The KeyCare Series

 

The KeyCare Plans offer you affordable cover in the KeyCare network of hospitals and doctors

You have access to additional benefits

 
Your cover in hospital

Whether you need to be hospitalised for a planned hospital procedure or need emergency cover, the KeyCare Series offers cover in a network of private hospitals with no overall limit.

We cover you in a private hospital for emergency and planned hospital admissions that you have authorised with us.

Emergency cover when you need it most

In an emergency, go straight to hospital but call us or get someone to call us within 12 hours.

If you need medically-equipped transport in a medical emergency, call 0860 999 911. This line is managed by highly qualified emergency personnel who will send the most appropriate air or road emergency evacuation transport.

Cover for planned hospital admissions

For planned hospital admissions, you have cover in any private hospital in the KeyCare hospital network. Please call us 48 hours before you go to hospital to confirm your admission. You will not have cover if you do not call us.

Click here to view a list of the KeyCare hospitals

No overall limit

There is no overall hospital limit on your hospital cover. Limits, clinical policies and guidelines apply to some healthcare services and procedures.

Your cover for healthcare professionals

We have negotiated with specialists to guarantee that when you use a specialist in the KeyCare direct payment arrangement we pay them directly at our agreed rate. This means that when consulting a specialist in our direct payment arrangement you will be covered in full.

Full cover for specialists participating in our payment arrangement

You can benefit by using healthcare professionals participating in the KeyCare direct payment arrangement because we will cover their approved accounts in full.

You may have a co-payment if you use other specialists

If you are treated in-hospital by any other specialist, we cover the accounts up to the Discovery Health Rate. If the specialist charges more than the Discovery Health Rate, you must pay the difference.

Other healthcare professionals

We cover GPs, radiology, pathology and other healthcare services up to 100% of the Discovery Health Rate.

Your cover for investigations and dentistry

Scopes (gastroscopies, colonoscopies, sigmoidoscopies and proctoscopies)

We will cover your scope but please phone us before going for it to confirm where the scope can be done.

MRI and CT scans

If your scan is related to an approved hospital admission we pay it from your Hospital Benefit. If it is not related to an approved hospital admission we pay it from your Specialist Benefit up to R2 000 for each person. We do not pay for MRI or CT scans that are related to conservative back or neck treatment.

Dentistry

We do not cover in-hospital dentistry on the KeyCare Plans.

Limited healthcare services
Mental health benefit21 days for each person
Alcohol and drug rehabilitation21 days for each person
Terminal care benefitR16 950 for each person
Chronic dialysisWe cover these expenses in full as long as we have approved your treatment plan and you use a provider in our network
DiscoveryCare looks after you in times of need

The Chronic Illness Benefit offers full cover for a list of medicines.

Your cover for chronic conditions

You have cover for a list of chronic conditions as long as your medicine is on the KeyCare medicine list and you get your approved medicine from our courier pharmacy. If you get your medicine anywhere else, you will need to pay 40% of the Discovery Health Medication Rate.

On the KeyCare Plus Plan your chosen GP must prescribe the medicine. We need to approve your chronic condition before we will pay for it from the Chronic Illness Benefit.

Your cover for cancer treatment

We cover your cancer treatment if it is a Prescribed Minimum Benefit and if you go to a cancer specialist in the ICON network. Please call us to register on the Oncology Programme.

Your cover for additional benefits

All KeyCare members have cover for the following benefits out of hospital:

Specialist Benefit

If you visit a specialist and you have a valid reference number from us, you will be covered up to R2 000 for each person. You must call us before your consultation and your GP must refer you.

Antenatal Benefit

You have access to expert care for antenatal treatment and specialist visits when your GP feels you need to see one.

The Antenatal Benefit covers you for the following healthcare services while you are pregnant, at the Discovery Health Rate:

  • four visits to a gynaecologist in a KeyCare network hospital
  • one routine scan (between 10 and 20 weeks)
  • selected antenatal blood tests requested by your gynaecologist.

Screening and Prevention Benefit

Early detection and prevention of diseases is vital to your wellbeing. The Screening and Prevention Benefit pays for a range of healthcare services that help to prevent and screen for diseases that would otherwise go unnoticed.

If you go for certain preventive screening tests, we will cover the claim. The screening tests include: blood glucose, blood pressure, cholesterol and body mass index at a Discovery Wellness Network provider. The benefit also covers a mammogram, Pap smear, PSA and HIV screening tests. Members from the age of 65 and members registered for certain chronic conditions are also covered for a seasonal flu vaccine from this benefit.

Your cover for day-to-day medical expenses (available on KeyCare Plus only)

We have networks of GPs, dentists and optometrists all over South Africa to make sure that KeyCare Plus members have access to quality day-to-day healthcare services.

