Discovery Classic Smart vs Coastal Core - Breaking down all the differences

airborne

airborne

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The choice I have is to stay with Coastal Core at R3011 or move to Classic Smart at R2822.
Members can downgrade their plan choice within their existing medical scheme at any point in time.
They have the option to upgrade their plan choice annually only on 1 January each year.

The main difference is with Coastal Core you can use any private hospital in the Coastal areas vs Classic Smart needs a co-payment of R12 200 for planned admissions to hospitals not in the Smart Hospital Network but you can use any hospital if it's an emergency with no co-payment needed, it will be a similar situation for inland Core vs Classic Smart.

Classic Smart has some other benefits which Coastal Core does not :
200% Discovery Health Rate vs 100% on Coastal Core (You should have gap cover so that difference won't matter)
Co-payment of R 3 850 per scan for out-of hospital MRI/CT scans vs No cover on Coastal Core

Classic Smart has quite a few out of hospital benefits as well:
1. One eye test is covered per person per year at a Smart Network optometrist. You are liable for an upfront co-payment of R 70.
2. One defined dental examination per person per year at any dentist, dental therapist or oral hygienist. You are responsible for an upfront co-payment of R 125
3. You have cover for a defined list of acute medications prescribed by your Smart Network GP. This benefit is limited to R 1 905 per person per year or R 3 180 per family per year
4. You have cover for over-the-counter medication up to a maximum of R 875 per family per year.
5. You get unlimited GP consultations at your Smart Network GP. You are responsible for a co-payment of R 70.
6. For Sports Injuries only: You have cover for basic x-rays, 2 specialist consultations and a total of 4 consultations to a physiotherapist, biokineticist or chiropractor when related to a sports injury and if the benefit is activated and you are referred by your Smart Network GP. You are responsible for a co-payment of R 125 for each consultation and/or x-ray.

Is there anything else I need to consider before making the move from Coastal Core to Classic Smart?

It seems like a no brainer but for one thing how valuable is it to have free range to choose any hospital for admission, I'm assuming some specialists will only work from one hospital so if that isn't a network hospital you will need to pay the R12 200 co-payment, which may add up after multiple admissions.
 
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Would also like to know as I am on the same Coastal Core and considering the move to Classic Smart.
However, from what I know members can downgrade their plan choice within their existing medical scheme at any point in time. They have the option to upgrade their plan choice annually on 1 January.
They also are introducing Personal Pathways which, like the Wellth Fund, gives R1000 and R2000 respectively like an MSA for completing activities.
Wonder what happens if you switch mid year?
 
kabusi said:
Would also like to know as I am on the same Coastal Core and considering the move to Classic Smart.
However, from what I know members can downgrade their plan choice within their existing medical scheme at any point in time. They have the option to upgrade their plan choice annually on 1 January.
They also are introducing Personal Pathways which, like the Wellth Fund, gives R1000 and R2000 respectively like an MSA for completing activities.
Wonder what happens if you switch mid year?
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That's a good point, I think maybe it's just my broker is going on holiday from the 13th :cautious:
I'll update the OP.

But barring someone bringing up something negative about Classic Smart vs Core I think it looks like a good switch.
Slightly cheaper and some handy out of hospital benefits.
 
Then there's Essential Smart with the latter being R 800 cheaper still.

Something about sports injuries and 100% vs 200% cover which is anyway 1/3 of the bill and you have gap cover...

These cheaper plans are basically the same, they're covering the legislated PMBs at the cheapest cost (network hospital arrangements) and that's about it.

The add-ons are not worth very much if you think about it. R 80/month for medication you can save in your own stokvel.
 
Tomtomtom said:
Then there's Essential Smart with the latter being R 800 cheaper still.

Something about sports injuries and 100% vs 200% cover which is anyway 1/3 of the bill and you have gap cover...

These cheaper plans are basically the same, they're covering the legislated PMBs at the cheapest cost (network hospital arrangements) and that's about it.

The add-ons are not worth very much if you think about it. R 80/month for medication you can save in your own stokvel.
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What exactly are the differences between Essential and Classic Smart?
Using the compare tool on the Discovery website is essentially useless.

