The Wealth Room

High level summary of key updates:

• Weighted average contribution increase of 7.9%
• Enhancements to our Executive Plan and Smart Plans
• Introduction of the Young Families Offering, with significant risk benefits for pregnant moms and their babies for the first 2 years of life
• Day-to-day Extender Benefit Updates
• Updates to our HIVCare Programme
• Introduction of an Industry leading digital health technology platform –  DrConnect
• Significant enhancements to Healthy Company and Discovery PrimaryCare
• Introduction of Discovery Gap Core

Additional detail regarding key updates:

2018 Increase

• Weighted average contribution increase of 7.9% for 2018
• Plan specific increases range between 7.3% and 8.3%
• Industry leading financial stability with more than R14 billion in reserves
• 23 plans to match members’ unique healthcare needs
• Contributions which are on average 15.1% below the market average
• Cover ratios in excess of 96% throughout the plan range
• World class service offering to members-

Executive Plan Enhancements

• 7.3% increase
• Enhanced Global Treatment Platform to access medical treatment outside of SA
• International Second Opinion: Second opinion for life-threatening and life-changing conditions facilitated by Cleveland Clinic, funded from risk benefits
• Overseas Treatment Benefit: Advanced medical care up to R750,000 for treatment not available in SA; R300,000 for voluntary in-hospital treatment outside of SA. Both benefits subject to scheme guidelines and managed care protocols and a 20% co-payment
• International Travel Benefit: $1 million per member while traveling abroad
• Access to Vitality Purple
• Restructuring of day-to-day and in-hospital cover
• In-hospital treatment by specialists: Paid from Hospital Benefit up to 300% of DH rate
• In-hospital treatment by other healthcare professionals: Paid from Hospital Benefit up to 200% of DH rate (currently covered from day-to-day)
• In-hospital dental treatment: No overall limit, an upfront deductible is payable
• R26,200 limit for dental appliances
• Out-of-hospital dental treatment paid from day-to-day benefits

New Maternity Benefit on all plans

• In 2018, Discovery Health Medical Scheme members on all plans will have access to comprehensive maternity and post-birth risk benefits
• Members will be further supported through access to 24/7 support, advice and guidance through the My Pregnancy and My Baby programs made available on the Discovery app
• These benefits do not affect member’s day to day benefits and are funded from risk
• Benefits are covered at the Discovery Health Rate
• Benefit applies from January 2018 and must be activated by the member 

During Pregnancy

• Antenatal Consultations: Covered up to twelve visits at a Gynae, GP or midwife based on plan type
• Ultrasound scans and Prenatal screening: Up to two ultrasound scans and one nuchal translucency or Non-Invasive Prenatal Test (NIPT) covered
• Blood tests: Defined list of tests per pregnancy included
• Antenatal classes or consultation with a nurse:  Covered up to five pre or post-natal classes or consults with a registered nurse
• Executive and Comprehensive –

• • Plans have cover for up to R5,000 for essential registered devices e.g. Breast pumps and smart thermometers with a co-payment 25%
  • Private Ward: Up to R1,880 p/day in a private ward

For two years after birth

• Antenatal classes or consultation with a nurse: Covered up to five pre or post-natal classes or consults with a registered nurse
• GP and Specialist visits: Baby covered up to two visits with GP, Pediatrician or an ENT, subject to plan type
• Six week consultation: Members are covered for one six week, post-birth consult with a midwife, GP or Gynecologist
• Nutrition Assessment: Members are covered for one nutrition assessment with a dietician
• Mental Health: Members are covered for up to two mental health consults with a counsellor or Psychologist
• Lactation Consultation: Members are covered for one lactation consultation with a registered nurse of Lactation specialist

Maternity Digital Tools

Access to 24/7 clinical support, advice and guidance

• My Pregnancy App features:

• • My pregnancy dashboard
  • Pregnancy health record
  • Maternity cost estimator
  • Pregnancy care checklist
  • Connect with Doctors

• My Baby App features:

• • My Baby dashboard
  • Education cost estimator 
  • Kids digital health record
  • Digital vaccination card

