Discovery Active Smart: 2027 contributions and benefits

At a glance

Plan type: Hospital plan
Hospitals: Network hospitals
Hospital and specialists: 100% of Scheme tariff
Day-to-day costs: Your own
Chronic conditions: 27 (Chronic Disease List)
Cancer: PMB level of care
Children you pay for: Up to 3

Discovery’s 2027 benefits are not in our records yet. Its 2027 contributions are below.

Monthly contributions

2027 rates take effect on 1 January 2027. 2027 contributions: Discovery 2027 contribution table, p1. Its 2027 benefits are not in our records yet. You pay for up to 3 children.

Member	2026	2027	Change
Main member	R1 350	R1 450	+7.4%
Adult dependant	R1 350	R1 450	+7.4%
Child	R1 350	R1 450	+7.4%

Benefits

We hold Discovery’s 2027 contributions; its 2027 benefit rules are not in our records yet. Each row shows the 2026 rule, marked.

Benefits in force for 2026.

In hospital

Hospitals

Network hospitals only (Dynamic Smart Hospital Network)

Discovery active smart plan, p16

Hospitals

2027 not in our records yet. 2026: Network hospitals only (Dynamic Smart Hospital Network)

Discovery active smart plan, p16 (2026)

Specialists in hospital

100% of Scheme tariff. A specialist who charges more leaves a shortfall.

Discovery active smart plan, p1

Specialists in hospital

2027 not in our records yet. 2026: 100% of Scheme tariff. A specialist who charges more leaves a shortfall.

Discovery active smart plan, p1 (2026)

Hospital outside the network

A co-payment of R15 300 if you choose a hospital outside the network for a planned admission.

Discovery active smart plan, p16

Hospital outside the network

2027 not in our records yet. 2026: A co-payment of R15 300 if you choose a hospital outside the network for a planned admission.

Discovery active smart plan, p16 (2026)

Chronic and cancer

Chronic conditions

27 conditions, the Chronic Disease List.

Chronic conditions

2027 not in our records yet. 2026: 27 conditions, the Chronic Disease List.

(2026)

Cancer

Cover at the PMB level of care, through ICON / SAOC.

Discovery annexure 8a oncology treatment programme, p1

Cancer

2027 not in our records yet. 2026: Cover at the PMB level of care, through ICON / SAOC.

Discovery annexure 8a oncology treatment programme, p1 (2026)

Day to day

Maternity

no managed-care maternity programme — benefit-based, paid from the scheme’s risk benefits, not savings.

Discovery catalogue maternity in hospital rows, per plan

Maternity

2027 not in our records yet. 2026: no managed-care maternity programme — benefit-based, paid from the scheme’s risk benefits, not savings.

Discovery catalogue maternity in hospital rows, per plan (2026)

GP visits

Out-of-hospital consultation codes billed by Smart Network GPs shall be paid from Health Care Cover up to a maximum of 100% of the Discovery Health Rate, and subject to a R130 co-payment per consultation. This co-payment does not apply to video call consultations. GPs in the network: Unlimited, subject to a R130 co-payment per consultation

Discovery active smart plan 2026, p18

GP visits

2027 not in our records yet. 2026: Out-of-hospital consultation codes billed by Smart Network GPs shall be paid from Health Care Cover up to a maximum of 100% of the Discovery Health Rate, and subject to a R130 co-payment per consultation. This co-payment does not apply to video call consultations. GPs in the network: Unlimited, subject to a R130 co-payment per consultation

Discovery active smart plan 2026, p18 (2026)

Specialist visits

Specialists Premier Rate specialists: Up to a maximum of the Premier Rate. Classic Direct specialists: Where a procedure is performed in the Scheme's day-surgery network, claims will be funded up to a maximum of the agreed Discovery Health Rate. Other specialists: Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery active smart plan 2026, p1

Specialist visits

2027 not in our records yet. 2026: Specialists Premier Rate specialists: Up to a maximum of the Premier Rate. Classic Direct specialists: Where a procedure is performed in the Scheme's day-surgery network, claims will be funded up to a maximum of the agreed Discovery Health Rate. Other specialists: Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery active smart plan 2026, p1 (2026)

Prescribed medicine (acute)

Not covered.

