From 1 January 2021 Discovery Health Medical Scheme and participating administered Schemes have introduced extended cover for the treatment of infertility in the form of the Assisted Reproductive Therapy Benefit.
In summary, once activated, the benefit:
1. Is available to female members on the Executive Plan and Comprehensive Series who are 25 to 42 years of age
2. Covers a comprehensive basket of care which includes cover for consultations, ultrasounds, egg retrieval, embryo transfers, admission costs and lab fees, medication and embryo and sperm storage
3. Cover up to 75% of the agreed Discovery Health Rate up to a limit of R110 000 per member per year with a co-payment of 25%. The member will also be responsible for the full cost of any other services not covered by the benefit.
4. Cover equivalent to up to 2 cycles of ART for members aged 25 to 39 and up to one cycle for members aged 40 to 42 per benefit year
* Egg donated cycles will be covered at 75% of the agreed Discovery Health Rate up to a limit of R110 000 per member per year with a co-payment of 25%. The additional costs relating to egg donation may result in higher co-payments.
5. Is available at all Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG) accredited facilities and is subject to clinical criteria, protocols and treatment guidelines.
* General SASREG guidelines available at: https://sasreg.co.za/guidelines/
Diagnostic procedures and any additional treatment required before or during the therapy will be funded from the member’s available day- to-day benefits or Prescribed Minimum Benefits (PMBs), where applicable.
How to activate:
How do you as Discovery female member on an Executive Plan or Comprehensive Series plan* activate the Assisted Reproduction (ART) benefit?
Members who meet the benefit and clinical entry criteria, can activate the benefit either via:
* www.discovery.co.za under Medical Aid > Benefits and cover > Most queried benefits.
* If they are unable to activate the benefit online, they can call Discovery on 0860 99 88 77 and speak to one of our consultants.
*Comprehensive Series: Classic | Classic Delta | Essential | Essential Delta | Classic Smart