Discovery Coastal Core: 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: R250 000 a year
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, p2. Its 2027 benefits are not in our records yet. You pay for up to 3 children.

Member	2026	2027	Change
Main member	R3 250	R3 540	+8.9%
Adult dependant	R2 438	R2 657	+9.0%
Child	R1 291	R1 406	+8.9%

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 (Coastal Hospital Network)

Discovery coastal core plan, p19

Hospitals

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

Discovery coastal core plan, p19 (2026)

Specialists in hospital

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

Discovery coastal core 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 coastal core plan, p1 (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

Up to R250 000 a year.

Discovery annexure 8a oncology treatment programme, p1

Cancer

2027 not in our records yet. 2026: Up to R250 000 a year.

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

Not covered.

Discovery coastal core plan 2026, p19

GP visits

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

Discovery coastal core plan 2026, p19 (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 Discovery Health Rate.

Discovery coastal core 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 Discovery Health Rate.

Discovery coastal core plan 2026, p1 (2026)

Prescribed medicine (acute)

Statutory Prescribed Minimum Benefits — Basis of cover is contained in Annexure 7. All Prescribed Minimum Benefits to accumulate to available limits first. Unlimited

Discovery coastal core plan 2026, p21

Prescribed medicine (acute)

2027 not in our records yet. 2026: Statutory Prescribed Minimum Benefits — Basis of cover is contained in Annexure 7. All Prescribed Minimum Benefits to accumulate to available limits first. Unlimited

Discovery coastal core plan 2026, p21 (2026)

Basic dentistry

Not covered.

Discovery coastal core plan 2026, p18

Basic dentistry

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

Discovery coastal core plan 2026, p18 (2026)

Eyes (optometry)

Not covered.

Discovery coastal core plan 2026, p18

Eyes (optometry)

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

Discovery coastal core plan 2026, p18 (2026)

Basic X-rays

Radiology and pathology — Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery coastal core plan 2026, p1

Basic X-rays

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

Discovery coastal core plan 2026, p1 (2026)

Blood tests (pathology)

Radiology and 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.

Discovery coastal core plan 2026, p1

Blood tests (pathology)

2027 not in our records yet. 2026: Radiology and 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.

Discovery coastal core plan 2026, p1 (2026)

Full benefit list

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

In hospital

Day procedures

A 30% co-payment shall be payable by the member on the hospital account for elective admissions at non-coastal private hospitals and which are not in the Scheme's selected network of hospitals for Coastal Plans ("the Network"). No co-payment shall be payable by the member in the case of emergency services rendered at private hospitals which are not in the Network.

Discovery coastal core plan 2026, p19

Day procedures

Up to a maximum of 100% of the Discovery Health Rate at the Scheme's defined list of day-surgery providers. A R7 250 Deductible shall be payable by the beneficiary in respect of the hospital account for elective admissions at a facility which is not a network facility.

Discovery coastal core 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 coastal core plan 2026, p2

Day procedures

A Deductible of R8 950 for admissions to hospital or a Deductible of R5 750 for admissions to day-case facilities shall be payable by the beneficiary ... For beneficiaries 13 years and younger a Deductible of R3 470 for admissions to hospital or a Deductible of R1 550 for admissions to day-case facilities ...

Discovery coastal core plan 2026, p4

Day procedures

Gastroscopies, colonoscopies, proctoscopies and sigmoidoscopies performed in-hospital — ... 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 ... Where both a gastroscopy and colonoscopy are performed ... R5 700 ... day clinic, or R9 950 ... acute facilities ... value-based network, the first R8 250 ...