Discovery active smart plan 2026, p16

Prescribed medicine (acute)

2027 not in our records yet. 2026: Not covered.

Discovery active smart plan 2026, p16 (2026)

Basic dentistry

Dental check-up Up to a maximum of 100% of the Discovery Health Rate subject to a R195 co-payment by the member. One check-up per beneficiary per year

Discovery active smart plan 2026, p18

Basic dentistry

2027 not in our records yet. 2026: Dental check-up Up to a maximum of 100% of the Discovery Health Rate subject to a R195 co-payment by the member. One check-up per beneficiary per year

Discovery active smart plan 2026, p18 (2026)

Eyes (optometry)

Eye test Up to a maximum of 100% of the Discovery Health Rate at a network provider. Subject to a R130 co-payment by the member. One test per beneficiary per year

Discovery active smart plan 2026, p18

Eyes (optometry)

2027 not in our records yet. 2026: Eye test Up to a maximum of 100% of the Discovery Health Rate at a network provider. Subject to a R130 co-payment by the member. One test per beneficiary per year

Discovery active smart plan 2026, p18 (2026)

Basic X-rays

Radiology & Pathology Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery active smart plan 2026, p1

Basic X-rays

2027 not in our records yet. 2026: Radiology & Pathology Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery active smart plan 2026, p1 (2026)

Blood tests (pathology)

Radiology & Pathology Up to a maximum of 100% of the Discovery Health Rate. Pathology is subject to a preferred provider network. Where members use a non-preferred provider payment will be made directly to the member. Point-of-care pathology testing is subject to meeting the Scheme's treatment guidelines and managed care criteria. Unlimited

Discovery active smart plan 2026, p1

Blood tests (pathology)

2027 not in our records yet. 2026: Radiology & Pathology Up to a maximum of 100% of the Discovery Health Rate. Pathology is subject to a preferred provider network. Where members use a non-preferred provider payment will be made directly to the member. Point-of-care pathology testing is subject to meeting the Scheme's treatment guidelines and managed care criteria. Unlimited

Discovery active smart plan 2026, p1 (2026)

Full benefit list

Every benefit we hold for Active Smart, in Discovery’s own wording, from its 2026 documents. Discovery’s full 2027 list is not in our records yet.

In hospital

Surgery and anaesthetics

Accommodation, theatre fees, materials used, prescribed medication for duration of hospitalisation Up to a maximum of 100% of the Discovery Health Rate.

Discovery active smart plan 2026, p1

Hospital stay and theatre

Accommodation, theatre fees, materials used, prescribed medication for duration of hospitalisation Up to a maximum of 100% of the Discovery Health Rate. Subject to authorisation and/or approval and the meeting the Scheme's clinical and managed care criteria. Unlimited

Discovery active smart plan 2026, p1

Day procedures

Planned and elective admissions Up to a maximum of 100% of the Discovery Health Rate. A R7 750 Deductible shall be payable by the beneficiary in respect of the hospital account for all elective admissions at a network facility. For planned or elective procedures performed outside of a network facility the higher deductible of R15 300 shall be payable by the member.

Discovery active smart plan 2026, p2

Day procedures

Health care services reflected in Annexure 9 in a defined list of network facilities Up to a maximum of 100% of the Discovery Health Rate at the Scheme's defined list of day-surgery providers. A R15 300 Deductible shall be payable by the beneficiary in respect of the hospital account for elective admission at a facility which is not a network facility.

Discovery active smart plan 2026, p2

Day procedures

Administration of defined intravenous infusions Up to a maximum of 100% of the Discovery Health Rate at the Scheme's network provider. A 20% co-payment shall be payable by the beneficiary in respect of the hospital account when treatment is received at a provider who is not a network provider.

Discovery active smart plan 2026, p3

Day procedures

Gastroscopies, colonoscopies, proctoscopies, sigmoidoscopies performed in-hospital Save for the cover contained in Annexure 8, or where indicated and approved for dyspepsia or for children aged 12 and under, the first R4 650 in respect of the hospital account when performed in a day clinic, or R8 000 in respect of the hospital account when performed in acute facilities, per admission paid by the beneficiary. Where performed in an acute facility by a doctor who is part of the Scheme's value-based network, the first R6 650 in respect of the hospital account is paid by the beneficiary.