Cover for GP visits

When joining KeyCare Plus, you choose a GP from the KeyCare GP network. When you go to your chosen GP, we will cover your consultations and some minor procedures.

We will cover you for one out-of-network visit for each person; this includes a GP visit, with selected blood tests and x-rays and acute medicines (they must be on the KeyCare acute medicine list).

X-rays and blood tests

We pay for selected basic x-rays and blood tests, only if requested by your chosen KeyCare network GP.

Acute medicines

We pay for medicines on the KeyCare acute medicine list when they are prescribed by your chosen KeyCare network GP.

Cover for dentistry

We cover selected basic dentistry (consultations, fillings and extractions) only at a dentist within the KeyCare dentist network.

Cover for eye care

We cover one eye test and one pair of clear single-vision, bifocal or multi-focal lenses with a basic frame or a basic set of contact lenses for each person 24 months from your last claim, only at an optometrist within the KeyCare optometry network.

Casualty visits

If you go to one of our preferred casualty units in the KeyCare network of hospitals, you only pay the first R95 of the consultation.

You can also visit other casualty units in the KeyCare network of hospitals but you pay the first R210 of the consultation.

Please remember to call us to confirm your benefits.

Trauma Recovery Extender Benefit

We will cover specific out-of-hospital claims for your recovery after certain traumatic events. Your cover applies for the rest of the year in which the trauma takes place, as well as the year after your trauma.

Mobility Devices Benefit

We cover wheelchairs, wheelchair batteries and cushions, transfer boards and mobile ramps, commodes, long-leg calipers, crutches and walkers on the KeyCare mobility list, from a network provider. There is an overall limit of R3 300 for each family.

Exclusions on the KeyCare Plans

Discovery Health does not cover certain healthcare services. You can find a full list of these exclusions here. In addition to the general Discovery Health Medical Scheme exclusions that apply on all plans, KeyCare Plans have the following exclusions, except as set out in the Prescribed Minimum Benefits:

  1. Hospital admissions related to:
    • dentistry
    • obesity
    • skin disorders
    • investigations and diagnostic work-up
    • functional nasal surgery
    • elective caesarean section, except if medically necessary
    • surgery for oesophageal reflux and hiatus hernia
    • back and neck treatment or surgery
    • joint replacements, including but not limited to hips, knees shoulders and elbows
    • cochlear implants, auditory brain implants and internal nerve stimulators. This includes procedures, devices and processors
    • healthcare services that should be done out of hospital and for which an admission to hospital is not necessary.
  2. Brachytherapy for prostate cancer
  3. Refractive eye surgery
  4. Non-cancerous breast conditions
  5. Healthcare services outside South Africa

We also do not cover the cost of treatment for any complications, or the direct or indirect expenses related to these excluded conditions and treatments.

If we apply waiting periods because you have never belonged to a medical scheme or have had a break in membership of more than 90 days before joining Discovery Health, you will not have access to the Prescribed Minimum Benefits during your waiting periods. This includes emergency admissions.

List of KeyCare hospitals for 2010

Eastern Cape

East London
East London Private Hospital
St James Operating Theatres
St Dominic’s Private Hospital

Humansdorp
Isivivana Private Hospital

Port Elizabeth
New Mercantile Hospital

Queenstown
Queenstown Private Hospital

Uitenhage
Cuyler Clinic

Umtata
St Marys Private Hospital

Free State

Bethlehem
Hoogland Medi-Clinic

Bloemfontein
Bloemfontein Eye Centre
Hospitaalpark Clinic (Pasteur Hospital)
Pelonomi Private Hospital
Life Rosepark Clinic
Universitas Private Hospital

Welkom
Ernest Oppenheimer Hospital
Hydromed Welkom Medi-Clinic
St Helena Hospital

Gauteng

Benoni
The Glynwood Hospital

Boksburg
Botshelong Empilweni Clinic (Clinix Vosloorus)
Sunshine Centre

Brakpan
Dalview Clinic

Germiston
Roseacres Clinic

Heidelberg
Suikerbosrand Clinic

Johannesburg
Rand Clinic
Johannesburg Eye Clinic
Garden City Clinic
Brenthurst Clinic

Kempton Park
Arwyp Hospital

Lakefield
Optiklin Eye Hospital

Lenasia
Lenmed Clinic Limited

Midrand
Life Carstenhof Clinic

Pretoria
Bougainville Private Hospital
Centurian Eye Hospital
Eugene Marais Hospital
Jacaranda
Legae Private Clinic
Louis Pasteur Hospital
Medforum Medi-Clinic
Moot Algemene Hospital
Muelmed Hospital
Pretoria Eye Institute
Zuid Afrikaans Hospital

