Discovery News for Discovery Health members

Transcription

1 Discovery News for Discovery Health members Increase Dr Connect Purple Products 2018 Annual contribution increases are as follows: 8.3%, Priority and KeyCare plans 7.6% Saver and Core plans 7.3% Executive and Smart plans This is an average increase across all plans of 7.9% for Contribution rates are on page 3 of this newsletter and Savings and Thresholds on page 4. As always Discovery s focus is on all members getting active and becoming healthier. Into 2018 they have identified 4 groups to focus on, to improve benefits and health. High income earners can enjoy purple products; low income earners can get access to certain Vitality benefits at no cost, or low cost; specific range of incentives for members aged 18 to 30; and a range of benefits and support for pregnancy to child s age 2. With immediate effect, Discovery has partnered with Health Tap to offer Dr Connect to all members. Download the DrConnect app on your phone, and then access through this app or the Discovery Health app. Dr Connect offers the following: Ask a doctor medical questions and receive curated answers from medical professionals. Subscribe to health goals to manage chronic conditions, wellness and pregnancy Get personalised checklists from doctors Virtual follow up consults with doctors using video, voice or text There is no additional charge for this service, and the app is available on Google Play and the Apple App Store. The Health section of your Discovery app will then show options for Ask a Doctor and Health Goals. Your personal medical providers can access your details on the app if you have given consent on HealthID. Discovery has identified a range of Purple Collection products for those members who want a more exclusive Discovery experience. The range includes Health, Vitality, Life, Insure, Card and Investments. The Discovery Health Purple product is the Executive plan, that has been enhanced to include higher Savings, additional day-to-day extender benefits, list of brand medication included in the Chronic Benefit, and access to the Global Treatment Platform for advanced medical care outside of South Africa. Members also have access to one million USD for emergency cover outside of South Africa. Purple Vitality entitles you to 50% off a Discovery Executive Wellness Assessment, low monthly rental for high-quality home gym equipment, personalised coaching, 50% off fitness devices, 25% off premier bicycle brands and 50% off at a range of luxury spas. If you are on the Executive Plan, you can request an upgrade to Vitality Purple. Discovery Purple Platinum Card enhances your Vitality benefits to include free gym membership nationally for one member, up to 100% discounts on business class flights, and up to 50% discount for 20 nights accommodation at venues within the Purple Hotel Collection. Members with this card also have access to a global concierge service. September 2017 This is written by an independent commentator and not by Discovery Health. Any Discovery Health member is welcome to subscribe. Queries regarding this can be sent to keith@dorman.co.za. Discovery Website Discovery Client Services KeyCare Client Services Discovery Emergency Number Discovery Health Plans Executive Plan Classic and Classic Delta Classic Comp Zero MSA Essential and Essential Delta Classic & Essential Smart Classic & Essential Priority Classic & Classic Delta Saver and Core Essential & Essential Delta Saver and Core Coastal Saver and Core KeyCare Plus, Access, Core Discovery Rewards Vitality / KeyFit Dorman & Associates cc Contact Details Phone +27 (0) Fax +27 (0) Addresses keith@dorman.co.za Authorised FSP: 6593 Council for Medical Schemes: ORG139

2 Pregnancy and Young Families 2018 In 2018, Discovery s pregnancy and young family benefit will include benefits paid from risk, not Savings. DURING PREGNANCY Antenatal consultations: up to 12 visits at gynaecologist, GP or midwife, depending on your plan Ultrasound scans and prenatal screening: two scans and one nuchal translucency or non-invasive pre-natal test Certain blood tests R1880 per day in private ward for delivery in hospital, on Executive and plans Up to R5000 for essential registered devices, eg breast pumps, on Executive and plans NURSE Up to five pre or post-natal consultations with a nurse FOR TWO YEARS AFTER BIRTH Baby is covered for one or two visits (depending on plan) with GP, paediatrician or ENT Six week post-birth consultation with midwife, GP or gynaecologist One nutrition assessment with dietician Two mental health consultations with counsellor or psychologist One lactation consultation with nurse or lactation specialist OTHER BENEFITS Screening benefit includes growth assessment and health milestone tracking Depending on plan, cover for two kids casualty visits for child under age 10 at network provider DIGITAL My Pregnancy Program on the Discovery App includes dashboard showing expected size of baby during pregnancy, pregnancy care checklist, health record, DrConnect, maternity cost estimator My Baby Program on the Discovery App includes baby profile with key birth information, digital health record, digital vaccination card, education cost estimator VITALITY benefits include a Baby Box with information and gifts, and discounts on certain baby items Young Professionals: Smart Suite 2018 Discovery has integrated products for young people under age 30, where traditionally costs are high, specifically vehicle insurance. The products are as follows: Discovery Health: The Smart plans, with benefits accessed through the Discovery App including Facetime with doctors instead of physical appointments. Vitality Active: For R30 per month, members have access to 25% off gym membership, weekly rewards and dream surprise rewards for achieving weekly fitness and driving goals. Discovery life: Life cover starting a premiums of R100 per month and opportunity to get premiums back. Discovery Insure: 20% discount on car insurance for responsible driving and 25% of Uber for night driving. Investments: Minimum premium dropped to R300 per month with the ability to boost savings and reduce fees. SMART HEALTH Private Hospital Care in the Smart Hospital Network 27 Chronic Conditions covered, using MedXpress, Clicks or Dis-Chem for medication DrConnect for medical advice, on your mobile app GP visits, medication, eye and dental check-ups, within the network depending on your plan, with fixed copayments and limits. This includes Facetime digital appointments. R5 million emergency travel benefit outside of South Africa VITALITY ACTIVE Weekly goals for fitness and driving If you reach one goal and not the other, you qualify for 50% of the weekly reward. Reach both goals to qualify for a full reward. Reach your goals for 3 weeks in a row, and spin the wheel for a dream reward Challenge friends to reach their goals and compare on a leaderboard