Discovery coastal core plan 2026, p6

Medicine on discharge

Not covered. 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 coastal core plan 2026, p13

HIV/AIDS

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

Discovery coastal core plan 2026, p13

HIV/AIDS

Post-exposure HIV prophylaxis following occupational exposure, traumatic exposure or sexual assault — Up to a maximum of 100% of cost. Unlimited

Discovery coastal core plan 2026, p13

HIV/AIDS

HIV prophylaxis for mother-to-child transmission — Up to a maximum of 100% of cost. Unlimited

Discovery coastal core plan 2026, p13

HIV/AIDS

HIV Management for members registered on the Scheme's Disease Management Programme — Basis of cover is contained in Annexure 7. Up to 100% of the Discovery Health Rate for services covered in the Scheme's basket of care if referred by the Scheme's DSP. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p20

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 in a coastal hospital. Subject to authorisation and/or approval and meeting the Scheme's clinical and managed care criteria. Unlimited

Discovery coastal core plan 2026, p1

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 ... 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 coastal core plan 2026, p17

Travel cover

Africa Evacuation Benefit as set out in Annexure B — Basis of cover as contained in Annexure B. Up to 100% of the cost ... Subject to authorisation. For medical emergencies only.

Discovery coastal core plan 2026, p17

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 coastal core plan 2026, p2

Planned PMB procedures

All Prescribed Minimum Benefits (PMBs) to accumulate to available limits. Once benefit limits are reached funding in respect of PMBs will continue to fund in accordance with the basis of cover as contained in Annexure 7.

Discovery coastal core plan 2026, p1

Planned PMB procedures

Pre-operative assessment for the following list of major surgeries: arthroplasty, colorectal surgery, coronary artery bypass graft, radical prostatectomy and mastectomy — Up to a maximum of 100% of the Discovery Health Rate. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p3

Planned PMB procedures

Cataract surgery — Up to a maximum of 100% of the Discovery Health Rate for the hospital account at a network facility. Up to 80% of the Discovery Health Rate for the hospital account if performed at a non-network facility. Up to a maximum of 100% of the Discovery Health Rate for related accounts paid from Health Care Cover. Unlimited

Discovery coastal core plan 2026, p12

Internal prostheses

Shoulder joint prostheses — Up to a maximum of 100% of the Discovery Health Rate. Network supplier: Unlimited if prosthesis is supplied by the Scheme's network provider. Non-network supplier: R46 000 per prosthesis per admission if prosthesis is not supplied by the Scheme's network provider

Discovery coastal core plan 2026, p10

Internal prostheses

Hip and knee joint replacements — Up to a maximum of 100% of the Discovery Health Rate at a network provider. Network does not apply to any admissions related to trauma. Up to 80% of the Discovery Health Rate for the hospital account if performed at a non-network facility. Unlimited at a network provider. Non-network provider: R31 850 per prosthesis per admission

Discovery coastal core plan 2026, p10

Internal prostheses

Spinal prostheses and/or devices — Up to a maximum of 100% of the Discovery Health Rate. Maximum of one procedure per person per year. Network supplier: Unlimited if prosthesis is supplied by the Scheme's network provider. Non-network supplier: R18 900 per person for one spine level ... R37 800 per person for two or more spine levels if prosthesis is not supplied by the Scheme's network provider. Where the prostheses and/or device is subject to the spinal surgery being performed in a network facility, up to 80% of the Discovery Health Rate if performed at a non-network facility.

Discovery coastal core plan 2026, p11

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 ... Bare metal stent limit: R10 650 per stent per admission ... Drug-eluting balloon: R13 800 per balloon per admission if not supplied by the Scheme's network provider

Discovery coastal core plan 2026, p12

Internal prostheses

Intra-ocular lenses for cataract surgery — Up to a maximum of 100% of the Discovery Health Rate. Covered in full when supplied by the Scheme's preferred suppliers, otherwise covered up to the Discovery Health Rate for the lens

Discovery coastal core plan 2026, p12

Internal prostheses

Internal nerve stimulators — Up to a maximum of 100% of the Discovery Health Rate. R192 000 per person per year. The device accumulates to the limit. The balance of the hospital and related accounts do not accumulate to the annual limit.

