On 1 January 2023, a new protocol was implemented by Discovery Health with regard to funding for sleep studies (Polysomnograms). Certain requirements have to be met before authorization is granted. Should the procedure be approved, the test will be covered from the hospital benefit. The requirements are as follows:

1. As part of the funding request, your referring physician has to sign a document developed by the South African Society for Sleep and Health (SASSH). We will provide you with the document and you should submit it to Discovery once completed.
   
2. A full sleep study (used to assist with the diagnosis of a variety of sleep disorders) is authorized only when requested by a pulmonologist, neurologist, ENT surgeon, specialist physician, paediatrician, or any other doctor certified / accredited by the SASSH.
3. An apnea screening (used only to assist with the diagnosis of sleep apnea) can be requested by any medical doctor. Funding will only be approved for scheme members registered for the following chronic conditions: 

• Cardiac dysrhythmia
• Hypertension
• Type 2 diabetes
• Depression
• Cor pulmonale
• Cerebrovascular disease / Stroke

Studies not meeting the criteria of either number 1 or 2 listed above, are covered from member day-to-day benefits where available, in which case patients will be required to pay privately and claim back themselves.

Final full polysomnogram form.pdf

Apnea specific referral sheet.pdf