Discovery Health Hospital Network (🇿🇦 2024*) (2024)

• Ovulation Calculator
• Medical Aid Tax Calculator

Menu

Overview

Discovery Health Medical Scheme is one of South Africa’s largest and most trusted medical aid schemes, renowned for its innovative and comprehensive health coverage solutions. The medical scheme offers a variety of health plans designed to meet the diverse needs of its members, from basic coverage to comprehensive benefits.

Among these options, the hospital network plans stand out for their tailored approach to healthcare. These plans are specifically designed to provide affordable access to a wide network of hospitals across the country. Members who choose network plans can enjoy lower premiums while still receiving high-quality medical care.

What is a medical scheme hospital network?

Medical aid plans offered by medical aid schemes often include hospital network plans, which help control healthcare expenses without sacrificing access to high-quality treatment. The hospitals and clinics included in these plans are limited to those in a predetermined network that have committed to offering services at discounted rates.

Hospital network plans are often provided for the following reasons:

Cost management

The best way for medical aid plans to keep costs down is to negotiate prices with individual hospitals. The scheme is able to provide cheaper rates than plans that cover medical expenses regardless of the facility because of these agreements. Healthcare becomes more inexpensive for members as a result of cost reductions that are usually passed on.

Quality assurance

Quality care is further assured by hospital network strategies. Medical aid schemes evaluate medical facilities for network membership according to predetermined quality standards and performance indicators. As a result of this screening, members only get treatment from hospitals and clinics that have earned praise for their excellent care and positive results for their patients.

Simplified choices for members

These plans make choosing a hospital simpler for members because the network is curated by the medical aid. This takes away some of the complexities of selecting a hospital, as members can be confident that network hospitals meet certain standards of care.

Improved benefits

Improved benefits, including reduced co-payments and extra coverage for specific network operations, are available with some network plans. This helps members keep their out-of-pocket costs down and encourages them to use the network’s facilities.

Resource allocation

One way these plans help with healthcare resource allocation is by sending members to certain hospitals. Overutilization of services can be reduced and more people in need of care can be reached if this leads to more efficient management of patient influx and outflow.

When to choose network plans

A network plan might be a suitable option under certain circ*mstances. Here are key factors that would make a network plan a good option:

Budget Constraints

If affordability is a primary concern, network plans are typically less expensive than comprehensive plans that offer wider hospital choice. These plans can provide significant savings on monthly premiums.

Routine Healthcare Needs

For individuals or families with generally good health and routine healthcare needs, network plans often provide sufficient coverage. These plans cover essential healthcare services without the added cost of more extensive coverage options that may not be necessary.

Location Convenience

If the hospitals and clinics included in the network are conveniently located near your home or work, a network plan could be particularly advantageous. Convenience in accessing care can encourage timely medical attention and regular check-ups.

Preferred Hospitals on List

If your preferred or trusted hospitals and doctors are part of the network, this could make a network plan an attractive choice. This ensures you can continue receiving care from healthcare providers you are comfortable with, within the financial structure of a network plan.

Lower Out-of-Pocket Costs

Network plans often have structured co-payments that are lower than those of more flexible plans, especially if you stick to the network. This can make financial planning for healthcare expenses more predictable.

Additional Benefits

Some network plans offer additional benefits such as wellness programs, preventive care, and health management programs, which are appealing if you’re looking for more than just basic coverage.

Streamlined Administration

Dealing with a smaller network of providers can sometimes mean fewer complications in terms of paperwork and claims processing. This can make the administrative aspect of using your medical aid simpler and more user-friendly.

Effective Management of Chronic Conditions

If you have a chronic condition, some network plans provide tailored programs that help manage the disease effectively within the network facilities, ensuring continuity of care and specialized attention.

Discovery Health Network Hospitals

Gauteng

• 🏥Alberton: Netcare Alberton Hospital
• 🏥 Benoni: Life The Glynnwood Hospital, Netcare Optiklin Eye Hospital, Sunshine Hospital
• 🏥 Brakpan: Life Dalview Hospital
• 🏥 Centurion: Mediclinic Midstream, Netcare Unitas Hospital
• 🏥 Germiston: Life Bedford Gardens Hospital, Life Roseacres Hospital
• 🏥 Heidelberg: Life Suikerbosrand Hospital
• 🏥 Johannesburg: Clinix Selby Park Hospital, Life Brenthurst Hospital, Life Fourways Hospital, Mediclinic Morningside, Nelson Mandela Children’s Hospital, Netcare Garden City Hospital, Netcare Park Lane Hospital, Wits Donald Gordon Medical Centre
• 🏥 Kempton Park: Arwyp Medical Centre
• 🏥 Krugersdorp: Netcare Pinehaven
• 🏥 Lenasia: Lenmed Ahmed Kathrada Private Hospital, Lenmed Daxina Private Hospital
• 🏥 Mabopane: Mediclinic Legae
• 🏥 Midrand: Life Carstenhof Hospital, Netcare Waterfall City Hospital
• 🏥 Pretoria: Life Eugene Marais Hospital, Life Groenkloof Hospital, Life Wilgers Hospital, Louis Pasteur Hospital, Mediclinic Medforum, Mediclinic Muelmed, Netcare Femina Hospital, Netcare Jakaranda Hospital, Optimed Eye and Laser Clinic, Pretoria Eye Institute
• 🏥 Randburg: Netcare Olivedale Hospital
• 🏥 Randfontein: Lenmed Health Randfontein Private Hospital, Life Robinson Private Hospital
• 🏥 Roodepoort: Life Flora Hospital, Life Wilgeheuwel Hospital
• 🏥 Saxonwold: Life Genesis Clinic
• 🏥 Soshanguve: Botshilu Private Hospital
• 🏥 Soweto: Clinix Tshepo-Themba Private Hospital, Dr S K Matseke Memorial Hospital
• 🏥 Springs: Life Springs Parkland Hospital
• 🏥 Tembisa: Lenmed Health Zamokuhle Private Hospital
• 🏥 Vanderbijlpark: Mediclinic Emfuleni
• 🏥 Vereeniging: Clinix Naledi-Nkanyezi Private Hospital, Mediclinic Vereeniging, Midvaal Private Hospital
• 🏥 Vosloorus: Clinix Botshelong-Empilweni Private Hospital

