Medical cover outside the Republic of South Africa

The International Travel Benefit offers medical emergency cover outside the borders of the Republic of South Africa to members on all plans (excluding KeyCare plans).

Each person is covered for 90 days

• Cover for medical emergency treatment outside the borders of Republic of South Africa for 90 days from date of departure from the Republic of South Africa.

Each person is covered up to a limit

• 1 million US Dollars on the Executive Plan
• R5 million on the Comprehensive, Priority, Saver and Core Plans

We cover medical emergencies

• You are covered for the reasonable costs of medical emergency treatment while overseas. The treatment must be from a qualified healthcare professional.

You have to pay a portion of out-of-hospital claims

• We cover out-of-hospital, medical emergency claims after you have paid the first €100 or US$150 for each person, on each journey.

In-hospital emergency treatment

• Notify MSOI as soon as possible after the emergency on +27 11 529 6900 to authorise the admission and issue a payment guarantee.
• MSOI arranges direct payment to overseas healthcare professionals.
• If the medical condition necessitates an evacuation and you are fit to travel, MSOI will arrange your return to South Africa.

Remember: certain healthcare services will not be covered while travelling.

The Africa Benefit covers emergency evacuation from certain African countries for employees on assignments to African countries. Available to members on all plans (except KeyCare Plan) who work and or live in certain African countries.

Medical emergency evacuations from a defined list of sub-Saharan countries to South Africa

• The benefit applies to a defined list of sub-Saharan countries in Africa, as well as the islands of Madagascar, Mauritius, Seychelles, Réunion and the Comoros.

What to do if you need medical emergency evacuation

• If you need a medical emergency evacuation, you have to call MSOI. Once they have given the go-ahead for the evacuation, they will also arrange it.
• You will be evacuated to South Africa, where you will receive medical treatment. Healthcare services given in South Africa are covered according to your Health Plan and the Scheme rules.

Remember: When travelling to a country covered under the Africa Benefit, certain healthcare services in the first 90 days after your departure from South Africa will be covered according to the International Travel Benefit.

African countries that are covered under the African Benefit:

Emergency hospital expenses

Discovery Health Medical Scheme will pay the full cost of an authorised emergency hospital claim up to the benefit limit on your plan for each journey

Claiming for emergency out-of-hospital medical expenses

You can choose to:

• Pay upfront for out-of-hospital medical expenses, and claim back from us when you return to South Africa, or
• Call MSOI while you’re overseas if the total cost of your out-of-hospital claims is more than €100 or US$150 for each person. MSOI will approve the claim if it is related to a medical emergency, and will contact your healthcare professionals overseas to make sure they are paid directly.

Procedure for submitting claims

If you have already paid, you need to send us the following:

• A detailed, original account from the healthcare provider
• The Discovery Health International claim form, completed in full and including:
  • Proof of travel dates in the form of air ticket stubs or passport stamps
  • Proof of payment for all attached claims.

Remember to keep copies of the overseas medical claims you send us for your own records.

The International Travel Benefit provides cover for emergency medical treatment only; it does not cover elective treatment and treatment received outside of the 90-day period. However, your plan may cover you for elective treatment received while outside of South Africa, as long as the equivalent treatment is readily and freely available in South Africa and it would normally be covered by your plan in terms of the Scheme rules.

If the treatment meets these criteria, you will need to pay for these medical expenses upfront. You can then submit all the claims to us on your return to South Africa. Discovery Health Medical Scheme will reimburse you into the South African bank account we already have on record for you.

We will cover healthcare services related to your treatment according to the South African benchmark equivalent. This is known as a “global fee”. A global fee is a single amount that we calculate based on the average claims experience on your specific plan. Clinical protocols apply. This means that we only pay medically appropriate claims. Your cover is subject to the rules of the Discovery Health Medical Scheme, funding rules and clinical policies.

While travelling, the following will not be covered: 

• Healthcare services excluded by your waiting period(s), if applicable 
• Healthcare services related to a pre-existing condition where a member is aware of a reason which could give rise to a claim, if applicable
• Healthcare services related to any of Discovery Health Medical Scheme’s general exclusions. For example, you are not covered for search or rescue attempts or efforts, or for any travel to and in a country that is at war 
• Healthcare services if you resign from the Discovery Health Medical Scheme 
• Healthcare services if your membership is suspended
• Any claims incurred, if you are on a KeyCare Plan

Countries at war

Discovery Health Medical Scheme will not cover healthcare expenses which are in any way directly or indirectly related to travel to or in any one of the following countries:

Note: This list is subject to change.