Discovery Executive Plan: 2027 contributions and benefits

At a glance

Plan type: Comprehensive plan
Hospitals: Any private hospital
Hospital and specialists: 300% of Scheme tariff
Savings account: R3 085 a month for the main member (25%)
Chronic conditions: 49
Cancer: R500 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, p1. Its 2027 benefits are not in our records yet. You pay for up to 3 children.

Member	2026	2027	Change
Main member	R12 338	R13 442	+8.9%
Adult dependant	R12 338	R13 442	+8.9%
Child	R2 358	R2 569	+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

Any hospital

Hospitals

2027 not in our records yet. 2026: Any hospital

(2026)

Specialists in hospital

300% of Scheme tariff. A specialist who charges more leaves a shortfall.

Discovery executive plan, p1

Specialists in hospital

2027 not in our records yet. 2026: 300% of Scheme tariff. A specialist who charges more leaves a shortfall.

Discovery executive plan, p1 (2026)

Chronic and cancer

Chronic conditions

49 conditions (the 27 on the Chronic Disease List plus others the scheme adds).

Chronic conditions

2027 not in our records yet. 2026: 49 conditions (the 27 on the Chronic Disease List plus others the scheme adds).

(2026)

Cancer

Up to R500 000 a year.

Discovery annexure 8a oncology treatment programme, p2

Cancer

2027 not in our records yet. 2026: Up to R500 000 a year.

Discovery annexure 8a oncology treatment programme, p2 (2026)

Day to day

Medical savings account

25% of your contribution goes into a savings account for day-to-day costs.

Discovery executive plan, p19

Medical savings account

2027 not in our records yet. 2026: 25% of your contribution goes into a savings account for day-to-day costs.

Discovery executive plan, p19 (2026)

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

General Practitioner Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p26

GP visits

2027 not in our records yet. 2026: General Practitioner Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p26 (2026)

Specialist visits

Specialists Paid from MSA first and then ATB up to a maximum of 300% of the Discovery Health Rate.

Discovery executive plan 2026, p26

Specialist visits

2027 not in our records yet. 2026: Specialists Paid from MSA first and then ATB up to a maximum of 300% of the Discovery Health Rate.

Discovery executive plan 2026, p26 (2026)

Prescribed medicine (acute)

Prescribed medication for schedule 3 and above medication Preferentially priced generic and brand medication: Paid from the MSA first and then ATB up to a maximum of 100% of the Discovery Health Medication Rate with accumulation to Threshold at up to 100% of the Discovery Health Medication Rate.

Discovery executive plan 2026, p27

Prescribed medicine (acute)

2027 not in our records yet. 2026: Prescribed medication for schedule 3 and above medication Preferentially priced generic and brand medication: Paid from the MSA first and then ATB up to a maximum of 100% of the Discovery Health Medication Rate with accumulation to Threshold at up to 100% of the Discovery Health Medication Rate.

Discovery executive plan 2026, p27 (2026)

Basic dentistry

Dentistry Paid from MSA first and then ATB. Dentists and other related accounts: Up to a maximum of 100% of the Discovery Health Rate. Accumulation to the Threshold up to a maximum of the Discovery Health Rate.

Discovery executive plan 2026, p26

Basic dentistry

2027 not in our records yet. 2026: Dentistry Paid from MSA first and then ATB. Dentists and other related accounts: Up to a maximum of 100% of the Discovery Health Rate. Accumulation to the Threshold up to a maximum of the Discovery Health Rate.

Discovery executive plan 2026, p26 (2026)

Eyes (optometry)

Optometry consultations and optometry not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p30

Eyes (optometry)

2027 not in our records yet. 2026: Optometry consultations and optometry not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p30 (2026)

Basic X-rays

X-rays and radiology not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28

Basic X-rays

2027 not in our records yet. 2026: X-rays and radiology not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28 (2026)

Blood tests (pathology)

Pathology Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28

Blood tests (pathology)

2027 not in our records yet. 2026: Pathology Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28 (2026)

Full benefit list

Every benefit we hold for Executive Plan, 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

Specialists Up to a maximum of 300% of the Discovery Health Rate.

Discovery executive plan 2026, p1

Surgery and anaesthetics

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.

Discovery executive plan 2026, p1

Surgery and anaesthetics

Doctors and allied healthcare service providers while hospitalised Up to a maximum of 200% of the Discovery Health Rate.

Discovery executive 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 plus up to a maximum additional R2 800 per day in respect of private wards where applicable.

Discovery executive plan 2026, p1

Day procedures

Administration of defined intravenous infusions ... 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 executive plan 2026, p2

Day procedures

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.

