Active Smart provides coverage for a specified list of 27 medical conditions, known as the Chronic Disease List (CDL). Please note that the Chronic Drug Amount (CDA) does not apply to the Smart plans, and only medications included on the formulary will be covered.

Feel free to contact us to discuss the medicine list for the Chronic Illness Benefit (formulary).

To avoid a 20% co-payment, you must obtain your approved oncology medication from a designated service provider. Please consult your treating doctor to ensure they are using our designated service providers for your medication and for any treatments you receive in their rooms or at a treatment facility.

Yes, in-hospital would be covered, but note:

Neonatal admissions are limited to R70,000. 

Elective caesarean section is excluded, except if medically necessary. 

The Discovery maternity benefit, covering day-to-day benefits, is not covered on the Active Smart plan.

Scans may not be covered. For MRI and CT scans, if they are not related to your admission or if they are for conservative back and neck treatment, you will need to pay for them in full.

For planned admissions, you need to choose a hospital from the Hospital Network. 

To find the most appropriate hospital conveniently located near you, please use the Medical Provider Search tool available on the Discovery Health app or website.

Please note that this requirement does not apply in emergencies. For emergencies you would enjoy full cover in any Private hospital.

Extra exclusions, but not exclusive to the following*:

• Back and neck treatment or surgery

• Knee and shoulder surgery

• Joint replacements

• Elective caesarean section

*Except where required as part of a defined benefit or under the Prescribed Minimum Benefits.

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