A designated service provider is a health facility (hospital) or healthcare provider who has an agreement with Discovery Health to provide treatment or services for Prescribed Minimum Benefits at a contracted rate.

For all Prescribed Minimum Benefit conditions, members must use our designated service provider to get full cover. If a member chooses to use a hospital or healthcare professional who is not a designated service provider, we will up to 100% of the Fund Rate for the accounts.

Type	Appointed designated service provider (DSP)	Reimbursement rate if the beneficiary uses a designated service provider or involuntarily uses a non- designated service provider	Reimbursement rate if the beneficiary voluntarily does not use the designated service provider
Out-of-hospital consultations	Cases requiring specialists. Premier Direct Payment Arrangement on N Option Plus and Hybrid Direct Payment Arrangement on N Option Basic	Negotiated rate per Direct Payment Arrangement /GP Network agreements	Up to the Fund Rate
Out-of-hospital consultations	GP Network (rate only, not full benefit)
Medicine	Any dispensing provider or pharmacy contracted to the Scheme.	MMAP, in absence of MMAP then cost	MMAP, in the absence of MMAP then SEP + Scheme dispensing fee
Pathology and radiology	Any provider that has contracted with the Fund.	Negotiated rate	Up to the Fund Rate
Hospital admissions	Any provider that has contracted with the Scheme	Negotiated rate	Up to the Fund Rate
Mental illness	Drug and Alcohol abuse – SANCA	Negotiated rate	Up to a maximum of 21 days up to a maximum of the Fund Rate.
Mental illness	All other conditions: Any hospital with a psychiatric ward, subject to the condition meeting clinical entry criteria and the Scheme’s baskets of care.	Negotiated rate	Up to the Fund Rate
Terminal care	Hospice	Negotiated rate	Up to the Fund Rate
Renal dialysis, haemodialysis and peritoneal dialysis	National Renal Care	Negotiated rate	Up to the Fund Rate
Oncology	Specialists: Any Premier Rate Oncologist or the State. GPs: Any GP Rate provider who is a SAOC member.	Negotiated rate	Up to the Fund Rate
Medicine for HIV	Any dispensing provider or pharmacy contracted to the Scheme	Negotiated rate	Up to 100% of the Fund Rate