Discovery Gap Cover 2020

Hi to all my valued Health Clients !!

Discovery have enhanced their GAP cover for 2020 and Supplementary GAP cover which fits into their health plans seamlessly and when you submit your health claim it is handled as one claim together instead of 2 separate claims!!!

How does GAP cover work?

First of all you have to be a member of a Discovery Health Plan – Excluding Keycare and Primary Care plans

Gap cover is designed to cover unexpected medical expenses for treatment related to hospital admissions where healthcare professionals charge more than what your medical scheme pays for.

Discovery GAP cover (comprehensive) pays up to an additional 500% of your medical scheme rate if your in-hospital specialist account is higher than your what your medical scheme rate is. For eg: Classic core – pays at 200% MSR. Specialist charges 700% of MSR. Gap cover will pay out an additional 500% over and above the medical-aid payment of 200%.

It is not designed for day to day out of hospital expenses except for shortfalls out of hospital that are related to treatment as a result of admission. Up to R15 000 per policy through Hospital Benefit Extender.

In 2020 if you opt for the Discovery Gap Comprehensive option you will get cover for co-payments that apply to hospital accounts for gastroscopies, sigmoidoscopy, proctoscopy and colonoscopy procedures and out of hospital MRI and CT scans when your medical-scheme pays for the rest of the account.

In 2020 The Travel Benefit Extender benefit also provides cover for shortfalls on approved international emergency claims incurred while you travel outside South Africa.

It also assists with Oncology co-payments where the member has reached the oncology annual threshold and has co-payments. For eg: Classic Comprehensive – R400 000 annual oncology threshold with 20% co-payments after that. Classic Saver – R200 000 annual oncology threshold with 20% co-payments after that. The benefit is up to R100 000 per annum per person.

Discovery Supplementary GAP COVER offers lump sum payments up to R600 000 on diagnosis of qualifying illnesses associated with high treatment costs; access to advanced genomic sequencing for certain cancers; premium waiver benefits, and home support. This benefit is in addition to the normal GAP cover.  It also has a cash back benefit of up to 25% of premiums on this benefit dependent on claims.


Not available to Keycare or Primary care plans

There is an overall limit of R160 000 per person per annum that can be claimed from this gap-cover policy

There is an automatic 3 month waiting period for any treatment except authorised emergency hospital admissions.

There is an automatic 12 month waiting period for certain conditions listed in the brochure. Please contact me for a comprehensive quote and any further advice you may need !!

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