When comparing plans you'll see specialist-rate figures like 100%, 200%, or 300%. They describe how much of the published scheme rate your plan pays in-hospital. A higher percentage means a smaller out-of-pocket shortfall when a specialist charges above scheme rate. Most specialists charge 200 to 300% of scheme rate in private hospitals, so a plan paying at 100% leaves a meaningful gap.
SA example: On Discovery Executive (300% DHR), a specialist charging 300% is fully covered. On Discovery KeyCare (100% DHR), the same specialist creates a 200% shortfall, typically thousands of rand per admission.