Discovery Health - Vitality & Team Vitality plus everything else you need to know

[Vetplant]

Discovery people.

 

Might be moving over to Discovery in the new year.

Will probably be Classic Smart plan for myself and 3 dependents.

 

Anyone on this plan who can give me a bit of feedback? Happy with it or not?

Personally, I am loaded with the same amount of dependents and find the amount of your own money that they dictate to you what you can and can't spend on at their rates is unacceptable. Rather look at Essential Saver, with a Gap Cover from one of the big insurers. Works out cheaper and you are covered for way more in terms of Specialist fees.

 

But to quote the ads, "speak to your broker", I am not a financial advisor... 

[Captain Fastbastard Mayhem]

Personally, I am loaded with the same amount of dependents and find the amount of your own money that they dictate to you what you can and can't spend on at their rates is unacceptable. Rather look at Essential Saver, with a Gap Cover from one of the big insurers. Works out cheaper and you are covered for way more in terms of Specialist fees.

 

But to quote the ads, "speak to your broker", I am not a financial advisor... 

Right. Here goes. 

 

Essential Saver has the savings component that you use to cover things like specialist visits / consultations, X Ray's, tests, dentistry etc. But that pot is limited, and the pot level is smaller than the difference in cost between it and Classic Smart (R 8,400 p/a diff in cost, R 4,700 in savings for the primary member)

 

So - the SMART plan should be treated as a hospital plan, with access to MRI & CT scans. That's it's place. You CAN get specialist consultations paid out of the med aid, but you need to jump through a couple hoops to get there. 

 

In other words - the diff you pay does not make financial sense, JUST to get the MSA component. Better (more efficient) to cover those things yourself and claim back where you can. MSA covers those specialist consultations, dentistry, optometry, over-the-counter meds and so on. 

 

The SMART plan does have a network of hospitals that you need to use for planned procedures, though. So if you're on it, you'd best pair it with a Gap Cover that covers the invoice you'd get if you decide to go to a hospital outside the network. 

[Captain Fastbastard Mayhem]

Classic Smart: M+1A + 2C = R 5,058 pm (R 60,696 p/a)

 

Essential Saver: M + 1A + 2c = R 6,672 p/m (R 80,064 p/a)

 

Diff in cost = R 19,368 

 

MSA you get on essential saver = R 12,000

 

in other words, you're better off by R 7,368 per year on the Classic Smart. Or, you'd have the equivalent of R 19,368 p/a in "savings" if you go to Classic Smart instead of Essential Saver and invested the extra bit into some sort of savings account. 

 

This is not to say that some people should be on the essential saver, it's just to say that it's a case of "it depends"

[Escapee..]

Classic Smart: M+1A + 2C = R 5,058 pm (R 60,696 p/a)

 

Essential Saver: M + 1A + 2c = R 6,672 p/m (R 80,064 p/a)

 

Diff in cost = R 19,368 

 

MSA you get on essential saver = R 12,000

 

in other words, you're better off by R 7,368 per year on the Classic Smart. Or, you'd have the equivalent of R 19,368 p/a in "savings" if you go to Classic Smart instead of Essential Saver and invested the extra bit into some sort of savings account. 

 

This is not to say that some people should be on the essential saver, it's just to say that it's a case of "it depends"

 

Thanks Armpies 

[Captain Fastbastard Mayhem]

Thanks Armpies 

Pleasure, man. If you want more help, drop me a line / mail / etc. I used to be on the smart plan until I moved to Momentum Health. It's a shoe-in if you don't want to pay $$$ for med aid but still need coverage for investigative MRI & CT scans (which are what most of em are)

[Frosty]

Discovery people.

 

Might be moving over to Discovery in the new year.

Will probably be Classic Smart plan for myself and 3 dependents.

 

Anyone on this plan who can give me a bit of feedback? Happy with it or not?

I’m currently on it, and it’s not that bad if:

 

1. You’re relatively healthy and don’t visit the doctors often;

2. Your doctor is on the smart network;

3. The doctor prescribed medicine;

4. You get your meds from your preferred pharmacy, eg. Click, Dis-Chem, Medihelp.

 

If you go to an non-smart network doctor, your meds are not covered even if you go to your preferred pharmacy.

 

I’ve decided to stay on the Classic Smart for 2020 as the extra cost of MSA doesn’t add up to the expenses we incur by visiting a non-network doctor.

[Escapee..]

I’m currently on it, and it’s not that bad if:

 

1. You’re relatively healthy and don’t visit the doctors often;

2. Your doctor is on the smart network;

3. The doctor prescribed medicine;

4. You get your meds from your preferred pharmacy, eg. Click, Dis-Chem, Medihelp.

 

If you go to an non-smart network doctor, your meds are not covered even if you go to your preferred pharmacy.