Discovery executive plan 2026, p4

Day procedures

For beneficiaries younger than 13 years a Deductible of R3 470 for admissions to hospital or a Deductible of R1 550 for admissions to day-case facilities shall be payable by the beneficiary in respect of the hospital/day-case facility account.

Discovery executive plan 2026, p4

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. Up to a maximum of 200% of the Discovery Health Rate for related accounts. Specialists are covered up to a maximum of 300% of the Discovery Health Rate.

Discovery executive plan 2026, p2

Planned PMB procedures

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.

Discovery executive plan 2026, p2

Planned PMB 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 R6 800 in respect of the hospital account when performed in acute facilities, per admission is paid from MSA or ATB ... The balance of the hospital account will be paid from Health Care Cover up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p7

Planned PMB procedures

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.

Discovery executive plan 2026, p12

Planned PMB procedures

In-and out-of-hospital management for spinal care and surgery for a defined list of clinically appropriate procedures which include Lumbar Fusion, Cervical Fusion, Laminectomy, Laminotomy Up to a maximum of 100% of the Discovery Health Rate for the hospital account at a network facility. 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.

Discovery executive plan 2026, p12

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.

Discovery executive plan 2026, p14

Internal prostheses

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 upgrades limited to R190 000 per person every three years.

Discovery executive plan 2026, p11

Internal prostheses

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 executive plan 2026, p11

Internal prostheses

Internal nerve stimulators Up to a maximum of 100% of the Discovery Health Rate. R192 000 per person per year.

Discovery executive plan 2026, p11

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.

Discovery executive plan 2026, p11

Internal prostheses

Shoulder joint prostheses Non-network supplier: R53 000 per prosthesis per admission if prosthesis is not supplied by the Scheme's network provider.

Discovery executive plan 2026, p11

Internal prostheses

Hip and knee joint replacements ... The prostheses accumulate to the limit. Unlimited at a network provider.

Discovery executive plan 2026, p12

Internal prostheses

Hip and knee joint replacements Non-network provider: R31 850 per prosthesis per admission.

Discovery executive plan 2026, p12

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.

Discovery executive plan 2026, p13

Internal prostheses

Spinal prostheses and/or devices Non-network supplier: R28 350 per person for one spine level if prosthesis is not supplied by the Scheme's network provider. R56 650 per person for two or more spine levels if prosthesis is not supplied by the Scheme's network provider.

Discovery executive plan 2026, p13

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.

Discovery executive plan 2026, p13

Internal prostheses

Cardiac stents and balloons 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 executive plan 2026, p13

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 executive plan 2026, p14

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 an appropriate specialist.

Discovery executive plan 2026, p6

Dialysis

Chronic Dialysis Up to a maximum of 100% of the Discovery Health Rate. Drugs paid at 100% of the Discovery Health Medication Rate.

Discovery executive plan 2026, p8

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 21 days in-hospital.

Discovery executive plan 2026, p9

Mental health admissions

Management of mental health disorders ... Up to a maximum of 80% of the Discovery Health Rate for the hospital account if a non-network facility is used.

Discovery executive plan 2026, p9

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 executive plan 2026, p9

HIV/AIDS

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

Discovery executive plan 2026, p15

HIV/AIDS

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

Discovery executive plan 2026, p15

HIV/AIDS

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

Discovery executive plan 2026, p15

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 or from the MSA or ATB as per the Prescribed Medication Benefit.

Discovery executive plan 2026, p15

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 paid from Health Care Cover.

Discovery executive plan 2026, p3

Travel cover

International Travel Benefit as set out 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.

Discovery executive plan 2026, p20

Travel cover

Overseas Treatment Benefit as set out in Annexure B ... Treatment that is not available in South Africa: 80% of the cost from Health Care Cover ... R750 000 per person per year ... Treatment that is available in SA: 100% of the cost of the global fee amount and 80% of the cost above the global fee amount ... R300 000 per person per year.

Discovery executive plan 2026, p21

Cancer treatment

Non-PMB oncology (Oncology Treatment Programme): funded at 100% of the Discovery Health Rate up to a Threshold Claim Amount of R500,000 per person per 12-month cycle, then 80% of DHR with no overall limit. PMB oncology unlimited at PMB level via DSP (ICON/SAOC); voluntary non-DSP use funded at 80% of DHR (20% co-payment); 20% co-payment on PET-CT non-DSP.

