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

L-Dog said:
FYI yesterday I bought medication from Dischem R 68 through medical aid and R 57 if you pay cash. Not sure if it's the same for all or some medication but might often be better to leave the savings account for other items.
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I also noticed that and it’s true for all items when you claim at the pharmacy till, they have an agreed upon price and for some reason it's higher than the retail price.
 
Was in Clicks awhile ago and the OTC meds I was getting were on sale. After asking the pharmacist they said I can either pay cash to get the sale price or if they submit to Discovery they put through the normal, non sale price...
Cheeky move by Clicks if you ask me
 
saor said:
On Classic Smart:

View attachment 1810278

So for non-networked referrals to a physio they still pay the Discovert Health Rate? I'm not switching doctors at this point and my doctor isn't in their network.

I'm assuming this 20% co-payment for non-network GP's doesn't apply to the physio referal as well but is specific to GP visitits.

View attachment 1810279
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As far as I know it must be a referral from a network doctor, I'd find a network doctor that can refer and only use them when you need physio after an injury.

The second part of your question looks like it's only referring to the chronic PMB and isn't related to Classic Smart doctor benefit.
 
airborne said:
As far as I know it must be a referral from a network doctor, I'd find a network doctor that can refer and only use them when you need physio after an injury.

The second part of your question looks like it's only referring to the chronic PMB and isn't related to Classic Smart doctor benefit.
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Yeah primary care is for chronic etc. But you should have a normal gp that you use for smart benefit, they can refer you to a chiro. Never used that benefit myself.
 
I'm going to post this here because its one of the "benefits" of the smart plan for me.

I've just spent nearly a month fighting on my moms behalf with her medical aid ( Bonitas ). She is on a higher plan because she underwent knee replacement surgery this year , which was all thankfully covered and settled with no complications. But, my word, the surrounding items.

  1. To claim from the specialist for the initial consult, even though all the surgery and plans etc was done, was a pain, with referral letter required as well as only paying 50% ( ~R400 , what surgical consult charges so little? ) for the consultation.
  2. Then, she purchased a walking aid for both before and after surgery. Wow, what a huge headache. Was purchased cash at a Dischem with looking to claim from the medical aid post procedure as she needed it before, with recovery and just in general after. Suddenly it needs approval ( not mentioned in any documentation or feedback from the medical aid ) , then it was supposed to have been purchased through the dispensary , not normal even though all those aids are in the standard aisles etc. And then we find out, hey its coming our of your normal Day to Day anyway.
So while the surgery, pre / post op etc went off great ( this is all actually outsourced by the medical aid to a joint care program actually ), everything else was a utter pain. How they expect a 70+ year old person, who struggles to walk to sort this all out and jump through the bureaucratic hoops, is beyond me.

So, yes, why do I like the Smart, because I get the same if not better hospital benefits for money, cover for Chronic and some basic DayToDay while the rest is self funded, vs having to pay a monthly amount for savings, jumping through ridiculous hoops to use the money WHICH you put in anyway and you use MORE money via savings than cash payments.

I don't miss MSA. I do miss the days of KeyCare covering everything back in the early 2000's but our modern medical aids are not like that anymore.

Just sharing an experience and 2c, not medical or financial advice in any way shape or form.
 
airborne said:
They may be on the list but not for paying your monthly fees.

If your debit order bounces perhaps, very few Insurers or Medical aids allow your money payment to be via ad hoc payments in advance or others. It’s something to do with the way their agreements are structured/worded.
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Again weird since they state it is.
Why is the payment option via EasyPay no longer available for members to pay their
membership?
EasyPay is still active and members can therefore still make use of this payment method.
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airborne said:
They may be on the list but not for paying your monthly fees.

If your debit order bounces perhaps, very few Insurers or Medical aids allow your money payment to be via ad hoc payments in advance or others. It’s something to do with the way their agreements are structured/worded.
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Nah Bestmed and Discovery o know allow you to pay for the next year if you want. Just ask for their banking details and tell them why you want to do so eg. Pending retrenchment
 
Smiggles said:
Again weird since they state it is.
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Ok maybe you are lucky then, would be a score eBucks and all...but phone them to check that you can pay your normal monthly bill like that and it’s not just for arrears payments.
Pho3nix said:
Nah Bestmed and Discovery o know allow you to pay for the next year if you want. Just ask for their banking details and tell them why you want to do so eg. Pending retrenchment
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Yes Discovery only allows it if you pay the whole year upfront but that's not what @Smiggles is wanting to do.
 
So it's that time again when we can change Discovery plans.
Is Classic Smart still the best value Discovery hospital plan?
Anything to else to add or know going forward on the Classic Smart plan?

It's been great having at least some out of hospital cover, I've used the R70 doctor visits(R550 a pop without cover), R125 Dental check up(R650 without cover) and the OTC meds cover, I've just been using it for painkillers but they are so damn expensive I've saved a good R400 so far this year. I'm planning on using the physio cover for sports injury as I stuffed up something in my back out on the bicycle while taking things a little bit too seriously.
 
airborne said:
So it's that time again when we can change Discovery plans.
Is Classic Smart still the best value Discovery hospital plan?
Anything to else to add or know going forward on the Classic Smart plan?

It's been great having at least some out of hospital cover, I've used the R70 doctor visits(R550 a pop without cover), R125 Dental check up(R650 without cover) and the OTC meds cover, I've just been using it for painkillers but they are so damn expensive I've saved a good R400 so far this year. I'm planning on using the physio cover for sports injury as I stuffed up something in my back out on the bicycle while taking things a little bit too seriously.
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Probably the only thing to be aware of is that your regular GP might not be part of the plan or approved for it and therefore you need to be willing to change if you go for it.
 
SauRoNZA said:
Probably the only thing to be aware of is that your regular GP might not be part of the plan or approved for it and therefore you need to be willing to change if you go for it.
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By that you mean part of the Discovery network?
If so that is correct.
 
airborne said:
By that you mean part of the Discovery network?
If so that is correct.
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I don't remember the finer details but I remember when wanting to switch one of the issues was that my specific GP I would need to pay out of pocket.
 
Was thinking of changing from Coastal Core but after recently using it to cover my sleep study I'm not so sure anymore. At least on Coastal Core you can use any hospital in the coastal network and the convenience of being able to use the closest hospital is quite nice when you need it.
 
saor said:
Was thinking of changing from Coastal Core but after recently using it to cover my sleep study I'm not so sure anymore. At least on Coastal Core you can use any hospital in the coastal network and the convenience of being able to use the closest hospital is quite nice when you need it.
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If you have a decent Gap cover they will cover the co-payment for using a non-network hospital.
Also how often do you ever get admitted to hospital, I've never claimed for hospital use ever but I do have gap cover that will cover the co-payment for using a non-network hospital.
 
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