Discovery Health Medical Scheme · Chronic (CDL)

Chronic Illness Benefit (CIB)

Approved medicine and defined treatment baskets for a defined list of chronic conditions, once applied for and approved.

You must apply, and be approvedAn application goes in and the scheme decides. Approval is not automatic and the benefit does not backdate itself.

How: If not registered, medicine/management paid from day-to-day benefits

“A member shall ... upon completing a separate Chronic Illness Benefit application form and submitting same to the Scheme, [be entitled] to Chronic Illness Benefits in terms of Table B of the option selected.”

At a glance

Scheme: Discovery Health Medical Scheme
Benefit area: Chronic (CDL)
Who it is for: Every Discovery Health Medical Scheme option
Limit: The scheme states a limit without a rand figure · CIB-formulary medicine for CDL up to 100% DHR; baskets as set by the Scheme · each financial year
Who qualifies: Clinically diagnosed CDL (or ADL on comprehensive) meeting clinical entry criteria.
Where you may go: MedXpress Network pharmacies; KeyCare dispensing network GP/pharmacy / State (Start) — 20% non-DSP co-payment (KeyCare); 80% DHR if non-DSP

“be limited in each financial year in terms of the relevant sections of Table "B"”

“you need to get your approved chronic medicine from your dispensing network GP or from a pharmacy in the network to avoid a 20% non-designated service provider (non-DSP) co-payment”

Which plans carry it

Every Discovery Health Medical Scheme option.

The scheme states every option.

“The Prescribed Minimum Benefit (PMB) Chronic Disease List (CDL) conditions are covered on all health plans.”

Where this comes from

Discovery_2026_cover_for_medicine_and_treatment_of_chronic_conditions.pdf, p.6-7 · benefit_guide. Read from that document on 2026-08-29 for the 2026 plan year.

Every statement on this page is read from a Discovery Health Medical Scheme document and quoted so you can check it. Where a document says nothing, this page says so rather than filling the gap.

Check what your own plan leaves you to pay Your plan, your family, your conditions — the shortfall in rands before you choose a gap policy.

Programme rules are set by the scheme and change at renewal. This page renders what Discovery Health Medical Scheme’s own documents say, with the wording quoted so you can check it. Confirm with the scheme before you rely on it.