3 Designated Service Providers 2018 CHRONIC MEDICATION Delta and Core plans: MedXpress or MedXpress network pharmacies Smart Plans: MedXpress, Clicks or Dis-Chem KeyCare Plans: your allocated GP or KeyCare network pharmacies If you are on one of the above plans and you use a provider outside of the network, you will pay 20% of the claim. DAY-TO-DAY EXTENDER BENEFIT If your plan includes this benefit, then you need to use a GP on HealthID who meets the digital criteria to access the day-to-day Extender Benefit to get full cover for your consultation. GP NETWORKS The Smart Plan uses GPs and optometrists in the Smart Network and the KeyCare Plus and Access plans use the KeyCare Network. The available Smart Network GPs will be listed on the app according to your location when you request a GP visit. For KeyCare, you choose two GPs from the network to use, and you can change this choice twice a year. IN-HOSPITAL SPECIALISTS All specialists are paid in full for in-hospital claims if they have a payment agreement with Discovery. KeyCare members must use KeyCare Network specialists for full cover. If not, they would be paid according to the rate for your plan: 300% of medical aid rate for Executive, 200% for Classic Plans, 100% for Essential, Coastal plans and KeyCare. HOSPITALS Delta members use the Delta Hospital Network, or pay a R7650 co-payment. Coastal members must use hospitals in the coastal provinces, or pay a 30% co-payment. Smart members use the Smart Plan Hospital Network, or pay a co-payment of R8800. KeyCare members have full cover in the KeyCare Full Cover Network hospitals and 70% of medical aid rate in the KeyCare Partial Cover Network hospitals. Discovery Health Exclusions General exclusions on all plans: Cosmetic procedures and treatments Otoplasty for bat ears, port-wine stains and blepharoplasty (eyelid surgery) Breast reductions or enlargements and gynaecomastia Obesity Frail care Infertility Wilfully self-inflicted illness or injury Alcohol, drug or solvent abuse Wilful and material violation of the law Wilful participation in war, terrorist activity, riot, civil commotion, rebellion or uprising Injuries sustained or healthcare services arising during travel to or in a country at war Experimental, unproven or unregistered treatments or practices Search and rescue Any costs for which a third party is legally responsible KeyCare and Smart Plan additional exclusions (except where seen as Prescribed Minimum Benefits): Hospital admissions related to, among others: Dentistry; Nail disorders; Skin disorders, including benign growths and lipomas; Investigations and diagnostic work-up; Functional nasal surgery; Elective caesarean section, except if medically necessary; Surgery for oesophageal reflux and hiatus hernia; Back and neck treatment or surgery; Knee and shoulder surgery (note: arthroscopies are covered on Essential Smart); Joint replacements, including but not limited to hips, knees, shoulders and elbows; Cochlear implants, auditory brain implants and internal nerve stimulators this includes procedures, devices, processors and hearing aids (note: hearing aids are covered on the Essential Smart); Healthcare services that should be done out of hospital and for which an admission to hospital is not necessary Correction of hallux valgus (bunion) and Tailor s bunion (bunionette) Removal of varicose veins Refractive eye surgery Non-cancerous breast conditions Healthcare services outside South Africa (note: covered on Essential Smart Plan)

4 Discovery Health Medical Scheme 2018 contributions Series Plan Contributions Contributions to Medical Total contributions Main member Adult Child* Main member Adult Child* Main member Adult Child* Executive Executive Plan Classic Classic Delta Priority Saver Smart Core KeyCare Classic Zero MSA Essential Essential Delta Classic Priority Essential Priority Classic Saver Classic Delta Saver Essential Saver Essential Delta Saver Coastal Saver Classic Smart Essential Smart Classic Core Classic Delta Core Essential Core Essential Delta Core Coastal Core KeyCare Plus KeyCare Plus KeyCare Plus KeyCare Access KeyCare Access KeyCare Access KeyCare Access KeyCare Core KeyCare Core KeyCare Core * We count a maximum of three children when we work out the monthly contribution and annual Medical. ** Income verification will be conducted for the lower income bands. Income is considered as: The higher of the main member or registered spouse or partner s earnings, commission and rewards from employment; interest from investments; income from leasing of assets or property; distributions received from a trust, pension and/or provident fund; receipt of any financial assistance received from any statutory social assistance programme.