Discovery annexure 8a oncology treatment programme 2026, p2

Specialised (biological) medicine in hospital

The Specialised Medicine and Technology Benefit provides additional cover for a defined list of high-cost medicines, new technologies and procedures up to a limit of R200 000 for each person, each year. Cover is either at 80% or 100% of the Discovery Health Rate (DHR) or Reference Price, depending on the treatment. Subject to entry criteria; you must apply via a Chronic Illness Benefit application form.

Discovery 2026 specialised medicine and technology benefit, p2

Specialised (biological) medicine in hospital

Biologics for rheumatoid arthritis, Crohn's disease and ulcerative colitis (e.g. Actemra, Amgevita, Entyvio, Humira, Hyrimoz, Orencia, Rinvoq, Simponi, Stelara, Xeljanz, and the rituximab brands MabThera, Blitzima, Redditux, Ristova, Rixathon, Rituximab Cipla): Up to a maximum of the reference price of the preferentially priced equivalent.

Discovery 2026 specialised medicine and technology benefit, p3

Specialised (biological) medicine in hospital

Biologics for ankylosing spondylitis and psoriatic arthritis (e.g. Copellor, Cosentyx, Enbrel, Erelzi, Remsima, Revellex, Rinvoq, Simponi 50mg, Stelara, Xeljanz): Up to a maximum of 80% of the reference price of the preferentially priced equivalent.

Discovery 2026 specialised medicine and technology benefit, p3

Specialised (biological) medicine in hospital

Esbriet and Pirofibra (pulmonary fibrosis) and Forteo and Prolia (osteoporosis): 80% of the Discovery Health Rate.

Discovery 2026 specialised medicine and technology benefit, p3

Specialised (biological) medicine in hospital

Neotecla and Sensipar (chronic renal disease): 100% of the Discovery Health Rate.

Discovery 2026 specialised medicine and technology benefit, p3

Specialised (biological) medicine in hospital

Other high-cost treatments and surgical procedures: Balloon sinuplasty (chronic sinusitis), Bariatric surgery (obesity), Ozurdex (retinal vein occlusion / diabetic macular oedema), Pegasys and PegIntron (Hepatitis C): 80% of the Discovery Health Rate co-payment.

Discovery 2026 specialised medicine and technology benefit, p5

Fertility treatment

Assisted Reproductive Therapy (ART) healthcare services (consultations, radiology, oocyte retrieval, embryo freezing/storage/transfer, related admission costs, laboratory fees, supportive medication, cryopreservation): in addition to the cover contained in Annexure 7, up to a maximum of 75% of the Discovery Health Rate. R140 000 per person per year.

Discovery executive plan 2026, p24

Palliative care

Advanced Illness Benefit — Up to a maximum of 100% of the Discovery Health Rate. Unlimited.

Discovery executive plan 2026, p15

Day to day

Specialist visits

Specialists Paid from MSA first and then ATB up to a maximum of 300% of the Discovery Health Rate.

Discovery executive plan 2026, p26

GP visits

General Practitioner Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p26

GP visits

Day-to-day Extender Benefit for: pharmacy clinic consultations with or without video call consultations with a General Practitioner; General Practitioner consultations; Available once the MSA has been depleted and before the Threshold is reached (during the self-payment gap). Out-of-hospital consultation codes billed by a network pharmacy clinic or GP that meets the digital platform criteria shall be paid from Health Care Cover up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p24

Prescribed medicine (acute)

Discovery executive plan 2026, p27

Over-the-counter medicine

Over the counter medication (OTC) inclusive of schedule 0, 1 and 2 drugs whether prescribed or not, and products that are considered lifestyle enhancing Paid from MSA with no accumulation to Threshold and not covered from ATB.

Discovery executive plan 2026, p27

Chronic medicine (Chronic Disease List)

Medication for the chronic Prescribed Minimum Benefit conditions Save for medication contemplated in Rule 15.18 of the Main Body of the Rules, basis of cover contained in Annexure 7.

Discovery executive plan 2026, p25

Chronic medicine (other conditions)

Prescribed medications for conditions listed in Annexure 2 Up to 100% of the Discovery Health Medication Rate.

Discovery executive plan 2026, p25

Blood tests (pathology)

Pathology Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28

Basic X-rays

X-rays and radiology not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28

MRI, CT and PET scans

MRI and CT Scans The first R4 000 in respect of each out-of-hospital MRI and CT scan is paid from MSA or ATB, and accumulated to the Annual Threshold, with the balance from Health Care Cover up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28

Procedures in the doctor’s rooms

Gastroscopies, colonoscopies, proctoscopies and sigmoidoscopies performed in-rooms Up to a maximum of 300% 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 from MSA or ATB. Where both a gastroscopy and colonoscopy are performed, the first R3 100 is paid from MSA or ATB. The balance of the account will be paid from Health Care Cover up to a maximum of 300% of the Discovery Health Rate.

Discovery executive plan 2026, p8

Physiotherapy and other therapists

Allied and therapeutic healthcare services including: acousticians, biokineticists, chiropractors, dieticians, homeopaths, nursing providers, occupational therapists, physiotherapists, podiatrists, psychologists, psychometrics, counsellors, social workers, speech and hearing therapists Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p29

Physiotherapy and other therapists

Allied healthcare services including: occupational therapists, physiotherapists, chiropractors or biokineticists, psychologists, social workers, speech and hearing therapists for the following conditions: Quadriplegia, hemiplegia or paraplegia, hearing loss, prematurity at birth, congenital defects ... Up to a maximum of 100% of the Discovery Health Rate from Health Care Cover once the Annual Threshold is reached.

Discovery executive plan 2026, p19

Psychologist and counselling visits

Management of mental health disorders Up to a maximum of 300% of the Discovery Health Rate for specialist related accounts. GPs and other related accounts paid from Health Care Cover up to a maximum of 200% of the Discovery Health Rate. 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 executive plan 2026, p9

Eyes (optometry)

Optometry consultations and optometry not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p30

Eyes (optometry)

Spectacles, frames, contact lenses, intra-ocular lenses, refractive eye surgery and other health care services to treat errors of refraction irrespective of cause Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate. R10 950 per person per year.

Discovery executive plan 2026, p30

Hearing aids

Hearing aids Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate. R31 250 per family per year.

Discovery executive plan 2026, p30

Medical appliances

External Medical Items (EMI) including those supplied by orthotists and prosthetists Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate. R64 200 per family per year.

Discovery executive plan 2026, p29

Medical appliances

Mobility and breathing devices for conditions such as: Hemiplegia, paraplegia, quadriplegia, Cerebral Palsy, Parkinson's disease, Multiple Sclerosis, respiratory disorders ... Up to a maximum of 100% of the Discovery Health Rate. Available once the EMI limit is reached.

Discovery executive plan 2026, p14

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 executive plan 2026, p3

Medical appliances

Point-of-care medical devices: Payment from MSA up to a maximum of 100% of the Discovery Health Rate. Payment from ATB and accumulation to Threshold at 75% of the Discovery Health Medication Rate. One device per family.

Discovery executive plan 2026, p29

Alternative healthcare

Other alternative allied healthcare services as listed in Annexure 1 Paid from MSA with no accumulation to Threshold and not covered from ATB.

Discovery executive plan 2026, p29

Basic dentistry

Discovery executive plan 2026, p26

Specialised dentistry

All dental appliances and prostheses and the placement of such appliances/prostheses as well as orthodontics (surgical and non-surgical) are paid from MSA or ATB up to a maximum of 100% of the Discovery Health Rate. R37 500 per person per year ... Limit applies regardless of place of service and is pro-rated if beneficiary joins after 01 January.

Discovery executive plan 2026, p4

Specialised dentistry

Severe dental and oral procedures reflected in Annexure 3 Up to a maximum of 300% of the Discovery Health Rate for specialist related accounts. Dentist and other related accounts paid from Health Care Cover up to a maximum of 200% of the Discovery Health Rate. Up to a maximum of 100% of the Discovery Health Rate for hospital account.

Discovery executive plan 2026, p5

Specialised dentistry

Basic Dental Trauma Benefit 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 ... R70 800 per person per year for dental appliances and prosthesis and the placement of such appliances/prosthesis.

Discovery executive plan 2026, p5

Casualty visits

Day-to-day Extender Benefit for: non-PMB trauma services obtained from a casualty unit for children under the age of 10 years ... Out-of-hospital consultation, facility fee and consumable codes billed by the casualty unit for children under the age of 10 shall be paid from Health Care Cover up to a maximum of 100% of the Discovery Health Rate. In network casualty visit: Once MSA has been used up and before Threshold is reached, limited to 2 visits per child. Not in the network: Limited to funds available in MSA.

Discovery executive plan 2026, p24

Casualty visits

Non-PMB trauma services obtained from a casualty unit Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate for children under the age of 10.

Discovery executive plan 2026, p26

Maternity care (out of hospital)

Out-of-hospital healthcare services related to pregnancy and delivery: Up to 100% of the Discovery Health Rate, or agreed rate. Paid from Health Care Cover and is subject to applicable limits. Services in excess of the limit paid from MSA and ATB. Limits apply for the duration of the pregnancy.

