Discovery Medical Aid Plans 2026 – South Africa

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If you are searching for discovery medical aid plans 2026 PDF, ( brochure ) this updated guide explains the available Core options, hospital cover, chronic benefits, maternity support, cancer cover, and how to download the official 2026 PDF for South Africa.

The 2026 plans from Discovery Health Medical Scheme focus on unlimited hospital cover, enhanced day-to-day funding through the Personal Health Fund, digital healthcare access, and structured chronic condition management.

This article clearly explains:

  • What each Core plan covers
  • Differences between Classic, Essential, Delta and Coastal options
  • Key limits (including oncology and Personal Health Fund)
  • How to access the discovery medical aid plans 2026 pdf south africa price guide
  • Who each plan is best suited for

What Are Discovery Medical Aid Plans 2026?

Discovery medical aid plans 2026 are structured health insurance options offered in South Africa that provide:

  • Unlimited hospital cover (subject to scheme rules)
  • Prescribed Minimum Benefits (PMBs)
  • Chronic illness cover for 27 CDL conditions
  • Cancer treatment benefits
  • Maternity and newborn benefits
  • Flexible day-to-day funding via the Personal Health Fund

All plans comply with the Medical Schemes Act 131 of 1998 and include mandatory PMB cover.

For official comparisons and detailed benefit rules, refer to the Discovery Health plan comparison page and the 2026 Core Plan Guide PDF.

Core Plan Options for 2026

The 2026 Core range includes five main options:

1. Classic Core

  • Any approved private hospital
  • Specialists covered up to 200% of Discovery Health Rate (DHR)
  • Higher Personal Health Fund limits
  • Oncology cover up to R250,000 (then 80% of DHR)

Best for: Members who want flexibility and broader hospital access.

2. Classic Delta Core

  • Private hospital within Delta network
  • Lower monthly contributions (restricted network)
  • Specialists covered up to 200% of DHR (network rules apply)

Best for: Cost-conscious families comfortable using network hospitals.

3. Essential Core

  • Any approved private hospital
  • Specialists covered up to 100% of DHR
  • Lower Personal Health Fund limits than Classic

Best for: Individuals needing strong hospital cover at moderate cost.

4. Essential Delta Core

  • Delta hospital network required
  • Specialists covered up to 100% of DHR
  • Reduced contributions vs Essential Core

Best for: Budget-focused members who can use network facilities.

5. Coastal Core

  • Approved hospitals in the four coastal provinces
  • Specialists covered up to 100% of DHR
  • Oncology subject to network rules

Best for: Members living in coastal regions.

Hospital Cover in Discovery Medical Aid Plans 2026

All Core plans offer:

  • Unlimited hospital admissions (no overall annual hospital limit)
  • Cover for related accounts (anaesthetist, radiology, pathology)
  • Emergency medical treatment
  • Access to Hospital at Home (subject to approval)

Delta and Coastal options require use of designated service providers (DSPs) for full cover.

If you use non-network providers (outside emergencies), the scheme may pay up to 80% of DHR, and you may face co-payments.

Chronic Illness Benefits (CIB) – 27 CDL Conditions

Discovery covers the Chronic Disease List (CDL), including conditions such as:

  • Diabetes Type 1 & 2
  • Hypertension
  • HIV
  • Asthma
  • Epilepsy
  • Rheumatoid arthritis
  • Parkinson’s disease
  • Schizophrenia

Approved chronic medication on the formulary is covered in full at network pharmacies.

You must apply for the Chronic Illness Benefit to activate cover.

Personal Health Fund 2026 (Day-to-Day Cover)

One of the major enhancements in the discovery medical aid plans 2026 pdf south africa price guide is the expanded Personal Health Fund (PHF).

Maximum PHF Accumulation:

Classic plans:

  • Up to R16,000 per year (including boosts)

Essential & Coastal plans:

  • Up to R8,000 per year (including boosts)

Funds can be used for:

  • GP visits
  • Specialist consultations
  • Radiology
  • Pathology
  • Out-of-hospital medication

New members may qualify for a once-off full PHF allocation in their first year (subject to activation rules).

Oncology Cover (Cancer Treatment)

All Core plans include:

  • R250,000 initial oncology cover per 12-month cycle
  • After reaching R250,000 → 80% of DHR
  • PMB cancer treatment covered in full at DSPs
  • Advanced Illness (palliative care) benefit

Delta and Coastal plans require network providers for full cover.

Maternity Benefits 2026

Discovery provides comprehensive maternity support, including:

  • Up to 8 antenatal consultations
  • 2 ultrasound scans
  • Chromosome/NIPT testing (clinical criteria apply)
  • Postnatal support
  • Breastfeeding consultations
  • Mental health consultations
  • Baby cover for first 2 years

Claims are covered up to 100% of DHR.

To activate, members must register their pregnancy on the Discovery Health app or website.

Screening & Prevention Benefits

Annual screenings include:

  • Blood pressure
  • Cholesterol
  • Blood glucose
  • HIV testing
  • Mammograms
  • Pap smear or HPV test
  • PSA test
  • Bowel cancer screening
  • Falls-risk assessments for seniors

These tests help detect illness early and are covered under the Screening and Prevention Benefit.

Digital & Virtual Healthcare Access

Members receive access to:

  • 24/7 Virtual Urgent Care (limited sessions)
  • Digital Mental Health Care
  • Online pharmacy ordering
  • Emergency Assist panic button
  • Symptom checker
  • Menopause care platform
  • Home Monitoring Device Benefit (up to R4,850 per year)

These services improve convenience and reduce hospital dependency.

Discovery Medical Aid Plans 2026 PDF – South Africa Download

If you are looking for the discovery medical aid plans 2026 pdf south africa price guide:

The official 2026 Core Plan Guide PDF includes:

  • Detailed benefit breakdown
  • Network rules
  • Co-payment explanations
  • Oncology and chronic benefit limits
  • Hospital cover details
  • Plan comparison table

You can download the official PDF directly from Discovery’s website under the 2026 Health Plan Guides section.

Discovery Medical Aid Plans 2026 pdf

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