5 Annual Medical Series Plan Main member Adult Child* Executive Executive Plan Classic Classic Delta Essential Essential Delta Priority Classic Priority Essential Priority Classic Saver Classic Delta Saver Saver Essential Saver Essential Delta Saver Coastal Saver * We count a maximum of three children when we work out the annual Medical. If you join the medical scheme after January, you won t get the full amount because it is calculated by counting the remaining months in the year. Annual Threshold Amounts Annual Threshold Main member Adult Child* Executive Priority Above Threshold Benefit limits Executive Main member Adult Child* unlimited Priority * We count a maximum of three children when we work out the Annual Threshold and Above Threshold Benefit limit. If you join the medical scheme after January, you won t get the full amount because it is calculated by counting the remaining months in the year. GM_48268DHM_12/10/17_V1

6 Vitality Options in 2018 VITALITY MOVE Vitality Move is available to all Discovery Health members for free. You will receive a Vitality Move card when you activate the benefit. Swipe your card at Pick n Pay and stand a chance to win back your HealthyFood shopping spend. If you have a Vitality Health Check, you can win back your full shopping spend when you swipe the card. Upgrade your Vitality Move and pay R35 per person per month, and earn rewards based on fitness activities: Up to R100 off gym fees, and up to R100 off Pick n Pay shopping and R100 off movie tickets when you achieve 10 fitness days per month. A fitness day means a day where you have completed a parkrun, visited the gym or taken 10,000 steps. A transaction of R250 is required at Pick n Pay to qualify for rewards that week. VITALITY ACTIVE This is designed for members up to age 30 and they pay R40 per member. Your Vitality Active Rewards on your Discovery App will show two goals to work towards - fitness and drive. Reach your fitness goal with gym workouts, parkrun, fitness devices and timed race events. Reach your drive goal by driving 100km without cellphone use, harsh acceleration, harsh braking, harsh cornering or speeding each week. Reach both goals for 100% rewards and one goal for 50% rewards. Rewards include coffee, smoothie, popcorn, airtime or carwash. Reach your goals for 3 consecutive weeks and earn bonus rewards. Add unlimited friends to your profile, challenge them to goals, and compare your progress on a leader board. VITALITY Save on gym fees at Virgin Active and Planet Fitness; HealthyFood at Pick n Pay and Woolworths, HealthyCare at Clicks and Dis-Chem, HealthyGear at Sportsmans Warehouse and Total Sports; Vitality Active Rewards for achieving fitness goals include coffee, smoothies, popcorn, airtime and car washed, as well as Surprise Rewards when reaching goals for 3 consecutive weeks; Vitality Active Boosters for running shoes, fitness devices and bicycles; half-price movies at Ster Kinekor and movies free for kids who have completed a Health Review; Up to 35% (depending on Vitality Status) on flights, holiday accommodation and car rental. Active Rewards Boosters available for: Flights, Gym, Apple Watch, Bikes, Devices, and Shoes DiscoveryCard rewards and Discovery Miles rewards increase your Vitality Savings if you have those products. Status levels have remained unchanged: Single members: Bronze 10,000 points Silver 30,000 points Gold 45,000 points Member + 1: Bronze 20,000 points Silver 60,000 points Gold 90,000 points Member + 2: Bronze 30,000 points Silver 80,000 points Gold 120,000 points Each additional member over 18: Bronze 10,000 points Silver 20,000 points Gold 30,000 points VITALITY PURPLE As discussed on page 1, additional benefits for those who qualify to upgrade to Vitality Purple. Vitality Move Pick n Pay Vitality Move Pick n Pay & Gym 2018 Vitality Rates Member age 18 to 30 No charge R35 per member Member age over 30 Single member any age Member any age with one dependant Vitality Active R40 per member R60 per member n/a n/a n/a Member any age with more than one dependant Vitality n/a n/a R239 per policy R289 per policy R329 per policy Vitality Purple n/a n/a R399 per policy R459 per policy R499 per policy Thank you for reading our issue of Discovery News. To unsubscribe, please keith@dorman.co.za with unsubscribe in the subject heading. The information and opinions in this document have been recorded and arrived at in good faith and from sources believed to be reliable, but no representation or warranty, expressed or implied, is made to their accuracy, completeness or correctness. The information is provided for information purposes only and should not be construed as the rendering of advice. Dorman & Associates cc accordingly accepts no liability whatsoever for any direct, indirect or consequential loss arising from the use of this document or its contents.