Discovery Treatments
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 Discovery Health Medical Scheme members who are on either the Executive Plan, a plan in the Comprehensive series and female members of specific plans of participating schemes that are administered.
2. These female scheme members can be from 25 to 42 years of age (up to 50 years old for egg – donated cycles)
3. 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.
4. Cover up to 75% of the agreed Discovery Health Rate up to a specific limit 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.
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 specific 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: