How to Switch to Discovery Health or Change Your Plan
Thinking about switching medical schemes or changing your Discovery Health plan? Whether you are upgrading for better cover or adjusting your budget, getting the timing and structure right matters.
You can apply to join Discovery Health at any time of year, there is no fixed switching window. Your current medical scheme may require one full calendar month’s cancellation notice. You should only give notice after Discovery Health have accepted your application and you have reviewed and accept any underwriting terms. You cannot belong to two South African medical schemes at the same time.
Choosing the right plan is not just about price. It is about how benefits actually work in practice which becomes much clearer once you understand how medical aid is structured and applied in real scenarios. We have worked with thousands of members and know how to match benefits to your needs and budget.
Waiting Periods and Underwriting
When moving from one medical scheme to another, waiting periods may apply. This depends on:
- How long you have been on your current medical aid,
- Your health history and,
- The break in cover between medical schemes
These factors determine which one of the three categories of underwriting you fall into. Discovery can then apply the waiting periods linked to that category and send you a counter-offer letter if terms are applied.
The two main waiting periods are:
- General waiting period (3 months): you pay contributions but do not have access to benefits during this period. Emergencies and Prescribed Minimum Benefits (PMBs) may still be covered.
- Condition-specific waiting period (12 months): No cover for pre-existing conditions for the first 12 months.
Discovery applies underwriting based on your membership history. Most people fall into one of three categories
The three categories of underwriting
| Category | Who this applies to | Possible Waiting Periods | PMB Cover? |
|---|---|---|---|
| A | You’ve never belonged to a South African medical scheme before, or you had a break in cover of more than 90 days | • 3-month general waiting period • 12-month condition-specific waiting period • One or both may apply |
❌ No PMB cover during general waiting |
| B | You’ve belonged to a SA Medical Scheme for less than 2 years, with no break or a break of less than 90 days from leaving your current scheme to joining Discovery | • 12-month condition-specific waiting period • May continue an existing waiting period from your old scheme |
✅ Yes |
| C | You’ve been on a scheme for 2+ years, with no break or a break of less than 90 days from leaving your current scheme to joining Discovery | • 3-month general waiting period only | ✅ Yes |
Most people fall into A or C. Category A includes those who have never had medical aid or who have had a break in cover longer than 90 days. Category C includes members with at least two years of continuous cover and a break shorter than 90 days. In Category C only a three-month general waiting period may be applied, with PMB cover in line with legislation.
Late Joiner Penalty
Many people only discover this penalty when applying to join, when their premium is permanently higher than expected.
A Late Joiner Penalty permanently increases your monthly risk contribution by 5% to 75% if you join later in life without sufficient previous South African medical scheme cover. It typically applies from age 35 where there are uncovered years. Previous cover from age 21 is considered. We help calculate and minimise penalties by documenting full membership history.
Plan Upgrades and Downgrades
You can upgrade your Discovery Health plan once a year, effective 1 January. Plan change requests open around mid-October and close on 31 December. Downgrades are allowed at any time.
Upgrade limits exist to prevent anti-selection and to keep the scheme sustainable for all members. If you miss the upgrade deadline you will stay on your current plan until the next year.
FAQs
Can I add my child, spouse or parent to my plan?
Yes, but Discovery may apply waiting periods or a late joiner penalty depending on age, medical history and previous cover. Parents and adult dependants can usually be added only if there is financial dependency. Other rulings apply, contact us for details.
Can I add my grandchildren to my Discovery Health plan?
Potentially, yes, under specific conditions. We will advise based on your situation.
What happens to my medical savings if I move to Discovery?
If you move to a Discovery plan with a Medical Savings Account, a positive savings balance at your old scheme may be transferred to Discovery and allocated to your new savings account. If you move to a plan without savings, a positive balance may be paid out to you directly. Transfers or payouts only apply if your savings are in credit when you leave the old scheme.
What happens to my savings if I downgrade my Discovery Health plan?
If you downgrade to a plan without a Medical Savings Account, any positive balance is paid out to you after a four-month holding period to allow for outstanding claims. If you resign due to emigration, the timing may differ.
Can waiting periods or late joiner penalties be waived?
Yes, in specific cases. Employer group arrangements with underwriting concessions can allow waivers.
What if I am currently on Discovery Health and I take out my own policy?
If you are a dependant on someone else’s policy and take out your own plan, you may qualify for a continuation option. This lets you keep the same terms without new waiting periods or exclusions, provided there is no break in membership.
What if I move from a closed medical scheme to Discovery?
You may qualify for transferability without waiting periods, depending on membership history. A late joiner penalty could still apply if there are uncovered years. Proof of previous cover is required.
What if the main member passes away?
The spouse can take over as main member without reapplying, provided there is no break in cover and the request is submitted timeously.
