Document 6516057

What is the Health Wallet?
The Health Wallet allows you, as a member of a Medical Scheme, Vitality and as the main DiscoveryCard holder,
to pay for certain out-of–pocket medical transactions which would ordinarily have been covered under the rules
of your medical scheme, but which are not paid due to:
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Your Medical Savings Account having been exhausted in terms of the rules of the medical scheme; or
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You having selected a plan which does not have a medical savings account.
How to activate the Health Wallet
Only the principle DiscoveryCard holder can activate the Health Wallet.
You can activate the benefit at any point during the year however you can only opt-in and opt-out of the benefit
once a year.
You can activate the Health Wallet benefit:
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On the Discovery website (www.discovery.co.za). You can go to “DiscoveryCard” and activate the
Health Wallet under the Features and benefits section.
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By calling the call centre on 0860 11 2273.
How do I fund the Health Wallet
You can fund your Health Wallet through a combination of any of the following methods.
Debit order
You can elect a monthly amount of your choice you wish to contribute to your Health Wallet (subject to a
minimum contribution of R100 per month and no maximum). This monthly amount is paid into your Health
Wallet via a debit order from your nominated account.
You can earn Discovery Miles on the Debit order; refer to the Earning Discovery Miles section below for more
information.
Lump sum
You can make lump sum deposits into the Health Wallet.
Lump sum deposits are made by transferring funds from your straight facility into the Health Wallet.
You can earn Discovery Miles on the lump sum; refer to the Earning Discovery Miles section below for more
information.
Boost your Health Wallet with your cash backs
You can switch your HealthyFood, HealthyCare, HealthyGear, DiscoveryCard, MedSaver and ChroniCare cash
back to pay into the Health Wallet to boost your health cover.
Please note no interest in earned on the funds in the Health Wallet.
Can I access the funds in the Health Wallet?
The funds in the Health Wallet can be withdrawn under the following circumstances:
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Funds earned from your cash backs can be withdrawn at any time.
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Funds from Lump sum deposits and Debit orders cannot be accessed in the calendar year it has been
deposited. Remaining funds will be carried over to the next calendar year and can then only be
accessed for withdrawals.
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Any payouts received from the Severe Illness Benefit cannot be withdrawn in the year that it was paid
out. Remaining Severe Illness Benefit payouts at the end of the calendar year will be carried over to the
next calendar year and can then only be accessed for withdrawals.
The funds that are available for withdrawal can be transferred to your DiscoveryCard straight facility.
Earning Discovery Miles
Discovery Miles can be earned on deposits made into the Health Wallet and through debit orders and lump sum
payments into the Health Wallet provided you activate the Discovery Miles benefit. For more information on
Discovery Miles please refer to the Discovery website (www.discovery.co.za) for the terms and conditions.
You can earn Miles for you Health Wallet by;
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Setting up a monthly debit order and earning one Discovery Mile for every R12 paid into your Health
Wallet;
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Making a lump sum deposit and earning one Discovery Mile for every R6 until 1 June every year and
thereafter earn one Discovery Mile for every R12 until 31 December.
You do not earn Discovery Miles on deposits for Severe Illness benefit payouts or from your cash backs you have
elected to be paid into your Health Wallet.
Only the first R30 000 deposited into the Health Wallet in any calendar year will earn Discovery Miles.
Fast miles will not apply.
What happens when my Health Wallet is empty?
The Health Wallet can automatically access your DiscoveryCard credit straight facility to pay for claims when your
Health Wallet is empty.
You have the ability to select this feature as it is not automatically applicable. This can be done on the Discovery
Website (www.discovery.co.za)
Please also refer to the How do I fund the Health Wallet section for more information on funding options.
Severe Illness Benefit
The Health Wallet also provides you with Severe Illness Benefit that is provided by Discovery Life.
The following rules apply:
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If you elect the HEALTH WALLET, You will be entitled to severe illness cover through Discovery Life.
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You are not allowed to opt in or out of this benefit more than once per year.
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The benefit applies to all family members covered under the primary cardholders Medical Scheme
membership. The benefit will NOT however apply to Adult dependants on such membership.
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If you, your spouse or child are diagnosed with a severe illness, the Health Wallet will be boosted by a
maximum amount of R100,000 depending on the severity of the condition as well as your Vitality
status.
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The maximum amount of cover will be determined by your Vitality status at the time of any claim: Blue:
R20,000 per life; Bronze R30,000 per life; Silver R50,000 per life; Gold R80,000 per life and Diamond
R100,000 per life. Accordingly, the value of your fund may fluctuate from time to time depending on
Your Vitality status and any payouts you may have received.
