Know Your Money with Bronwyn Waner and Craig Finch
Know Your Money with Bronwyn Waner and Craig Finch
165. Designing Medical Aid For Modern Young Families
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Prices go up, needs don’t pause. We open with why Discovery Health deferred contribution increases from January to April, putting relief back into members’ budgets, and then get straight into what families care about most: affordable everyday care without nasty surprises. Aldu from Discovery Health Medical Scheme joins us to unpack the Smart Saver Series, a new plan range built for young families who visit GPs, dentists, and optometrists more than they visit specialists, and who want predictable costs when life happens.
We break down the two options—Essential Smart Saver and Classic Smart Saver—so you can see exactly where they differ. Essential funds in-hospital specialists at 100% of the Discovery Health Rate, while Classic goes up to 200%, a key edge if you want more specialist latitude. Both plans use the Smart Hospital and Smart GP networks for elective care, with emergency access at any facility. The real win is day-to-day value: network GP visits with low fixed copays (R75 on Classic, R130 on Essential) and unlimited access, plus one annual dental and optometry check per beneficiary at those same small copays. Add an OTC allowance, risk-funded scripts on Classic, and you’ve got routine costs under control.
We also spotlight features that speak directly to modern family life. A built-in contraceptive benefit supports proactive health and budgeting. A kids’ injury benefit reduces the stress of a casualty visit with a low copay and freedom to use the nearest hospital. Then there’s the savings waterfall: risk-funded benefits first, the Personal Health Fund tied to health engagement next, and finally your Medical Savings Account, which carries over year to year. That structure protects your pocket for those less frequent but pricier needs like ENT, gynae, or orthopaedic consults, while still letting you use savings for any provider when you choose.
If you’re weighing a plan change before April or trying to balance cost with real-world use, this walkthrough gives you clear, practical guidance to decide. Subscribe for more money-smart health cover insights, share this with a friend who’s comparing options, and leave a review to tell us which Smart Saver feature matters most to you.
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Hello everybody, welcome to Know Your Money. I'm Bronwan Wayner.
Why Increases Are Deferred To April
SPEAKER_02And I'm Craig Finch, and we are from Growth Financial Planning. We hope you enjoy our podcast. Hello everybody, Eldo from Discovery Health Medical Scheme. Thank you so much for joining us in the studio. Bromman, good to see you again. Thank you. And this time of the year, we everybody's medical aid started for the new year, and we'd like you to please give us the enhancements that Discovery has done for the new year. And I think there's a little bit of a change because April is a time when the plan goes up. You're not increasing it just as yet. So there's quite a good feature before that we'd like you to tell our viewers, please, Alder.
The New Smart Saver Series Unpacked
Built For Young Families’ Real Needs
SPEAKER_03Oh, thanks, Greg, and thanks for having me as well. So, yeah, your spot on our contribution increase was deferred from 1 January to 1 April. It was quite a nice benefit to give back to the members as well. By doing this contribution deferral, we actually gave back about like 1.5 billion grand in reserves to the members by just extending this contribution period. I think what is important though for members who haven't made their plan decision yet, that they will be able to increase their plan to like buy up to a higher plan if they still want to before the contribution increase kicks in on 1 April. But across the whole Discovery Health Medical scheme, we've made so many exciting new benefit additions. I think the key one to call out is definitely the new plan series that we've introduced. It's called the Smart Saver Series. So for that's almost like a specific like new segment in our plan range that we've introduced. And for those listening who's familiar with our plan option structure, that's in essence a new plan series sitting between our smart option and our saver option. So a lot of people would say, like, why more options? We already have so many options on Discovery Health Medical Scheme already. One thing that was interesting that we picked up is that we don't really cater for young families as we should be. There's almost like a gap in the market in terms of like making sure that our products speak to the young families, especially like as we have more affordability pressures and like the economic times and these hardships that young families are facing. So the intent of the new series that we created was really to say how do we actually create a new benefit structure that specifically speaks to the unique healthcare needs of our young families, and that's really like where our health RD team came up with the new series, the Smart Saver Series. So, in essence, what we picked up in our research, which is quite interesting, is that not all families are the same. It's interesting because when you almost like look at their day-to-day needs, we find that young families typically rely on things like seeing a GP, getting medication, going for like a dentist visit and optometry visits. Like that's almost like uniform across all of the families. They all have those like typical needs. But when you look at like their specialists, like almost that like secondary level of care, the type of care that they seek there is very unique. Some families require, like, for example, an ENT, where others go for gyne visits, where others have like almost like more orthopaedic needs if they almost like engage in sport and things like that. So that's almost like a less like standard type of benefit that we see family seeking. What was very interesting though is just young families take control of their health much more than the average older family typically does. So going, for example, like for like VHC checkups, engaging in like digital um platforms like personal. Oh, thanks for flagging that. Um so going for vitality health checks, so just like a normal like wellness check, um, where you take your blood glucose, your blood pressure, um your BMI, and those like health metrics.
SPEAKER_02So the younger people do that more than the older people.
Plan Options: Essential Vs Classic
SPEAKER_03Yes, yeah. I think the rate's like about like 20% more um than what like the young families typically engage in these types of actions, than the average family. Um so it's quite significant in terms of like them taking ownership proactively of their health in comparison to the other type of families that we see on the scheme. And that's exactly like these like insights that we've pulled together to create our new smart saver series. Um so it comprises of two plans. We have an essential smart saver plan that we introduced and also a classic smart saver plan. Um so similar to the Discovery Health Medical Scheme ecosystem, um, there are differences between these plans. Um, the essential one being almost like the entry-level type of plan where the hospital cover differs. Um, it pays up to a hundred percent rate of the discovery health rate, but the classic plan would pay up to 200% of the discovery health rate for in-hospital specialists, um, for example. Also network-based. Yes, yeah, thanks. That's important to flag, yeah. Both plans, network. Yes, yeah, yeah. So um, for those familiar with our current networks, the smart hospital network and the smart GP network, um, both of those networks also apply to these plans. It's a very broad.
Networks And Hospital Access Rules
SPEAKER_01So maybe we can just explain that a little bit further. So your other plans is like essential or classic is the 100% or the 200%. And then you have versions where it's Delta version. So it means it's the same sort of plan, but you're limited to the hospitals that you can go to. The SMART series also has a limited network of hospitals that you can go to. And you're saying your one now also has that. Is it the same network as Delta and SMART, or is it a little bit different?
Risk Benefits: GP, Dental, Optometry
SPEAKER_03So it's the same as the SMART hospital network today. Okay. So for emergencies and those types of admissions, you can go to any type of hospital still. Um but just for your elective type of admissions, you need to go within this network. And the new plan series, the smart saver series, leverages the smart um hospital network. And the savor is that your cash in the is that so that's exactly yeah. So the savor alludes to the fact that we have a medical savings account built into this plan as well. But no threshold. Uh no above threshold benefit, correct, yeah. So it's almost taking our existing SMART plan and adding to it a medical savings account and a few other benefits as well.
SPEAKER_02Um you mentioned orthopedic with some families, or there are different does that come out the savings portion, or is it a specific cover that you might have?
SPEAKER_03So that's a good question. So maybe let me explain like the overall structure of the plan. So, firstly, like we have like a set of risk-based benefits. So that's like benefits that the medical scheme will cover by themselves. So it doesn't come out of your pocket as a member, it also doesn't impact your medical savings account. So the benefits that we build in there are those types of benefits that we know young families typically seek. So, for example, going to the GP. So on both these plans, there's a network GP, a GP network that you can visit. Um, for example, on the classic plan, you pay 75 Rand to see one of the smart GPs. You have an unlimited amount of GP visits that you can use.
SPEAKER_01It's amazing.
OTC, Scripts, And Extra Protections
SPEAKER_03Yeah, it's imagine like paying 75 Rand to visit a GP. Um and on the essential plan is 130 um to pay a GP, which is still low if you think about it. Um and then similarly, like thinking about things like dentistry and optometry, which we know like every family uses as well, going for a checkup annually. Um so you can go for a dentist and optometry checkup at the same like small type of co-payment of 75 Rand or like 130 Rand. Like it goes up like a little bit, but it's still like very small co-payment.
SPEAKER_01Is that also limited or a certain amount of times a year?