Healthy Company

A comprehensive corporate wellness solution offering health screening, employee support tools and integrated reporting:

HealthyCompany Screening

Employers have access to four screening solutions:

o Discovery Traditional Wellness Day

o Discovery Premier Mobile Wellness Experience

o Discovery Premier Wellness Experience

o Discovery Executive wellness

The results are communicated to each Employee and aggregated results to the Employer

HealthyCompany Care

Utilises data from Vitality, HealthyCompany Care and the medical scheme

Stratifies employees according to their risk profiles in 3 areas:

o Physical wellbeing

o Emotional wellbeing

o Financial wellbeing

This triggers relevant interventions:

o Episode management

o Ongoing management

o Prevention

Employers have access to a multi-skilled coach, a fully integrated mobile app, educational content (library of doctor generated advice,) financial planning and legal consultation

HealthyCompany Insights

Integrates data from Screening and Care programs and creates a dashboard

o Clear and Actionable insights for each employee and the employer

o Updates employer risk stratification

o Assists employer in defining their health and wellness strategy

• PrimaryCare

Enhanced benefits for employees:

• • Ability to extend cover to dependents
  • Cover for 27 chronic conditions on PrimaryCare Comprehensive

Enhanced benefits for employers:

• • Inclusion of PrimaryCare employees in Discovery Wellness Experience

PrimaryCare Essential

• • Through PrimaryCare Essential, members and dependents can access primary healthcare services at PrimaryCare network GPs, including consultations, medical procedures and day-to-day prescription medicine which is to be collected from a Clicks pharmacy
  • In addition, members have access to R5,000 funeral cover including their dependents under the age of 70 years.
  • Members will have access to Vitality Move as well as the PrimaryCare Wellness Experience

PrimaryCare Comprehensive

• • Members and their dependents will have access to a rich set of services, in addition to those offered by PrimaryCare Essential

Maternity

Members are supported throughout their maternity journey, with the following benefits included:

• Unlimited GP consultations
• Unlimited day-to-day prescription medicine based on the defined medicine list
• Range of essential blood tests
• Two ultrasound scans

Emergency health services

Enhanced emergency healthcare services for a broad range of traumatic events

Trauma Benefit

• • Employers can extend cover through the Trauma Benefit, to provide access to emergency private healthcare services for a broad range of traumatic events
  • Members are covered in full for these events up to a limit of R100,000 per admission and will not have to pay upfront for these medical services at a hospital or casualty facility in our network
  • The following traumas are covered in our network of private hospitals: burns, head injuries, loss of an arm, hand, leg or foot, near drowning, poisoning or a serious reaction that may cause death, injuries resulting from a crime, sexual assault, a fall, a car accident or an injury at work

Medical evacuation

If the member experiences a traumatic event, PrimaryCare provides cover for medical evacuation services to the nearest private hospital facility in our network, or a state facility

Casualty Treatment

At the hospital, the member will have access to medical treatment in the casualty facility

Additional Services

• • PrimaryCare Wellness Experience
  • Onsite occupational health services (additional cost)
  • Vitality Move: Vitality Move members can win shopping rewards at Pick n Pay, and can get up to R300 back monthly on shopping, gym and movies

• KeyCare 2018
  • income band thresholds increased by 5.6%
  • Specialist Benefit increased from R3,570 to R3,860
  • Casualty: Upfront payment R325
  • Medical Equipment: Increased overall limit of R5,200 p/family

• General Plan 2018 Updates
  • Limits, co-payments, deductibles and income bands:

1. • • • All co-payments and deductibles will increase in line with the plan-specific contribution increases with the exception of co-payments on MRI and CT scans
       • This will be the second consecutive year that MRI/CT scan co-payments have had a 0% increase
       • All benefit limits will increase in line with the plan-specific contribution increases, with the exception of oncology thresholds, External Medical Items (EMI) and internal prosthesis limits

• • Hospital cover:

1. • • • Cover in a private hospital ward on the Executive plan – R1,880 per day
       • Upfront payments to hospitals on Delta plans – R7,650 for planned procedures outside the Delta Network
       • Smart plan admissions out of hospital upfront payment – R8,800

