Discovery Health Medical Aid Application

Thank you for your wise decision to join Discovery Health Medical Aid Scheme Application. Once accepted you will can be secure in the knowledge that you are a member of one of the finest medical aid schemes currently on offer.

DISCOVERY MEDICAL AID APPLICATION

Please complete SECTIONS;

SECTION 2 - Your details

SECTION 3 & 4 - partner and dependants

SECTION 6 - Choice of plan. (IF KEYCARE PLUS- PLEASE ENSURE YOU NOMINATE A KEYCARE DOCTOR FOR EACH PERSON IF YOU TAKE THE KEYCARE PLUS PLAN!)

SECTION 7 - Proof of income requirements ONLY FOR KEYCARE

SECTION 8 - If your Employer pays your contribution.

8.1 - IF YOUR OWN BUSINESS PAYS THE CONTRIBUTION - SIGN

SECTION 9 - YOUR DEBIT ORDER DETAILS - SIGN

9.2 - YOUR ACCOUNT for refunds - SIGN

SECTION 10 - Previous medical aid details.

SECTION 11 - If you are moving from another medical aid.

SECTION 12 - Complete and check if you need to answer Section 11 (depends upon your Yes or No answers)

SECTION 13 - SIGN

SECTION 14 - SIGN

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Please complete the LOWER INCOME FORM - ONLY IF YOU ARE TAKING KEYCARE.
This is a requirement for Keycare reduced rate plans.

You also need to submit your last three months' bank statements as well as the applicable supporting documentation (part 3) depending on your employment status.
Discovery will revert to the maximum contribution rate if you do not supply proof of income

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Vitality or Keyfit - additional premium required - see your quote.

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PLEASE FAX A CERTIFICATE OF MEMBERSHIP - get from the old scheme.
This may avoid a late joiner penalty.

PLEASE NOTE - YOU MUST RETURN ALL PAGES OR THE APPLICATION CANNOT BE PROCESSED!

WHEN COMPLETED PLEASE SCAN AND EMAIL OR FAX TO 0866 688 122

Please phone me to discuss your concern.

083 377 88 93

Email: pyburn@peterpyburn.co.za

Don't leave your Discovery Health Medical Aid Application concern here. Call me for advice - no obligation!