Discovery coastal core plan 2026, p10

Mental health admissions

Management of mental health disorders — 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 ... for conditions as defined in Annexure A of the Regulations. All other conditions up to 21 days in-hospital

Discovery coastal core plan 2026, p8

Mental health admissions

Alcohol and drug rehabilitation — Basis of cover is contained in Annexure 7. 21 days in-hospital treatment per person per year

Discovery coastal core plan 2026, p8

MRI, CT and PET scans

MRI and CT Scans — Up to a maximum of 100% of 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 coastal core plan 2026, p4

Dialysis

Chronic Dialysis — Up to a maximum of 100% of the Discovery Health Rate at the Scheme's network provider. Drugs paid at 100% of the Discovery Health Medication Rate. Unlimited

Discovery coastal core plan 2026, p7

Surgery and anaesthetics

Doctors and allied health care service providers while hospitalised — Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery coastal core plan 2026, p1

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. Basket of care as set by the Scheme

Discovery coastal core 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 coastal core plan 2026, p13

Cancer treatment

Non-PMB oncology (Oncology Treatment Programme): 100% of DHR up to a Threshold Claim Amount of R250,000 per person per 12-month cycle, then 80% of DHR with no overall limit. PMB oncology unlimited via DSP; non-network 80% DHR (20% co-pay).

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

Fertility treatment

Not covered. Assisted Reproductive Therapy Benefit not available on this plan — the benefit is available on the Executive Plan and Comprehensive Series only.

discovery- 2026 - assisted reproductive therapy benefit, p2

Day to day

Prescribed medicine (acute)

Statutory Prescribed Minimum Benefits — Basis of cover is contained in Annexure 7. All Prescribed Minimum Benefits to accumulate to available limits first. Unlimited

Discovery coastal core plan 2026, p21

Prescribed medicine (acute)

Benefit for out-of-hospital management and appropriate supportive treatment of specific global World Health Organisation (WHO) recognised disease outbreaks: COVID-19, Mpox — In addition to cover contained in Annexure 7, up to a maximum of 100% of the Discovery Health Rate. Basket of care as set by the Scheme per condition

Discovery coastal core plan 2026, p17

Alternative healthcare

Allied and therapeutic healthcare services including: o Acousticians, biokineticists, chiropractors, dieticians, homeopaths, nursing providers, occupational therapists, physiotherapists, podiatrists, psychologists, psychometrics, counsellors, social workers, speech and hearing therapists limited to: Member: R10 100; M + 1 dependant: R15 250; M + 2 dependants: R18 950; M + 3 dependants or more: R22 800

Discovery coastal core plan 2026, p18

Medical appliances

External Medical Items (EMI) including those supplied by orthotists and prosthetists — Up to a maximum of Discovery Health Rate. Unless part of a defined benefit those listed in Annexure 6 are for member's own account. Those not listed on Annexure 6: Unlimited. No cover for out-of-hospital

Discovery coastal core plan 2026, p13

Medical appliances

External Medical Items: Limited to R28 900 per family per year, except for prosthetic limbs which shall be subject to a limit of R107 650 per person per year

Discovery coastal core plan 2026, p18

Medical appliances

Home-monitoring devices for clinically appropriate chronic and acute conditions — Up to a maximum of 100% of the Discovery Health Rate paid from Health Care Cover. Up to R4 850 per person per year

Discovery coastal core plan 2026, p3

Auxiliary services

Discovery coastal core plan 2026, p3

Auxiliary services

Home-based virtual care for the elderly — Up to a maximum of 100% of the Discovery Health Rate, for members 65 years and older. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p3

Auxiliary services

Home-based support programme following prolonged NICU admissions — Up to a maximum of 100% of the Discovery Health Rate. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p3

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 coastal core plan 2026, p20

Chronic medicine (Chronic Disease List)

Diabetes Management / HIV Management / Cardiovascular Disease Management for members registered on the Scheme's Disease Management Programme — Basis of cover is contained in Annexure 7. Up to 100% of the Discovery Health Rate for services covered in the Scheme's basket of care if referred by the Scheme's DSP.

