Discovery to launch new ‘affordable’ medical aid plan in South Africa

Discovery Health Medical Scheme plans to introduce a new medical scheme plan to address the needs of new entrants and young professionals.

Discovery said Active Smart intends to launch on 1 January 2025 and is still subject to approval and registration by the Council for Medical Schemes (CMS).

“Young professionals have distinctive healthcare needs, and they often invest time researching affordable plans that provide benefits they need most,” said Dr Ron Whelan, CEO of Discovery Health.

“The Active Smart plan delivers a tailored solution, meeting these needs at an affordable price.”

The new product is priced at R1,350 per principal member monthly.

“This monthly contribution enables Discovery Health Medical Scheme to expand access to medical scheme cover for new entrants and young professionals who may have otherwise foregone medical scheme cover due to cost constraints,” added Whelan.

Many young people who enter the job market often have limited disposable income, leading to many delaying the purchase of medical aid.

“Medical scheme contributions consume a larger share of younger people’s disposable income,” added Whelan.

“Discovery Health data analysis shows that for members aged 20-29, approximately 7% of their income goes toward medical scheme contributions, whereas for older working adults, approximately 4% or lower of their monthly income goes toward medical scheme contributions.”

“Discovery Health research estimates that 109,000 uncovered young professionals would take up medical scheme cover if there were an affordable option and where contributions amount to roughly 5% of their income.”

“The Active Smart plan is designed to carefully balance needs of new entrants and affordability, thereby enabling greater access to private healthcare for young professionals.”

Features of the new plan

Discovery said that new features of the proposed plan include:

• Hospital Coverage: Full coverage for emergencies in any private hospital. In addition, members will have access to planned hospital admission in the Dynamic Smart Hospital Network, subject to a fixed deductible per admission.
  • Whelan said that young adults face a 36% higher risk of trauma events compared to older adults.

• Day-to-Day Benefits: Unlimited virtual and in-person consultations with a Smart GP, a dental check-up, an eye test, and over-the-counter medication.
  • “A Discovery Health survey of young adults in South Africa shows that access to day-to-day benefits including GP, dental and optometry consultation, and over-the-counter and prescription medicine is highly valued,” said Whelan.

• Personal Health Fund: Active Smart plan members can accumulate up to R1,000 per adult in addition to the day-to-day benefits set out above based on their engagement in their Personal Health Pathway. This feature delivers specific healthcare actions based on individual needs.
  • The Personal Health Fund, which is also subject to approval by the Council for Medical Schemes, can then be used for various medical expenses, including prescription medicines, physiotherapy, and contraceptives.

• Digital access: The Active Smart plan offers members access to the Dynamic Smart Hospital Network, underpinned by technology that advises members on high-quality healthcare providers and Smart network hospitals in their preferred region.

What the kids want

The Active Smart plan also addresses five core healthcare priorities identified as being the most important to new entrants and young professionals:

• Preventive care: Coverage for routine health check-ups, pap smears, and annual flu vaccinations for at-risk members through the plan’s Screening and Prevention Benefit, as well as the Personal Health Fund.
  • Discovery said that it has seen a 23% increase in the prevalence of hypertension among younger members since 2019.

• Mental health support: Access to the Discovery Health Medical Scheme Mental Health Care Programme, which includes consultations with a Premier Plus GP, anti-depressant medications, psychotherapy, and online Cognitive Behavioural Therapy.
  • Claims for mental health conditions have also jumped, with one in seven young adults now claiming for such conditions, compared to one in 20 in 2013.

• Emergency cover: Full coverage for emergencies in any private hospital and unlimited access for planned (i.e. non-emergency) admissions to the Dynamic Smart Hospital Network, subject to a fixed deductible.

• Dental and eye care: The plan offers an annual eye test with a network optometrist for R125 and a yearly dental check-up for R190.

• Over-the-counter medicines: Members can obtain over-the-counter medication and contraceptives through the pharmacy network. Members can also utilise their Personal Health Fund to supplement their medical expenses.

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