Kids’ Injury Cover And Limits
SPEAKER_03So just once. So that's almost like saying, like typically, like clinically, uh everyone should go for that type of checkup once a year. So it's aligned with that. Um, so yeah, so that's almost like the risk-based benefit or the medical scheme funded benefits that we have. And then we also have like an over-the-counter medicine benefits on both the options. Um, I think it's a go it goes up to around like 900 Rand on the classic plan. Um, so almost a thousand Rand of over-the-counter medicine that you can use per annum. Yes, yeah. That you can also purchase. Um, and then also like on the classic plan, prescribe medicine as well. Like thinking if the GP have to prescribe medicine for you, that you also have access to like risk cover or medical scheme covered, prescribed medicine. And all of these benefits are basically covered by the medical scheme. So it doesn't touch your savings. So that's almost like the standard type of benefits that we see young families typically require. Um, but then on top of that, we also included a contraceptive benefit, which is quite a big thing for Discovery Health Medical Scheme. Um, it's one of our first plans that we actually built in a contraceptive benefit. Our health RD team was extremely excited about it. Um, so yeah, so there's also a contraceptive benefit, and then thinking just about like kids typically getting into injuries. Um, we know how expensive it is, like taking them to casualty if one of these injuries happens. So both the plans also have an injury benefit for kids built in.
SPEAKER_02And that's built into the risk side, it's got nothing to do with savings. Completely, yeah.
SPEAKER_03So it doesn't impact your savings at all. If you take your kid to the casualty unit, there's a co-payment of like 75 Rand or so, very low again.
SPEAKER_02Um You have to go to the network hospitals for that?
SPEAKER_03Uh no, it's not restricted to yeah, yeah. A broken arm or whatever, you can go to the nearest.
SPEAKER_01And how many visits is that?
SPEAKER_03So there's one casualty visit. So we went through our data and like typically per child or per family. Per child, yes, yeah. So one per child, yeah. Based on the data, it's very infrequent that you almost like incur like that level of need that you actually need to go into casualty more than once. Um and obviously like uh when you fall out the tree once, you don't want to fall out of the tree.
SPEAKER_02Yeah.
Savings, Personal Health Fund, And Carryover
SPEAKER_03Yes, yeah. So all of those are almost like just like based in based into the medical scheme benefits. Okay. And then after that, we have what we um call the personal health fund, um, which is where you basically unlock additional savings by act by engaging in our personal health pathways program.
SPEAKER_02I think we'd like to talk about that in another episode, the personal health fund as well. Yes, y'all, definitely.
SPEAKER_01Just to sort of understand, so there used to be the SMART plans, which is like for young people that don't really need to have a medical aid savings account. And then there was the classic um saver series, which is having that medical aid pocket, and now you've kind of created a thing in the middle. So a little bit cheaper than the the one above, but also a little bit better than the one below, and that's mainly for families.
SPEAKER_03Is that exactly in a nutshell you've captured it quite well, yeah.
SPEAKER_02And then the and because you've got the cash element, you can go to any any doctor, any or any healthcare professional using your cash. Yes. That's not covered on the risk benefit, right?
Closing And Next Episode Tease
SPEAKER_03Yes, yeah, correct. So even on top of the personal health fund, that's where you almost like get the medical savings account. So we only start um touching your medical savings account if the benefit isn't medical scheme funded, so those are benefits that we talked about, or if you don't have any money available in your personal health fund. Okay. So only then will we actually start paying out of your medical savings account, um, which is exactly like what the intention was of the plan to almost like have this medical savings account layer for those types of events that are infrequent. Like where you need like specialist type of care.
SPEAKER_01And just a last question on pediatricians, is that covered in any way or would that be from the savings account?
SPEAKER_03So you would have access to PEED visits through your maternity benefit. Um, and that's also like available standard across most of the Discovery Health Medical Scheme options. I think there's one of two that doesn't have access to it. But then also like if you want to use your medical savings account or your personal health fund, by all means you can pay for any PEED to visit them and for the consultation. And does this savings carry over year by year? Yes, yeah. So your MSA amount carries over, the personal health fund doesn't, but the medical savings account it works like any other medical savings account that we have.
SPEAKER_01Awesome.
SPEAKER_03So I'd like to chat about the personal one. Yes. Next episode.
SPEAKER_01Awesome. Thanks so much.
SPEAKER_02Perfect. Thank you. Thank you for listening. If you have enjoyed this podcast or would like to subscribe, please visit our website at www.growth.fp.co.za. The information we have provided in this podcast is our personal opinion. For more detailed information, please discuss your financial association with a financial planner.