Discovery coastal core plan 2026, p20

Chronic medicine (Chronic Disease List)

Disease Management for cardio-metabolic risk syndrome for members registered on the Scheme's Disease Management Programme — Up to a maximum of 100% of the Discovery Health Rate. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p8

Chronic medicine (Chronic Disease List)

Blood glucose monitoring device — Any beneficiary approved and registered on the Scheme's Chronic Illness Benefit for diabetes is covered up to 100% of the Discovery Health Rate, paid from Health Care Cover. 1 per beneficiary per year limited to the home-monitoring device limit as stipulated in Table A

Discovery coastal core plan 2026, p20

Chronic medicine (other conditions)

Not covered. Specialised Medicine and Technology treatment contemplated in clause 15.18 of the Main Body of the Rules — No cover. Not applicable

Discovery coastal core plan 2026, p20

Specialised dentistry

Dentistry — A Deductible of R8 950 for admissions to hospital or a Deductible of R5 750 for admissions to day-case facilities shall be payable by the beneficiary in respect of the hospital/day-case facility account. The balance ... paid from Health Care Cover up to a maximum of 100% of Discovery Health Rate. For beneficiaries 13 years and younger a Deductible of R3 470 for admissions to hospital or a Deductible of R1 550 ... day-case facilities. All dental appliances and prostheses and the placement of such appliances/prostheses as well as orthodontics (surgical and non-surgical) are paid by the beneficiary.

Discovery coastal core plan 2026, p4

Specialised dentistry

Severe dental and oral procedures reflected in Annexure 3 — Up to a maximum of 100% of the Discovery Health Rate for related accounts. Up to a maximum of 100% of the Discovery Health Rate for hospital account. Where such event is also subject to Annexure 9, a R7 250 Deductible shall be payable by the beneficiary in respect of the hospital account for elective admissions at a facility which is not a network facility.

Discovery coastal core plan 2026, p5

Specialised dentistry

Basic Dental Trauma Benefit — Basis of cover as contained in Annexure B. R70 800 per person per year for dental appliances and prosthesis and the placement of such appliances/prosthesis. A Deductible of R8 950 for admissions to hospital or a Deductible of R5 750 for admissions to day-case facilities ... For beneficiaries younger than 13 years a Deductible of R3 470 ... or R1 550 ...

Discovery coastal core plan 2026, p5

Basic dentistry

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 coastal core 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 coastal core plan 2026, p16

GP visits

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

Discovery coastal core plan 2026, p19

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 coastal core plan 2026, p9

Hearing aids

Cochlear implants and auditory brain implants (including processors) and processor upgrades — Up to a maximum of 100% of the Discovery Health Rate. R252 000 per person per year. Processor upgrade limited to R190 000 per person every three years

Discovery coastal core plan 2026, p9

Hearing aids

Bone Anchored/Transcutaneous Hearing Aids (BAHA) and processor upgrades — Up to a maximum of 100% of the Discovery Health Rate. R150 000 per person per year. Processor upgrade limited to R78 000 per person every three years

Discovery coastal core plan 2026, p9

Hearing aids

Hearing aids: Limited to R17 850 per family per year

Discovery coastal core plan 2026, p18

Maternity care (out of hospital)

Out-of-hospital healthcare services related to pregnancy and delivery: antenatal classes and/or postnatal visits: 5 consultations or classes per pregnancy and/or delivery — antenatal consultations: 8 per pregnancy — prenatal screening, including chromosome testing or Non Invasive Prenatal Testing (NIPT): 1 per pregnancy — pregnancy scans: 2 per pregnancy — blood tests: 1 routine basket of pregnancy tests per pregnancy — postnatal consultations for complications post delivery: 1 per delivery — dietician nutrition assessment: 1 during pregnancy or after delivery — mental health consultations: 2 during pregnancy or after delivery — consultations for infants: 2 per child

Discovery coastal core plan 2026, p19

Psychologist and counselling visits

Management of mental health disorders — 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 coastal core plan 2026, p8

Psychologist and counselling visits

Disease Management Programme to reduce the risks of depression for at-risk members — Up to a maximum of 100% of the Discovery Health Rate at a network psychologist or Premier Plus network GP, following completion of the mental wellbeing assessment. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p8

Psychologist and counselling visits

Disease Management for major depression for members registered on the Scheme's Disease Management Programme — In addition to the cover contained in Annexure 7 up to 100% of the Discovery Health Rate for services covered in the Scheme's basket of care if referred by the Scheme's DSP. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p8

Eyes (optometry)

Not covered. Excludes OTC medicines (inclusive of schedule 0, 1 and 2 drugs whether prescribed or not), optometry, antenatal classes and dentistry ...