Discovery active smart plan 2026, p5

Medicine on discharge

Medication and materials billed by hospital as TTO Save for cover contained in Annexure 7, TTOs are not covered from Hospital Benefits, but paid from Chronic Illness Benefit where applicable. Subject to Chronic Illness Benefit

Discovery active smart plan 2026, p10

HIV/AIDS

HIV/AIDS and AIDS-related treatment Basis of cover is contained in Annexure 7. Unlimited

Discovery active smart plan 2026, p10

Hospital stay and theatre

Planned and elective admissions ... Neonatal admission: Up to R72 600 per family per year All other admissions: Unlimited

Discovery active smart plan 2026, p2

Travel cover

International Travel Benefit as set out in Annexure B Basis of cover as contained in Annexure B. Up to 100% of the cost for in- and out-of-hospital treatment and where such treatment is paid in a foreign currency, the cost will be paid at an exchange rate for such currency as set by the bank at which the Scheme has its account. The first US$150 or €100 in respect of out-of-hospital treatment per person per journey is payable by the member. The balance will be paid from Health Care Cover. R5 000 000 per person per journey, for both in- and out-of-hospital treatment

Discovery active smart plan 2026, p14

Birth (in hospital)

Planned and elective admissions ... Neonatal admission: Up to R72 600 per family per year All other admissions: Unlimited

Discovery active smart plan 2026, p2

Organ and stem cell transplants

Stem cell and organ transplants (pre-transplant work-up, in-hospital treatment, post-transplant treatment, immunosuppressive drugs, and donor costs) In-hospital: Up to a maximum of 100% of the Discovery Health Rate for the hospital account and up to a maximum of 100% of the Discovery Health Rate for related accounts. Out-of-hospital: Treatment related to transplant covered up to a maximum of 100% of the Discovery Health Rate. Basket of care as set by the Scheme specific to transplant

Discovery active smart plan 2026, p2

Planned PMB procedures

Discovery active smart plan 2026, p2

Internal prostheses

Cardiac stents and balloons Up to a maximum of 100% of the Discovery Health Rate. Network supplier: Unlimited if supplied by the Scheme's network provider Non-network supplier: Drug-eluting stent: R14 950 per stent per admission if not supplied by the Scheme's network provider Bare metal stent limit: R10 650 per stent per admission if not supplied by the Scheme's network provider Drug-eluting balloon: R13 800 per balloon per admission if not supplied by the Scheme's network provider

Discovery active smart plan 2026, p9

Mental health admissions

Management of mental health disorders Up to a maximum of 100% of the Discovery Health Rate for related accounts in a network facility. Up to a maximum of 100% of the Discovery Health Rate for the hospital account in a network facility. Up to a maximum of 80% of the Discovery Health Rate for the hospital and related accounts if a non-network facility is used. Up to 21 days in-hospital, or up to 15 out-of-hospital consultations, for conditions as defined in Annexure A of the Regulations All other conditions up to 21 days in-hospital

Discovery active smart plan 2026, p7

MRI, CT and PET scans

MRI and CT Scans Up to a maximum of 100% of the Discovery Health Rate for in-hospital scans performed in respect of treatment related to an authorised admission. Subject to referral by appropriate specialist. Unlimited

Discovery active smart plan 2026, p4

Dialysis

Chronic Dialysis Basis of cover is contained in Annexure 7. Subject to PMBs

Discovery active smart plan 2026, p6

Step-down and sub-acute care

Home-based healthcare for clinically appropriate chronic and acute treatment and conditions that can be treated at home In addition to cover contained in Annexure 7, up to a maximum of 100% of the Discovery Health Rate. A R5 450 deductible shall be payable by the beneficiary in respect of the hospital account for elective admissions at any private facility that is not a designated service provider. Basket of care as set by the Scheme

Discovery active smart plan 2026, p3

Palliative care

Advanced Illness Benefit Up to a maximum of 100% of the Discovery Health Rate. Subject to authorisation and the treatment meeting the Scheme's guidelines and managed care criteria. Unlimited

Discovery active smart plan 2026, p10

Fertility treatment

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Cancer treatment

Oncology: PMB level of care only. Unlimited PMB oncology basket via a designated service provider (ICON/SAOC); non-PMB oncology cover is not available on this plan. Voluntary non-network use funded at 80% of DHR (20% co-payment).