I don't really need the out of hospital stuff of Classic Smart except the MRI/Ct scan cover and Sports Injuries cover could be handy.
I asked for options and my broker only suggested Classic Smart, they are pretty useless.
 
The other benefit is the R1000 extra personal pathways. Anyone unlocked how this works yet?
 
I just switched.
I had the same info as you but in addition:
  • I work for a really big company and we have a dedicated medical aid advisor advising +/- 5000 people. I had a chat to them and they said there is nothing else hidden besides checking with your hospitals/doctors for cover. She did say the cover is particularly good in the Western Cape with Smart Classic.
  • I was a bit nervous as my wife has had a number of procedures over the last 5 years or so and Coastal Core paid basically everything. We called all of the doctors and specialists rooms we have used and they all verified they are covered in Smart Classic. Pretty much all of the major hospitals are there as well.
With this in mind we made the switch starting from next year.
 
Brawler said:
I just switched.
I had the same info as you but in addition:
  • I work for a really big company and we have a dedicated medical aid advisor advising +/- 5000 people. I had a chat to them and they said there is nothing else hidden besides checking with your hospitals/doctors for cover. She did say the cover is particularly good in the Western Cape with Smart Classic.
  • I was a bit nervous as my wife has had a number of procedures over the last 5 years or so and Coastal Core paid basically everything. We called all of the doctors and specialists rooms we have used and they all verified they are covered in Smart Classic. Pretty much all of the major hospitals are there as well.
With this in mind we made the switch starting from next year.
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Why did they advise not to go on the cheaper smart plans like essential smart?
 
TiredPlatypus said:
Brokers never seen to mention it and website compare tool hides it but look at the right hand column for extra exclusions for essential smart on page 37 of

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Good spot. This is a big deal for me. No back or neck surgery? Wtf man. I will likely need a back surgery in a few years. Will read more later and might change back.
 
Brawler said:
Good spot. This is a big deal for me. No back or neck surgery? Wtf man. I will likely need a back surgery in a few years. Will read more later and might change back.
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If I read your post correctly you are are on smart? Think you are covered then. The way I read it the back and neck exclusions only apply for essential and active.

But it does frustrate me I feel like those kind of exclusions should be closer to page 1.
 
Brawler said:
Good spot. This is a big deal for me. No back or neck surgery? Wtf man. I will likely need a back surgery in a few years. Will read more later and might change back.
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Looks like that is still covered on the Classic Smart plan thankfully
 
TiredPlatypus said:
If I read your post correctly you are are on smart? Think you are covered then. The way I read it the back and neck exclusions only apply for essential and active.

But it does frustrate me I feel like those kind of exclusions should be closer to page 1.
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Most of the budget plans are like that, what does it actually mean, if you have a spinal injury say in a car accident they won't cover it or is the exclusion for elective surgeries like an old back injury that's resulted in degenerating discs, they won't cover a disc fusion or artificial disc replacement?
Scooby_Doo said:
This thread is for classic though?
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I was asking about Essential smart but I can see Classic is the bottom of the barrel before you start losing vital cover.
 
TiredPlatypus said:
If I read your post correctly you are are on smart? Think you are covered then. The way I read it the back and neck exclusions only apply for essential and active.

But it does frustrate me I feel like those kind of exclusions should be closer to page 1.
Click to expand...
Thanks. Had a beer or two and read quickly ;)
Yeah currently on Coastal Core and just asked to be changed to Smart Classic.
 
Brawler said:
Thanks. Had a beer or two and read quickly ;)
Yeah currently on Coastal Core and just asked to be changed to Smart Classic.
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The only real drawback is the co-payment of R12 200 for planned admissions to hospitals not in the Smart Hospital Network but there are some other very useful benefits to Smart Classic that may get used more.
 
airborne said:
The only real drawback is the co-payment of R12 200 for planned admissions to hospitals not in the Smart Hospital Network but there are some other very useful benefits to Smart Classic that may get used more.
Click to expand...
Well if you have gap cover the R12200 will be covered. So no limit on hospitals.
 
We are on Classic Smart. No problems really. You just need to check before hand that where you go is covered by the smart plan. They also don't cover basic things like x-rays, ultra sounds when not in hospital. I also remember having to pay for an endoscopy or a copayment not sure which. If you aren't a sickly person it's a no brainer.
 
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