 

I’ve decided to stay on the Classic Smart for 2020 as the extra cost of MSA doesn’t add up to the expenses we incur by visiting a non-network doctor.

 

Thanks Frosty

Looks its a good option for us as well then.

 

 

Good Cap Cover option?

[Captain Fastbastard Mayhem]

Thanks Frosty

Looks its a good option for us as well then.

 

 

Good Cap Cover option?

Stratum / Zest are the ones I deal with for good reason (we found they were the best of the bunch ito admin from the ones we've tried)

 

Just check the terms and conditions surrounding payment of claims if they determine it's a PMB. Stratum and Zest will cover, but fight with the med aid to get something that they believe is a PMB, covered as a PMB. Some just flat out exclude any claim that is a PMB, even though there may still be a gap somewhere. 

[Frosty]

Thanks Frosty

Looks its a good option for us as well then.

 

 

Good Cap Cover option?

I’ve stopped the gap cover - was with Zest. It’s great to have as long as it’s used. Instead, I’ve invested money and using this as cover for that “what if” day. A specialist may never be needed, and that gap cover money paid will never be recovered and the investment can be used for other things (when needed). That’s how my broker explained it, and makes sense to manage my risk.

[Captain Fastbastard Mayhem]

I’ve stopped the gap cover - was with Zest. It’s great to have as long as it’s used. Instead, I’ve invested money and using this as cover for that “what if” day. A specialist may never be needed, and that gap cover money paid will never be recovered and the investment can be used for other things (when needed). That’s how my broker explained it, and makes sense to manage my risk.

If you have that R30k plus lying around / saved in an investment or savings account somewhere, that makes perfect sense. But if you're also on Classic Comp and have no chronic conditions etc and no gap cover, then it makes no sense at all...

[Reme Le Hane]

If you have that R30k plus lying around / saved in an investment or savings account somewhere, that makes perfect sense. But if you're also on Classic Comp and have no chronic conditions etc and no gap cover, then it makes no sense at all...

Like most insurance it's all money down the drain till you need it. Unfortunately, life never waits until you have enough saved up for the emergency.

[Frosty]

If you have that R30k plus lying around / saved in an investment or savings account somewhere, that makes perfect sense. But if you're also on Classic Comp and have no chronic conditions etc and no gap cover, then it makes no sense at all...

Like most insurance it's all money down the drain till you need it. Unfortunately, life never waits until you have enough saved up for the emergency.

Just sharing what I did with my gap cover.

5 years at >R400/month = R24000 that you don’t ever see again. Sure, anything can happen, at any time, so adjustments have to be made as one goes and not think that today’s decision will last a lifetime.

[Captain Fastbastard Mayhem]

Just sharing what I did with my gap cover.

5 years at >R400/month = R24000 that you don’t ever see again. Sure, anything can happen, at any time, so adjustments have to be made as one goes and not think that today’s decision will last a lifetime.

.ja,that's the thing though. If something had happened in month 2, you'd have been up **** creek. So you can't equate that cost unless you have the capital in place already, unfortunately.

[ChrisF]

.ja,that's the thing though. If something had happened in month 2, you'd have been up **** creek. So you can't equate that cost unless you have the capital in place already, unfortunately.

 

Truly scary part being some of the GAP cover claims .... 

[Captain Fastbastard Mayhem]

Truly scary part being some of the GAP cover claims ....

Yeah, we had a max claim this year. Well, very close to max. 150k almost.

[Reme Le Hane]

Just sharing what I did with my gap cover.

5 years at >R400/month = R24000 that you don’t ever see again. Sure, anything can happen, at any time, so adjustments have to be made as one goes and not think that today’s decision will last a lifetime.

Yes, but the exact same argument can be made for building, content and car insurance, even medical aid as a hole. Every insurance is a lot of money in hindsight, but again, who can afford to up and replace a house or a car.

 

Friend of mine had a mtb accident, first bill was 140k, medical and gap covered all of it, and that's just bill 1,its 4 months of recovery, therapy and all that **** that they are going to pay for.

 

So sure over the years you spend a lot of money, but the cost of decent treatment in this country, 1 accident and all your savings and a **** lot more are gone.

 

Like that 24k,someone punches u hard enough on the face and that won't even cover the cat scan.

 

10 years ago I had 1 and it was 20k, I shudder to think what they cost now.

 

My mother just had 2 eye ops, it was 11k per op, 11k for the hospital and 5k for drugs dude, that's 54k and she has been on med for 1 year at 1.6k per month. So assuming I saved that 1.6k instead even with interest I have not paid for 1 eye, let alone both.

Edited November 25, 2019 by Reme Le Hane