Discovery executive plan 2026, p23

Maternity care (out of hospital)

Non-invasive Prenatal Screening Test or defined chromosome testing Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p27

Maternity care (out of hospital)

Antenatal classes Once the out-of-hospital cover related to pregnancy and delivery is reached, paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate. R2 500 per family per pregnancy.

Discovery executive plan 2026, p30

Auxiliary services

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

Discovery executive plan 2026, p19

Auxiliary services

Advanced Illness Benefit Up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p15

Auxiliary services

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. Consultations in excess of the annual limit ... paid from MSA or ATB.

Discovery executive plan 2026, p10

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.

Discovery executive plan 2026, p3

Care after a hospital stay

Trauma Recovery Extension: over and above the DTP PMB entitlement, this benefit covers certain out-of-hospital healthcare services (External Medical Items, hearing aids, allied services, prescribed medicine, additional counselling) arising from an emergency, trauma-related event resulting in defined PMB conditions (paraplegia, quadriplegia, near-drowning, severe anaphylaxis, poisoning, crime-related injury, severe burns, head injuries, loss of limb), to 31 December of the year after the trauma.

Discovery executive plan 2026, p22

Specialist visits

Specialists Paid from MSA first and then ATB up to a maximum of 300% of the Discovery Health Rate.

Discovery executive plan 2026, p26

GP visits

General Practitioner Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p26

Prescribed medicine (acute)

Discovery executive plan 2026, p27

Blood tests (pathology)

Pathology Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28

Basic X-rays

X-rays and radiology not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p28

Physiotherapy and other therapists

Discovery executive plan 2026, p29

Eyes (optometry)

Optometry consultations and optometry not otherwise specified Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p30

Eyes (optometry)

Discovery executive plan 2026, p30

Hearing aids

Hearing aids Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate. R31 250 per family per year.

Discovery executive plan 2026, p30

Medical appliances

Discovery executive plan 2026, p29

Medical appliances

Discovery executive plan 2026, p29

Basic dentistry

Discovery executive plan 2026, p26

Specialised dentistry

Discovery executive plan 2026, p4

Casualty visits

Non-PMB trauma services obtained from a casualty unit Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate for children under the age of 10.

Discovery executive plan 2026, p26

Maternity care (out of hospital)

Non-invasive Prenatal Screening Test or defined chromosome testing Paid from MSA first and then ATB up to a maximum of 100% of the Discovery Health Rate.

Discovery executive plan 2026, p27

Maternity care (out of hospital)

Discovery executive plan 2026, p30

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.

Discovery executive plan 2026, p15

Screening and prevention

Screening Benefit B - Consist of appropriate tests ... 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. Tests in excess of annual limit paid from MSA and ATB.

Discovery executive plan 2026, p15

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. Screening Benefit D - Group of age appropriate screening tests ... for members 65 years and older.

Discovery executive plan 2026, p16

Screening and prevention

Preventative Benefit - Seasonal Influenza Vaccination Up to a maximum of 100% of the Discovery Health Medication Rate for the vaccination. Seasonal flu vaccines in excess of the annual limit paid from MSA or ATB.

Discovery executive plan 2026, p16

Screening and prevention

Vaccines and immunisations Save for where stipulated under a defined benefit, paid from MSA with no accumulation to Threshold and not covered from ATB.

Discovery executive plan 2026, p27

Screening and prevention

Self-administered antigen testing for COVID-19 Paid from MSA first and then ATB at a maximum of 100% of the Discovery Health Rate. R1 090 per family per year.

Discovery executive plan 2026, p28

Screening and prevention

Self-administered antigen testing for COVID-19 Paid from MSA first and then ATB at a maximum of 100% of the Discovery Health Rate. R1 090 per family per year.

Discovery executive plan 2026, p28

Conditions

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

Discovery also names these on Executive Plan’s 2026 chronic list:

Others on its list have no page of ours yet.

Questions about Executive Plan

Answered from Discovery’s documents.

How much does Executive Plan cost in 2027?

From 1 January 2027: R13 442 a month for the main member, R13 442 for an adult dependant and R2 569 for a child. You pay for up to 3 children.

How much is Executive Plan going up for 2027?

For the main member, from R12 338 to R13 442 a month, +8.9%.

Does Executive Plan have a medical savings account?

Yes. 25% of your contribution goes into a savings account, which pays for day-to-day costs such as GP visits and medicine.

How many chronic conditions does Executive Plan cover?

49: the 27 on the Chronic Disease List and others the scheme adds.

Will I have a shortfall if my specialist charges more?

Executive Plan pays specialists in hospital at 300% 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 →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.