2022 PRIORITY PLAN

1 2022 PRIORITY PLAN. Classic | Essential Living my every moment Live healthy in every moment At Discovery health Medical Scheme, we are reimagining healthcare so that you can experience quality care with advanced technology that supports you through every life stage because we want you to live healthy in every moment. Read this guide to understand more about your health plan including: . What to do when you need to go to a doctor or to a hospital . How you are covered for preventive screening, diagnosis and treatment of medical conditions . Which benefits you need to apply for and if there are any limits for certain benefits . Tips on how you can use technology to conveniently manage and access healthcare and all the information you need through the Discovery app and website The benefits explained in this brochure are provided by Discovery health Medical Scheme, registration number 1125, administered by Discovery health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider.

2 This brochure is only a summary of the key benefits and features of Discovery health Medical Scheme plans, awaiting formal approval from the Council for Medical Schemes. In all instances, Discovery health Medical Scheme Rules prevail. Please consult the Scheme Rules on When reference is made in this brochure to we' in the context of benefits, members, payments or cover, this refers to Discovery health Medical Scheme. We are continuously improving our communication to you. The latest version of this guide as well as detailed benefit information is available on 01 | Discovery health Medical Scheme Contents page DAY-TO-DAY. KEY TERMS DAY SURGERY. BENEFITS AND COVER. KEY FEATURES. MATERNITY BENEFITS EXTRA BENEFITS. AND BENEFITS. EMERGENCY COVER. CHRONIC CONDITIONS. AND PRESCRIBED CONTRIBUTIONS.

3 AND CARE PROGRAMMES. MINIMUM BENEFITS. SCREENING AND. COVER FOR CANCER EXCLUSIONS. PREVENTION BENEFITS. HOSPITAL COVER. CONNECTED CARE VALUE ADDED OFFERS. AND ANNUAL LIMITS. 02 | Discovery health Medical Scheme HOME. Key Terms KEY TERMS. KEY FEATURES. AND BENEFITS. About some of the terms we use in this document EMERGENCY. A C. COVER AND PMB. SCREENING AND. PREVENTION. A B O V E T H R E S H O L D B E N E F I T ( A T B ) CHRONIC DISEASE LIST (CDL) CO-PAYMENT. Once the day-to-day claims you have sent to us add A defined list of chronic conditions we cover according This is an amount that you need to pay towards a CONNECTED. CARE. up to the Annual Threshold, we pay the rest of your to the Prescribed Minimum Benefits (PMBs). healthcare service. The amount can vary by the type day-to-day claims from the Above Threshold Benefit of covered healthcare service, place of service or if the (ATB), at the Discovery health Rate (DHR) or a portion amount the service provider charges is higher than the HOSPITAL.

4 CHRONIC DRUG AMOUNT (CDA) AT HOME. of it. The PRIORITY plans have a limited ATB. rate we cover. If the co-payment amount is higher than he Chronic Drug Amount (CDA) is the monthly amount T the amount charged for the healthcare service, you will DAY-TO-DAY. ANNUAL THRESHOLD that we pay up to for a medicine class, subject to a have to pay for the cost of the healthcare service. BENEFITS. member's plan type. This applies to chronic medicine AND COVER. We set the Annual Threshold amount at the beginning that is not listed on the formulary or medicine list. of each year. The number and type of dependants COVER. MATERNITY. (spouse, adult or child) on your plan will determine over refers to the benefits you have access to and how C BENEFITS. CHRONIC ILLNESS BENEFIT (CIB). the amount. we pay for these healthcare services such as consultations, he Chronic Illness Benefit (CIB) covers you for a T medicine and hospitals, on your health plan.

5 CHRONIC. The Annual Threshold is an amount that your claims CONDITIONS AND. defined list of chronic conditions. You need to apply PROGRAMMES. need to add up to before we pay your day-to-day to have your medicine and treatment covered for claims from the Above Threshold Benefit. your chronic condition. COVER FOR. CANCER. CONNECTED CARE. HOSPITAL COVER. Connected Care is an integrated healthcare ecosystem AND ANNUAL. LIMITS. of benefits, services and connected digital capabilities to help you manage your health and wellness. DAY SURGERY. EXTRA BENEFITS. CONTRIBUTIONS. EXCLUSIONS. Connected Care is brought to you by Discovery health (Pty) Ltd; registration number 1997/013480/07, an authorised financial services provider and administrator of medical schemes. 03 | Discovery health Medical Scheme | Key Terms VALUE-ADDED.

