Discovery Health has announced that it will cover the cost of a claims system error that resulted in the overpayment of certain Above Threshold Benefit (ATB) claims during 2025. Affected Discovery Health Medical Scheme members will not be required to repay any amounts related to the error, and no other members of the Scheme will be disadvantaged because of this decision. 

The error affected a limited group of members whose ATB claims were inadvertently overpaid during 2025. With Discovery Health absorbing the full cost, neither the Scheme nor any members are negatively impacted in any way. 

Dr Ron Whelan, CEO of Discovery Health, said: "Notwithstanding the validity of the recovery, having carefully listened to members’ concerns and considered their individual experiences and circumstances, Discovery Health has decided to cover the cost on members’ behalf."

The error affected 16,507 members across certain Executive, Comprehensive and Priority plans where ATB applies. The affected group represents 10.5% of the members on those plans, and less than 0.6% of the Scheme’s total membership. There is no impact on members outside this group, and benefits for 2026 across all plans remain completely unaffected. 

For affected members, claims statements will be updated to reflect this decision. Any deductions made to Medical Savings Accounts, Personal Health Fund or HealthPay accounts will be reinstated, and members who have already repaid amounts will be refunded in full. A dedicated service team will contact affected members directly to address outstanding queries and provide clarity.  

Dr Whelan, CEO of Discovery Health, concluded: 

“We apologise unreservedly to members affected by this error. Covering this cost is the right decision, one that reflects our commitment to fairness, integrity and putting members first, especially when we fall short.”