circumstances, or in-rooms scopes at a network provider).
Are MRI or CT scans always covered?
No. MRI and CT scans are paid up to 100% of the Discovery Health Rate when related to a hospital admission and covered from the Hospital Benefit; if not related to admission (or for certain conservative treatment contexts), you may have to pay yourself.
What maternity cover do I get during pregnancy on this plan?
The Maternity Benefit includes up to 8 antenatal consultations, up to two 2D ultrasound scans (or one 2D plus a nuchal translucency test), defined blood tests, and other defined pregnancy-related services (subject to activation and rules).
How do I activate the Maternity Benefit so that my cover applies?
You can activate it by creating your pregnancy/baby profile on the Discovery Health app or website, preauthorising your delivery, or registering your baby as a dependant on the Scheme.