The Discovery Health Medical Scheme is an independent non-profit entity governed by the Medical Schemes Act, and regulated by the Council for Medical Schemes. It is administered by a separate company, Discovery Health (Pty) Ltd, an authorised financial services provider.
Got itBy getting the treatment that is tailored for you, you save time and money. Each time you go to a new doctor, you have to fill in a form explaining your medical history which includes what medicine you take and what medical conditions you have. Nominating a primary care GP makes sure your doctor has this information and can manage your health knowing what has worked for you in the past.
The importance of having a single primary care doctor
Clinical research shows that having one doctor who coordinates your care gives you superior health outcomes. To enhance your care so you can be in your best possible health, you should have one doctor who manages your health.
A nominated primary care doctor knows your comprehensive medical history
Your primary care GP knows your complete medical history, can help you navigate your plan benefits and takes the healthcare approach that works best for you. This saves you time and money and gives you the right care for your health.
Benefit from a long-term relationship with your primary care doctor
Having a single primary care GP helps you to develop a meaningful relationship with your doctor. You can feel comfortable to be open and ask all your questions so they can tailor treatment to your specific needs.
Each doctor you see knows a small piece of your health history. To get the best care so you can be in your best possible health, you should have one doctor who coordinates your care. This person is your primary care General Practitioner or "GP".
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Nominating a primary care general practitioner (GP) makes sure your doctor has all your medical history at hand so they can better coordinate the care that you need and help you manage the care for your conditions so you can have the best possible health outcomes. This is especially important when managing chronic conditions because:
The Scheme covers Prescribed Minimum Benefit (PMB) chronic conditions in full. Discovery Health is; however, only able to guarantee full cover for chronic care if you choose to nominate a GP in the Discovery GP Network. If your chosen doctor has elected not to participate in an agreement with Discovery Health, the Scheme will pay at 80% of the Discovery Health Rate (DHR) from the Scheme benefit. Your day-to-day benefits are not impacted by this funding, and you will be responsible for the difference between what we pay and the actual cost of your consultation. The rule of visiting a network doctor does not apply in emergencies.
After you nominate your selected combination of doctor and practice, this doctor should be your first contact for any future chronic consultations. Make sure you always visit the doctor at the same address when it is for your chronic condition.
We strongly encourage you to nominate a GP. You will still have access to your Chronic Illness Benefit (CIB) basket of care benefits, however, having a nominated GP in the Discovery GP Network will ensure that you enjoy full cover for your consultations and treatments, according to your health plan.
Yes, you can view and update your nominated GP at any time. You may change your nominated primary care doctor three times every calendar year (1 January - 31 December).
If you currently consult a specialist for the treatment of your chronic condition, you will be able to continue to do so. Cover for specialist consults will be in accordance with your Prescribed Minimum Benefit basket of care.
You will be able to see if a doctor is on the Discovery GP network using our Find a provider tool on www.discovery.co.za.
Once logged in you can easily filter down and find out which doctors have full network cover for your consultation.
You can nominate your primary doctor easily on your Care Portal. Access the Discovery Health app here to nominate your doctor now.
Once you've changed your nominated GP, you can use your benefits at your new GP from the first day of the month after you've made the change.