6 BENEFITS. HOME. Key Terms KEY TERMS. KEY TERMS. KEY FEATURES. AND BENEFITS. About some of the terms we use in this document EMERGENCY. D. COVER AND PMB. SCREENING AND. PREVENTION. DAY-TO-DAY BENEFITS DESIGNATED SERVICE PROVIDER (DSP) D I S C O V E R Y M E D X P R E S S. These are the available funds allocated to the Medical healthcare provider (for example doctor, specialist, A iscovery MedXpress is a convenient and cost-effective D CONNECTED. CARE. Savings Account (MSA) and limited Above Threshold allied healthcare professional, pharmacist or hospital) medicine ordering and delivery service for your monthly Benefit (ATB). who we have an agreement with to provide treatment chronic medicine, or you can choose to collect your or services at a contracted rate. Visit medicine in-store at a MedXpress Network Pharmacy.

7 HOSPITAL. AT HOME. D AY-TO-DAY EXTENDER BENEFIT (DEB) or click on Find a healthcare provider on the Discovery E. app to view the full list of DSPs. he Day-to-day Extender Benefit (DEB) extends your T DAY-TO-DAY. BENEFITS. day-to-day cover for essential healthcare services in our DISCOVERY health RATE (DHR) AND COVER. network if you have spent your annual Medical Savings Account (MSA) allocation and before you reach the his is a rate we pay for healthcare services from T EMERGENCY MEDICAL CONDITION MATERNITY. hospitals, pharmacies, healthcare professionals BENEFITS. Annual Threshold. An emergency medical condition, also referred to as an and other providers of relevant health services. emergency, is the sudden and, at the time, unexpected CHRONIC. DEDUCTIBLE onset of a health condition that requires immediate CONDITIONS AND.

8 DISCOVERY health RATE PROGRAMMES. This is the amount that you must pay upfront to the medical and surgical treatment, where failure to provide FOR MEDICINE medical or surgical treatment would result in serious hospital or day clinic for specific treatments/procedures COVER FOR. or if you use a facility outside of the network. If the his is the rate we pay for medicine. It is the Single T impairment to bodily functions or serious dysfunction CANCER. upfront amount is higher than the amount charged for Exit Price of medicine plus the relevant dispensing fee. of a bodily organ or part or would place the person's life the healthcare service, you will have to pay for the cost in serious jeopardy. HOSPITAL COVER. AND ANNUAL. of the healthcare service. DISCOVERY HOME CARE An emergency does not necessarily require a hospital LIMITS.

9 Admission. We may ask you for additional information iscovery Home Care is an additional service that offers D. to confirm the emergency. DAY SURGERY. you quality home-based care in the comfort of your home for healthcare services like IV infusions, wound care, post-natal care and advanced illness care. EXTRA BENEFITS. CONTRIBUTIONS. Discovery Home Care is a service provider. Practice 080 000 8000190, Grove Nursing Services (Pty) Ltd registration number 2015/191080/07, trading as Discovery HomeCare. EXCLUSIONS. Discovery MedXpress, Find a healthcare provider and the Discovery app are brought to you by Discovery health (Pty) Ltd; registration number 1997/013480/07, an authorised financial services provider and administrator of medical schemes. 04 | Discovery health Medical Scheme | Key Terms VALUE-ADDED.

10 BENEFITS. HOME. Key Terms KEY TERMS. KEY TERMS. KEY FEATURES. AND BENEFITS. About some of the terms we use in this document EMERGENCY. F M N. COVER AND PMB. SCREENING AND. PREVENTION. FIND A HEALTHCARE PROVIDER MEDICAL SAVINGS ACCOUNT (MSA) NETWORKS. Find a healthcare provider is a medical and provider The Medical Savings Account (MSA) is an amount that ou may need to make use of specific hospitals, Y CONNECTED. CARE. search tool which is available on the Discovery app is allocated to you at the beginning of each year or when pharmacies, doctors, specialists or allied health or website you join the Scheme. You pay this amount back in equal professionals in a network. We have payment portions as part of your monthly contribution. We pay arrangements with these providers to ensure you HOSPITAL.