Discovery annexure 8a oncology treatment programme 2026, p1

Specialised (biological) medicine in hospital

Not covered. The Specialised Medicine and Technology Benefit is not available on this plan.

Discovery 2026 specialised medicine and technology benefit, p2

Day to day

Prescribed medicine (acute)

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Alternative healthcare

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Medical appliances

Not covered. Those not listed in Annexure 6: Unlimited No cover for out-of-hospital

Discovery active smart plan 2026, p10

Auxiliary services

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Chronic medicine (Chronic Disease List)

Medication for the chronic Prescribed Minimum Benefit conditions Save for medication contemplated in clause 15.18 of the main body of the Rules, basis of cover contained in Annexure 7. Subject to the Scheme's protocols, clinical entry criteria and drug utilisation review. As contained in Annexure 7

Discovery active smart plan 2026, p17

Chronic medicine (other conditions)

Not covered. Medication for the chronic Prescribed Minimum Benefit conditions

Discovery active smart plan 2026, p17

Contraceptives

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Specialised dentistry

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Basic dentistry

Dental check-up Up to a maximum of 100% of the Discovery Health Rate subject to a R195 co-payment by the member. One check-up per beneficiary per year

Discovery active smart plan 2026, p18

Casualty visits

Emergency Medical Services local Up to a maximum of 100% of the Discovery Health Rate. Inter-hospital transfers subject to authorisation. Unlimited

Discovery active smart plan 2026, p13

GP visits

Discovery active smart plan 2026, p18

GP visits

Not covered. GPs not in the network: No cover except in emergencies

Discovery active smart plan 2026, p18

GP visits

Virtual urgent care consultations In addition to the cover contained in Annexure 7, up to a maximum of 100% of the Discovery Health Rate paid from Health Care Cover for virtual urgent care consultations. 4 consultations per family per year

Discovery active smart plan 2026, p8

Hearing aids

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Maternity care (out of hospital)

Not covered. Excludes OTC medicines (inclusive of schedule 0, 1 and 2 drugs whether prescribed or not), optometry, antenatal classes and dentistry (other than severe dental and oral procedures contemplated in Annexure 3).

Discovery active smart plan 2026, p15

Psychologist and counselling visits

Up to a maximum of 100% of the Discovery Health Rate for out-of-hospital consultations, subject to registration on the Scheme's Disease Management Programme for Mental Health. Up to 80% of the Discovery Health Rate if not registered on the Scheme's Disease Management Programme. Up to 21 days in-hospital, or up to 15 out-of-hospital consultations, for conditions as defined in Annexure A of the Regulations

Discovery active smart plan 2026, p7

Eyes (optometry)

Eye test Up to a maximum of 100% of the Discovery Health Rate at a network provider. Subject to a R130 co-payment by the member. One test per beneficiary per year

Discovery active smart plan 2026, p18

Over-the-counter medicine

Over-the-counter medication (schedule 0 - 2 medication) Up to 100% of the Discovery Health Medicine Rate at a network pharmacy. A defined list of exclusion categories apply. R555 per family per year

Discovery active smart plan 2026, p18

Blood tests (pathology)

Discovery active smart plan 2026, p1

Physiotherapy and other therapists

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Care after a hospital stay

Not covered. All claims not paid by Health Care Cover or Chronic Illness Benefit are for beneficiary's account

Discovery active smart plan 2026, p16

Basic X-rays

Radiology & Pathology Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery active smart plan 2026, p1

MRI, CT and PET scans

Not covered. If done for conservative back or neck treatment or unrelated to admission, MRI/CT scan payable by member.

