Discovery introduces innovative Gap Cover options for additional value and security

Discovery introduces innovative Gap Cover options for additional value and security

Discovery Gap Cover and Discovery Supplementary Gap Cover provide policyholders with significant cover for unforeseen medical expenses related to a hospital admission or severe illness diagnosis, through a unique and comprehensive benefit structure.

10 April 2017 – Discovery has introduced innovative Gap Cover options, available from 01 May 2017. Combining the Group’s experience in healthcare, and short- and long-term insurance, they will now also offer various cost-effective options that protect members of medical schemes administered by Discovery Health against shortfalls in medical scheme cover related to hospital admissions and oncology treatment. Discovery Gap Cover, underwritten by Discovery Insure, will cover shortfalls on specialist accounts for hospital admissions, shortfalls for treatment before and after hospital admissions, additional funds for cancer treatment. Discovery Supplementary Gap Cover, underwritten by Discovery Life, provides financial support for high-cost treatments related to severe illness, genome sequencing for more personalised cancer treatment, and home support and continuation of medical scheme membership.

“In developing Discovery’s Gap Cover options, available to all medical schemes Discovery Health administers, we looked at available data and how best to protect patients from possible unforeseen costs where gaps can exist, while also giving them additional and differentiating security in times of illness. The Gap Cover options, therefore, don’t merely offer financial pay out where gaps exist between what providers charge and what medical schemes pay, but integrate with other insurance benefits to offer richer health protection, value and overall security. An intuitive and user-friendly claims process, enabled by integration with medical scheme systems, also make sure there is minimal client or administrative intervention necessary to receive these benefits,” says Hylton Kallner, Chief Executive Officer of Discovery Life.

Designed to identify gaps in hospital or illness cover from claims recorded on the medical scheme system, Discovery Gap Cover automatically takes effect as soon as claims associated with a hospital admission have been paid. The options work similar to short-term and life insurance, and premiums are based on the personal circumstances of the individuals requiring cover. Not to be seen as replacements for medical scheme cover, Kallner says, “Discovery’s Gap Cover options supplement and extend certain health insurance options at a cost effective premium that starts at R65 a month for Supplementary Gap Cover, or R130 a month for Gap Cover, depending on the chosen option. All scenario testing has shown that benefit payments far exceed actual possible gaps in cover, also in cases of cancer or other sever illnesses.”

With the new Discovery Gap Cover options, clients have additional cover that work with their medical scheme benefits to offer an extra layer of insurance against unexpected health-related expenses.

Highlighting some of the key features, Kallner commented that, “Cover for potential specialist-account shortfalls, additional funds to pay for specified in- and out-of-hospital expenses, such as rehabilitation and take home medicine, and cover for extended oncology treatment offers clients additional peace of mind in often stressful times. With the Supplementary Gap Cover, we have also further entrenched the shared-value model of rewarding specific behaviour that can positively influence risk with an annual PayBack of up to 25% of premiums. In the event of severe illness or cancer, this option offers a lump-sum payment of up to R500 000 to use for the latest treatment or funding of other associated costs. This cover is continual and can reach up to an amount of R1 million, depending on the conditions. It also offers comprehensive contribution protectors for continued membership of a medical scheme, and R10 000 a month as supplementation of income to support the household.”

“With Discovery Gap Cover our aim was to build on the value we offer all clients as we create a system that provides the best value and most-comprehensive cover, with access to the latest and best treatments,” Kallner says.

Discovery Gap Cover and the Supplementary Gap Cover options are not medical scheme products. There are certain requirements on application and waiting periods may apply based on the health plan at the time of activating the cover.

For media related enquiries, please contact Khensani Mthombeni by email on Khensanimth@discovery.co.za or call 011 529 0091