Consultations and procedures out of hospital

General Practitioner consultations out of hospital

GP consultations for the treatment of general conditions are paid at the SRR from available savings (MSA). Costs in excess of the SRR can be paid from available savings upon special request.

If you visit a GP on the Discovery Health GP network, the Scheme pays a network rate directly to the network GP for consultations and a defined list of procedures. You will not incur a co-payment unless your benefits have been exhausted. Please read more on the G P network

Specialist consultations out of hospital

Specialists, excluding radiologists and pathologists, are paid from available savings (MSA) up to 125% of the SRR.

Specialist and GP consultations for chronic PMB conditions

Specialist and GP consultations for chronic PMB conditions are paid by the Scheme, but are subject to Scheme protocols and registration of the chronic condition.

Allied healthcare services

Audiology, dietitians, occupational therapy, orthoptics, physiotherapy, podiatry, psychology, registered nurse services, social services and speech therapy are paid from available savings (MSA). Private nursing is subject to authorisation.

If any of these services are provided in support of in hospital procedures, they will be paid by the Scheme and not from your MSA.

*Orthotists and prosthetists are paid from available savings. The Scheme's Designated Service provider is the Discovery Health network of orthotists and prosthetists. If you use a non-DSP you are responsible for the difference in cost.