Discovery active smart plan 2026, p4

Specialist visits

Discovery active smart plan 2026, p1

Procedures in the doctor’s rooms

Gastroscopies, colonoscopies, proctoscopies and sigmoidoscopies performed in-rooms Up to a maximum of 100% of the Discovery Health Rate when performed at an in-rooms network provider. Save for the cover contained in Annexure 8, where indicated and approved for dyspepsia, and for children aged 12 and under, the first R1 800 is paid by the beneficiary. Where both a gastroscopy and colonoscopy are performed, the first R3 100 is paid by the beneficiary. The balance of the account will be paid from Health Care Cover up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery active smart plan 2026, p6

Screening and prevention

Screening and prevention

Screening Benefit A - Group of tests consisting of blood glucose test, blood pressure test, cholesterol test and Body Mass Index (BMI) Up to a maximum of 100% of the Discovery Health Rate for group of tests at a network provider. Unlimited

Discovery active smart plan 2026, p10

Screening and prevention

Screening Benefit B - Consist of appropriate tests (including self-sampling kits, where appropriate) and as determined by the Scheme: HIV screening, Mammogram, Prostate-Specific Antigen (PSA), colorectal and cervical cancer screening. One Mammogram every 2 years, one Pap Smear every 3 years or one HPV test every 5 years and one PSA test per person per year. One faecal occult blood test or immunochemical test every 2 years per person for persons between the ages of 45 to 75 years

Discovery active smart plan 2026, p11

Screening and prevention

Additional cover for Mammogram, breast MRI and biopsy, BRCA testing, colonoscopy and cervical cancer screening Up to a maximum of 100% of the Discovery Health Rate for test code. Basket of care as set by the Scheme Once off BRCA testing and colonoscopy

Discovery active smart plan 2026, p11

Screening and prevention

Screening Benefit C - Group of age appropriate tests including but not limited to growth assessment, blood pressure and health and milestone tracking Up to a maximum of 100% of the Discovery Health Rate at a network provider, for children between the ages of 2 and 18. Unlimited

Discovery active smart plan 2026, p11

Screening and prevention

Screening Benefit D – Group of age appropriate screening tests Up to a maximum of 100% of the Discovery Health Rate at a network provider, for members 65 years and older. Unlimited

Discovery active smart plan 2026, p11

Screening and prevention

Additional screening assessment or consultation Up to a maximum 100% of the Discovery Health Rate at an accredited network provider. One consultation per person per year

Discovery active smart plan 2026, p11

Screening and prevention

Preventative Benefit - Seasonal Influenza Vaccination Up to a maximum of 100% of the Discovery Health Medication Rate for the vaccination. One seasonal influenza vaccine per person per year

Discovery active smart plan 2026, p12

Screening and prevention

Preventative Benefit - Pneumococcal vaccination Up to a maximum of 100% of the Discovery Health Medication Rate for the vaccination. Up to 2 pneumococcal vaccine doses per person per lifetime

Discovery active smart plan 2026, p12

Conditions

The Chronic Disease List conditions are Prescribed Minimum Benefits on every medical aid. How each one works on a medical aid:

Discovery’s 2026 documents name no chronic conditions beyond the Chronic Disease List on Active Smart.

Questions about Active Smart

Answered from Discovery’s documents.

How much does Active Smart cost in 2027?

From 1 January 2027: R1 450 a month for the main member, R1 450 for an adult dependant and R1 450 for a child. You pay for up to 3 children.

How much is Active Smart going up for 2027?

For the main member, from R1 350 to R1 450 a month, +7.4%.

What happens if I use a hospital that isn't on the network?

For a planned admission at a hospital outside Discovery's network, the scheme charges a co-payment of R15 300.

Does Active Smart pay for GP visits and day-to-day costs?

No. Active Smart is a hospital plan, so day-to-day costs are your own.

How many chronic conditions does Active Smart cover?

27, the conditions on the Chronic Disease List.

Is cancer treatment covered?

Yes, at the PMB level of care, through ICON / SAOC.

Will I have a shortfall if my specialist charges more?

Active Smart pays specialists in hospital at 100% of the Scheme tariff. If a specialist charges more than that, the difference is a shortfall. Gap cover is the product that pays shortfalls.

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Factual information from Discovery Health Medical Scheme’s published documents. It is not advice. Compiled by Eldon de Waal, CFA, the licensed advisor behind AURA. Catalogue v175, built 2026-10-19.