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Understand and use your medical scheme’s screening and prevention benefits

Press release -

Understand and use your medical scheme’s screening and prevention benefits

Issued on behalf of Discovery Health Medical Scheme (DHMS)

It’s all too easy to brush off that mild headache as being a by-product of a stressful day, too much coffee or too little water. But what if it isn’t? Sometimes seemingly insignificant niggles are signs of something else going on in the body. And sometimes, there aren’t any obvious signs at all.

In fact, some health conditions are even dubbed “silent killers” because by the time symptoms surface, a disease is already at an advanced stage.

Health screening and preventative healthcare, while often perceived as non-essential, are critical components of long-term health management. Without regular health screenings, the health of individuals may deteriorate without any preventative and timely treatment interventions.

“Regular health check-ups are important because they give you a baseline for how you are doing in terms of maintaining your health,” says Dr Noluthando Nematswerani, Chief Clinical Officer at Discovery Health.

“They also give you the best chance at early detection of more severe or chronic health conditions, to allow for early intervention and prevent complications relating to late diagnosis. This, in turn improves your quality of life. Sometimes the results flag elevations in cholesterol or blood sugar levels which are easy enough to rectify with minor lifestyle adjustments but can have serious consequences when they are undiagnosed or unmanaged for long periods of time.”

How well do you understand your benefits?

“Most medical aids offer a host of screening and prevention benefits that are covered by the scheme’s risk cover and not from your day-to-day benefits or medical aid savings. It’s important to understand what these benefits are, and how often they are available to you, so that you can use them to your advantage.”

“For example, Discovery Health Medical Scheme (DHMS) provides members with several benefits to cover the cost of health screenings and preventative care. The Scheme offers the Screening and Prevention Benefit on all plans, covering the costs of a defined list of health screening and preventative healthcare services in accordance with treatment guidelines and best clinical practice. These include cancer screening benefits for breast, cervical, colon and prostate cancer and a defined list of clinically appropriate genetic tests such as the BRCA gene tests.”

Having these specific tests does not affect your day-to-day benefits, where benefit criteria are met. Some of these tests and treatments have set frequency limits. Once you have reached the frequency limit for the tests set out below, any additional screening and preventive tests and treatments will be paid from your available day-to-day benefits, where applicable.

  • Day-to-day benefits are the available funds allocated to the medical savings account (MSA) and above threshold benefit (ATB), where applicable.

Tests covered by the DHMS Screening and Prevention Benefit

DHMS screening and prevention benefit

Frequency of screening and cover

Breast cancer screening

  • Mammogram or ultrasound of the breasts every two years
  • Annual mammograms for high-risk members
  • BRCA gene testing and MRI breast screening, for high-risk members, where applicable

Lipogram (cholesterol) test

Forms part of the annual health check for adults

Pap smear

  • Every three years
  • Annually for high-risk members

Human Papilloma Virus (HPV) test

  • Every five years
  • Every three years for high-risk member and those registered on HIV Care Programme

Prostate-specific antigen (PSA) test

  • Annually (as recommended by the member’s healthcare professional)

Seasonal flu vaccine

  • Annually for high-risk members (during pregnancy, for members registered for certain chronic conditions, registered healthcare professionals and members older than 65 years)

Pneumococcal vaccine

  • Two doses per lifetime for high-risk members

HIV blood tests such as the Rapid, ELISA, Western blot

  • Unlimited amount of HIV screening tests up to a maximum of the Discovery Health Rate (DHR)

Bowel cancer screening

  • Every two years if aged 45 and over
  • Colonoscopy screening for high-risk members

Health check for adults

  • Annually to test blood glucose, blood pressure, cholesterol, body mass index or weight assessment

Health check for children

  • Annually for measurement of weight, height, body mass index and blood pressure

Health check for seniors (65+)

Includes an annual falls risk screening assessment, hearing and vision test

DHMS introduces WELLTH Fund and sees uptick in health checks

To encourage its members to do their health checks, DHMS introduced a ‘first of its kind’ WELLTH Fund benefit in January 2023, which is activated after a member (and their family members - where applicable) completes their health check. The WELLTH Fund is a once-in-a-lifetime benefit, available from 1 January 2023 to 31 December 2024. It aims to reset health awareness, remove funding hurdles, and enable the flexibility for all Scheme members to access a comprehensive list of screening and preventative healthcare services, over and above those already covered by the screening and prevention benefit. Any claims for screenings made against this fund will not impact a member’s medical savings account or above threshold benefit.

The WELLTH Fund gives members risk funding of up to R10,000 per policy (R2,500 per adult and R1,250 per child) to use for necessary screening to establish their health status and improve their long-term personal health outcomes.

“We are thrilled to report an uptick in the number of members using their screening and prevention benefits since the beginning of 2023 - with about 179 000 health checks completed, including for children, and about 160 000 policies have unlocked the WELLTH fund covering 263 000 beneficiaries.”

Nematswerani concludes: “This is why it is so vital to understand the nuts and bolts of your medical scheme cover and make use of its screening and prevention benefits. This understanding and regular screening could save your life!”



Discovery information

About Discovery Health Medical Scheme (DHMS)

Discovery Health Medical Scheme (DHMS) is the largest open medical scheme in South Africa and independent from Discovery Group. As with other medical schemes, DHMS is a non-profit entity that pools all contributions to fund healthcare claims. It is regulated by the Council for Medical Schemes, governed by the Medical Schemes Act 131 of 1998 and administered by Discovery Health (Pty) Ltd. Medical schemes have independent Boards of trustees and belong to the members. An independent Board oversees DHMS and the Principal Officer is Charlotte Mbewu.

About Discovery

Discovery Limited is a South African-founded financial services organisation that operates in the healthcare, life assurance, short-term insurance, banking, savings and investment and wellness markets. Since inception in 1992, Discovery has been guided by a clear core purpose – to make people healthier and to enhance and protect their lives. This has manifested in its globally recognised Vitality Shared-Value insurance model, active in 40 markets, impacting 40 million lives. The model is exported and scaled through the Global Vitality Network, an alliance of some of the largest insurers across key markets including AIA (Asia), Ping An (China), Generali (Europe), Sumitomo (Japan), John Hancock (US), Manulife (Canada) and Vitality Life & Health (UK, wholly owned). Discovery trades on the Johannesburg Securities Exchange as DSY. Follow us on Twitter @Discovery_SA


Karishma Jivan

Karishma Jivan

Press contact Senior Reputation Management Consultant Healthcare & Sustainability
Lianne Osterberger

Lianne Osterberger

Press contact Senior Manager: Media Relations and Reputation Management 083 27 27 313

Our core purpose and values guide us in all we do. A clear and profound promise: to make people healthier and enhance and protect their lives.

Discovery is a shared value insurance company whose purpose and ambition are achieved through a pioneering business model that incentivises people to be healthier, and enhances and protects their lives.

Discovery Limited
Discovery Group Limited, 1 Discovery Place, Sandton
2196 Johannesburg
South Africa