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The amounts reflected in 29.21 represent the maximum amount that can be claimed, in aggregate, by
each eligible life on the policy.
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The maximum cover available will increase as Your Vitality Status improves. At any point your
maximum available cover will decrease by the total amount of any previous claims paid.
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Pre-existing conditions are excluded in their entirety.
The severe illness benefit will cease on the earlier of:
The benefit being fully depleted due to a claim or multiple claims;
The life assured reaching age 65.
Termination of the main member’s Medical Scheme plan, Vitality or Health Wallet
You must be a Vitality member on the date that the severe illness is diagnosed and the date on which
you submit a claim to receive the severe illness benefit.
In order to receive the Severe Illness Benefit payout your DiscoveryCard must not be in arrears.
Cover for children is limited to 40% of the remaining sum assured at any point in time.
Any payout made from the Severe Illness Benefit will be paid directly into the Health Wallet subject to
the terms and conditions set out in this clause 29. The Severe Illness Benefit payout will carry over into
the next year and can be withdrawn in that year.
Any payout will be subject to the clinical criteria applied by Discovery Life from time to time.
You will receive a policy document from Discovery Life reflecting full details of the Sever Illness Benefit.
Where do you see your Health Wallet transactions?
You will be able to view your Health Wallet transactions with your DiscoveryCard statement and also on the
Discovery Website (www.discovery.co.za)
Paying for the Health Wallet
You pay one annual fee of R180 for the Health Wallet benefit.
We deduct the annual fee from your DiscoveryCard account on the same date each year.
The following transactions fees will be applicable:
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A claims processing fee of 5% of the claim value up to a maximum of R7.50 (seven Rand fifty) per claim
will be charged. This claims processing fee will be deducted off the available balance on Health Wallet.
The fees applicable to the Health Wallet may be adjusted from time to time; you will be notified of
such adjustments. For the full list of the fees and charges applicable to the Health Wallet please refer
to the Discovery website (www.discovery.co.za) or contact the DiscoveryCard Service team on 0860 11
2273.
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The transfer of funds between the DiscoveryCard straight facility into the Health Wallet and will be
charged R3 for each of these transactions.
Claiming from the Health Wallet
The Health Wallet provides a seamless process for processing claims.
The following rules apply when processing claims:
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Your Health Wallet works alongside your medical scheme plan and thus all medical expense claim must
be submitted to the medical scheme for processing.
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We will use your funds to pay for your healthcare expenses once the funds in your Medical Savings
Account are exhausted or you have a medical scheme plan without a Medical Savings Account.
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We will pay healthcare claims according to the rules of your medical scheme plan.
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The rate your claim is paid will be the same as elected for your Medical Savings Account. However if
you have a medical scheme plan without a Medical Savings account the full amount cost of the claim
will be paid.
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The processing of the Health Wallet Medical Transactions will be facilitated by DiscoveryCard,
depending on whether or not there are sufficient funds available (credit balance) on the Health Wallet
savings facility to settle the transaction. The Health Wallet Medical Transaction will be declined if you
are in arrears with your payments, in respect of amounts owing to First Rand Bank on your normal
credit facility.
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If your Health Wallet has sufficient funds to settle only part of the medical claim, the transaction will be
settled partly from your Health Wallet and the balance of the transaction will for your account to settle
with the Healthcare provider unless you have selected the option of activating an automatic payment
from your DiscoveryCard straight facility.
The Health Wallet will not be allowed to go into a negative balance.
Transactions processed on your card by a medical provider at a point of service will be charged to your
normal credit facility and not your Health Wallet facility.
The Health Wallet cannot be used in cases where you are required to make co-payments to your
medical provider.
Ending the benefit, closing your DiscoveryCard, your medical scheme plan or Vitality
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Should you terminate your medical scheme plan membership, or close your DiscoveryCard, credit
balances of your Health Wallet will be transferred to your DiscoveryCard straight facility and your
Health Wallet will be closed.
Should you default on your normal monthly card repayment, your Health Wallet may be closed and no
further transactions will be permitted until all amounts owing have been settled. Nothing will prevent
First Rand Bank from transferring any balance whether in credit or debit to your normal credit facility,
which will attract the normal interest rates applicable to your card account from the time of transfer.
You can only opt-out of the Health Wallet benefit once a year and can elect to opt out on the Discovery
Website (www.discovery.co.za) or by calling the call centre at 0860 11 2273. When you opt out of the
Health Wallet the funds available in the Health Wallet will be transferred into your DiscoveryCard
straight facility at a fee. Please refer to the Fees and Interest Rates on www.discovery.co.za