Eastern Cape

• 🏥 East London: Life Beacon Bay Hospital, Life East London Private Hospital, Life St Dominic’s Private Hospital, Life St James Hospital / Life Eye Hospital East London
• 🏥 Humansdorp: Life Isivivana Private Hospital
• 🏥 Port Elizabeth: Life Mercantile Hospital, Life St George’s Hospital, Netcare Greenacres Hospital
• 🏥 Queenstown: Life Queenstown Private Hospital
• 🏥 Uitenhage: Netcare Cuyler Hospital
• 🏥 Umtata: Life St Mary’s Private Hospital
• 🏥 Free State
• 🏥 Bethlehem: Mediclinic Hoogland
• 🏥 Bloemfontein: Life Rosepark Hospital, Mediclinic Bloemfontein, Netcare Pelonomi Private Hospital, Netcare Universitas Private Hospital, Pasteur Eye Hospital
• 🏥 Harrismith: Busamed Harrismith Hospital
• 🏥 Kroonstad: Netcare Kroon Hospital
• 🏥 Sasolburg: Netcare Vaalpark Hospital
• 🏥 Welkom: Mediclinic Welkom

KwaZulu Natal

• 🏥 Amanzimtoti: Netcare Kingsway Hospital
• 🏥 Ballito: Netcare Alberlito Hospital
• 🏥 Chatsworth: Life Chatsmed Garden Hospital
• 🏥 Durban: JMH Ascot Park Hospital, JMH City Hospital, Lenmed Ethekwini Hospital and Heart Centre, Life Entabeni Hospital, Life Westville Hospital, Netcare St Augustine’s Hospital, Netcare Umhlanga Hospital
• 🏥 Empangeni: Life Empangeni Private Hospital
• 🏥 Isipingo: JMH Isipingo Clinic
• 🏥 Kokstad: Netcare Kokstad Private Hospital
• 🏥 Ladysmith: Lenmed La Verna Hospital
• 🏥 Newcastle: Mediclinic Newcastle
• 🏥 Phoenix: Life Mount Edgecombe Hospital
• 🏥 Pietermaritzburg: Life Hilton Private Hospital, Mediclinic Pietermaritzburg, Midlands Medical Centre, Netcare St Anne’s Hospital
• 🏥 Pinetown: Hillcrest Private Hospital, Life Crompton Hospital
• 🏥 Port Shepstone: Hibiscus Hospital
• 🏥 Richards Bay: Melomed Richards Bay Private Hospital, Netcare The Bay Hospital
• 🏥 Tongaat: Mediclinic Victoria

Discovery Health Network Plans

Here’s a list of some of the medical aid plans from Discovery Health that are bound to network hospitals:

KeyCare Plans

These plans provide cost-effective private healthcare through an extensive network of providers. They are designed for those seeking affordable coverage, particularly useful for lower income brackets or those looking to minimize their medical expenses.

Executive Plan

This is the most comprehensive plan, offering extensive coverage for both in-hospital and day-to-day benefits. It includes extended chronic medicine cover and an unlimited Above Threshold Benefit, making it suitable for individuals who need wide-ranging medical care.

Comprehensive Series

These plans offer a balance between extensive in-hospital and out-of-hospital benefits, including cover for chronic conditions, and are tailored to those who need robust medical care but at a tier below the Executive Plan.

Network Hospital Exceptions

Members of Discovery Health’s network plans can visit non-network hospitals under certain conditions. Specifically, emergency admissions are covered up to a maximum of 100% of the Discovery Health Rate.

However, the patient must be transferred to a network hospital as soon as they are stabilized, unless the scheme agrees otherwise. This coverage is also subject to pre-authorization and the prescribed minimum benefits (PMBs) requirements​

Conclusion

Choosing a Discovery Health hospital network plan that provides a well-rounded approach to healthcare can be a sensible choice. These plans are made to be as affordable as possible without lowering the standards of treatment. Members save money on premiums and out-of-pocket expenses by being limited to a specific network of hospitals.

Nevertheless, keep in mind that network plans have some limitations. Some people may find the limited hospital options bothersome, particularly if their preferred or specialty facilities aren’t part of the network. Furthermore, access to non-network hospitals can result in greater expenditures in non-emergency scenarios, potentially cancelling out some of the premium savings.

If you’re looking for affordable healthcare options and are familiar with the hospitals that make up Discovery Health’s network, then their hospital plans are a good fit. If you give it some thought, a network plan might be a great way to get affordable, high-quality healthcare without sacrificing coverage.