• • Priority deductibles:

1. • • • Range from R3,050 to R15,000

• Discovery Gap Cover: What’s new in 2018

Introducing Discovery Gap Core

• In-hospital Specialist gap cover provides an additional 200% of DH rate cover
• Hospital Admission Benefit Extender provides up to R10 000 additional cover for in-hospital shortfalls
• Oncology Benefit Extender provides up to R75 000 for co-payments related to your oncology treatment plan
• Priced from as little as R90 p/month

Enhanced Oncology Benefit Extender

• The full value of the Oncology Extender Benefit will be available immediately to all policyholders, regardless of the policy duration
• Subject to underwriting and applicable waiting periods

• • Discovery Gap Comprehensive
    • R100 000 (Members on Executive & Comprehensive Plans)
    • R40 000 (Members on Priority, Saver, Core & Smart Plans)
  • Discovery Gap Core
    • R75 000  (Members on Executive & Comprehensive Plans)
    • R30 000 (Members on Priority, Saver, Core & Smart Plans)

• Vitality 2018

The Vitality Product range has been extended to include:

• • Vitality Move: Rewarding people for taking steps towards a healthier lifestyle
  • Vitality Active: Rewarding young adults under 30 for getting active and driving well
  • Vitality Purple: Rewarding our most discerning clients

Vitality Move

Vitality Move will be available to every Discovery Health Medical Scheme member – FREE of charge.  

• • Swipe your Vitality Move card every time you shop at Pick n Pay
  • Stand a chance to win back your HealthyFood shopping spend every time you swipe
  • Do a Vitality Check to learn more about your health and stand a chance to win back your FULL shopping spend, every time you swipe
  • Upgrade Vitality Move for R35 and enjoy the following additional rewards:

o Get up to R100 off your monthly gym membership at Virgin Active or Planet Fitness with no activation fee

o Get up to R100 in Pick n Pay shopping rewards every month

o Get up to R100 in movie rewards every month

Vitality Active

Great reasons to join Vitality Active @ R40 per month

• • Get 25% off monthly gym fees at Virgin Active or Planet Fitness with no activation fee
  • Earn weekly rewards for achieving your goals
  • Achieve a 3–in-a- row goal streak to earn surprise rewards
  • Get 100% of your of your Discovery Life Smart premiums back

Vitality Active Rewards

Vitality has expanded Vitality Active Rewards to make it even more engaging, rewarding and exciting

• • Earn 3 consecutive goals to spin the wheel and earn a surprise reward
  • Members can track their progress, invite and challenge friends

Vitality Booster Benefits

Vitality Active Rewards members will now be able to choose between a bicycle, a fitness device or the shoe booster benefit

• Members can earn the following cashbacks:

• • Up to 25% on the bicycle booster
  • Up to 75% on the device booster
  • Up to 100% on the shoe booster

• Vitality Purple (VP) – 2018
  • Offers access to the most exclusive health, wellness and lifestyle experiences
  • Vitality members with a qualifying Discovery Purple product or on an Executive plan may upgrade to Vitality Purple
  • Available from January 2018
  • Premiums: Member – R399, Member+1-  R459, Member+2 – R499
  • Vitality Purple offers exclusive rewards and a personalized, 24/7 service:

• • • • 50% off a Discovery Wellness Experience: Members have access either at the Discovery Executive Wellness Centre or in the comfort of their own home or office
      • 75% off any Virgin Active (Classic) or Planet Fitness (Platinum) gym membership. Benefit applies to the principal and spouse
      • Access to high quality home gym equipment at the lowest monthly rental rates
      • Exclusive access to a panel of elite coaches and experts: tailored training programmes and support provided by South Africa’s leading sports scientist and professional coaches
      • Up to 50% off the Purple Spa Collection: African pride, SPA, Africology, Armanis, Fairmont
      • Up to 50% off high end fitness devices (Garmin and Suunto)
      • Up to 25% off a premier road or mountain bike (Bianchi, Cannondale, Cervelo, Calnago, Scott)
      • Up to 25% off premier golf clubs ((The Pro Shop)
      • Front row seats at iconic local and international events