Discovery coastal core plan 2026, p18

Over-the-counter medicine

Not covered. Excludes OTC medicines (inclusive of schedule 0, 1 and 2 drugs whether prescribed or not) ...

Discovery coastal core plan 2026, p18

Blood tests (pathology)

Discovery coastal core plan 2026, p1

Physiotherapy and other therapists

Allied and therapeutic healthcare services including: o ... biokineticists ... occupational therapists, physiotherapists, podiatrists ... limited to: Member: R10 100; M + 1 dependant: R15 250; M + 2 dependants: R18 950; M + 3 dependants or more: R22 800

Discovery coastal core plan 2026, p18

Care after a hospital stay

Procedures performed in the Short Stay Surgical Care Network — Up to a maximum of 100% of the Discovery Health Rate at a network provider for clinically appropriate low acuity surgical procedures. Related post-operative basket of care as set by the Scheme

Discovery coastal core plan 2026, p3

Basic X-rays

Radiology and pathology — Up to a maximum of 100% of the Discovery Health Rate. Unlimited

Discovery coastal core plan 2026, p1

MRI, CT and PET scans

Not covered. MRI and CT Scans — If done for conservative back or neck treatment or unrelated to admission, MRI/CT scan payable by member. Subject to PMB's.

Discovery coastal core plan 2026, p4

Specialist visits

Discovery coastal core plan 2026, p1

Specialist visits

International clinical review service — Up to a maximum of 75% of the cost of the consultation. Unlimited

Discovery coastal core plan 2026, p13

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 ... paid from Health Care Cover up to a maximum of 100% of the Discovery Health Rate.

Discovery coastal core plan 2026, p7

Procedures in the doctor’s rooms

Conservative treatment for dyspepsia — Up to a maximum of 100% of the Discovery Health Rate. Basket of care as set by the Scheme

Discovery coastal core plan 2026, p7

Contraceptives

Not covered. No contraceptive benefit stated in the plan brochure; all claims not paid by Health Care Cover or the Chronic Illness Benefit are for the beneficiary's account.

Discovery coastal core plan 2026, p19

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 the 100% of the Discovery Health Rate for group of tests at a network provider. Unlimited

Discovery coastal core plan 2026, p14

Screening and prevention

Defined diabetes and cholesterol screening tests — Up to a maximum of 100% of the Discovery Health Rate for test code. Unlimited. Note: Consultation payable by the member. Where the consultation relates to a PMB the consultation will be paid from Health Care Cover.

Discovery coastal core plan 2026, p14

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 — Up to a maximum of 100% of the Discovery Health Rate for test code. Appropriate HIV screening tests as determined by the Scheme – Unlimited. 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 coastal core plan 2026, p14

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 coastal core plan 2026, p14

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 coastal core plan 2026, p14

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 coastal core plan 2026, p15

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 coastal core plan 2026, p15

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 coastal core plan 2026, p13

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 coastal core plan 2026, p15

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 Coastal Core.

Questions about Coastal Core

Answered from Discovery’s documents.

How much does Coastal Core cost in 2027?

From 1 January 2027: R3 540 a month for the main member, R2 657 for an adult dependant and R1 406 for a child. You pay for up to 3 children.

How much is Coastal Core going up for 2027?

For the main member, from R3 250 to R3 540 a month, +8.9%.

What is the difference between Coastal Core and Classic Core?

Coastal Core uses Discovery’s hospital network; Classic Core lets you use any hospital. In 2027 the main member pays R3 540 on Coastal Core and R4 215 on Classic Core.

Does Coastal Core pay for GP visits and day-to-day costs?

No. Coastal Core is a hospital plan, so day-to-day costs are your own.

How many chronic conditions does Coastal Core cover?

27, the conditions on the Chronic Disease List.

Will I have a shortfall if my specialist charges more?

Coastal Core 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.

Compare my picks →On this plan? Get help with it →Classic Core →All Discovery plans →Discovery 2027 price changes →Gap cover →

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.