Randfontein
Robinson Hospital
Sir Albert Medical Centre

Soweto
Clinix Soweto (Tshepo Themba)
Lesedi Clinic

Springs
Springs Parkland Clinic
St Mary’s Maternity Hospital

Thembisa
Zamokuhle Private Hospital

Vanderbijlpark
Emfuleni Medi-Clinic
Medivaal Hospital
Ocumed
Vaalpark

Westgate
Medgate Day Clinic

Vereeniging
Clinix Private Hospital Sebokeng (Pty) Ltd
Midvaal

KwaZulu Natal

Amanzimtoti
Kingsway Hospital

Chatsworth
Chatsmed Garden Hospital

Durban
City Hospital Ltd
Entabeni Hospital
McLord Hospital

Empangeni
Empangeni Garden Clinic (Pty) Ltd

Isipingo
Isipingo Clinic

Kokstad
Kokstad Private Hospital

Ladysmith
La Verna Hospital

Newcastle
Newcastle Private Hospital

Phoenix
Mount Edgecombe

Pietermaritzburg
Midlands Medical Centre
St Anne’s

Pinetown
The Crompton Hospital

Port Shepstone
Hibiscus Hospital

Richards Bay
The Bay Hospital

Sydenham
Nu Shifa Hospital

Tongaat
Victoria Private Hospital

Lesotho
Maseru Private Hospital

Limpopo

Bela Bela
St Vincent’s Hospital

Polokwane
Limpopo Medi-Clinic

Thabazimbi
Curamed Thabazimbi Hospital

Tzaneen
Tzaneen Private Hospital

Mpumalanga

Barberton
Barberton Medi-Clinic

Ermelo
Ermelo Private Hospital

Middelburg
Middelburg Private Hospital

Nelspruit
Nelspruit Private Hospital

Trichardt
Highveld Medi-Clinic

Witbank
Cosmos Hospital
Emalahleni Day Hospital

North West

Carletonville
Leslie Williams
Western Deep Clinic

Klerksdorp
Anncron Clinic

Mafikeng
Victoria Private Hospital (Mafi keng Hospital)

Orkney
West Vaal Clinic

Potchefstroom
Potchefstroom Medi-Clinic

Rustenburg
Peglerae Hospital

Northern Cape

Kathu
Kathu Medi-Clinic

Kimberley
Kimberley Medi-Clinic

Upington
Upington Private Hospital

Vryburg
Vryburg Private Hospital

Western Cape

Bellville
Bellville Medical Centre
Louis Leipoldt

Cape Town
Christiaan Barnard Memorial Hospital
UCT Medical Centre (Pty) Ltd

Ceres
Ceres Private Hospital

Gatesville
Gatesville Medical Centre

George
Geneva Clinic
George Medi-Clinic

Hermanus
Hermanus Medi-Clinic

Kuils River
Kuilsriver Private Hospital

Milnerton
Milnerton Medi-Clinic

Mitchells Plain
Mitchells Plain Medical Centre

Mossel Bay
Bayview Hospital

Oudtshoorn
Cango Day Clinic
Klein Karoo Medi-Clinic

Paarl
Paarl Medi-Clinic

West Coast
West Coast Private Hospital

Worcester
Worcester Medi-Clinic

Please note that this list of hospitals is subject to change. Click here list of hospitals and casualty units or phone us.

2010 Monthly contributions
KeyCare Core
Family sizeR0 - R6 000R6 001 - R8 000R8 001 +
PrincipalR396R492R761
Spouse / adult dependantR396R492R761
ChildR99R123R171
KeyCare Plus
Family sizeR0 - R3 750R3 751 - R6 000R6 001 - R8 000R8 001 +
PrincipalR412R494R692R1 030
Spouse / adult dependantR412R494R692R1 030
ChildR110R143R193R275
How to join Discovery Health

We market our Discovery Health Plans through independent and accredited financial advisers. If you want a financial adviser to help you choose a Health Plan to suit the needs of your family, please send us your contact details and we will contact you.

KeyCare hospital network for 2010

Applicable to the KeyCare Core and KeyCare Plus Plans. You must go to one of these hospitals for planned hospital admissions. If you do not use one of these hospitals for a planned admission, you will need to pay your claims.

Eastern Cape

East London
East London Private Hospital
St James Operating Theatres
St Dominic’s Private Hospital**

Humansdorp
Isivivana Private Hospital

Port Elizabeth
New Mercantile Hospital**

Queenstown
Queenstown Private Hospital*

Uitenhage
Cuyler Clinic

Umtata
St Marys Private Hospital*

Free State

Bethlehem
Hoogland Medi-Clinic*

Bloemfontein
Bloemfontein Eye Centre*
Hospitaalpark Clinic (Pasteur Hospital)
Pelonomi Private Hospital*
Life Rosepark Clinic**
Universitas Private Hospital*

Welkom
Ernest Oppenheimer Hospital*
Hydromed Welkom Medi-Clinic**
St Helena Hospital*

Gauteng

Benoni
The Glynwood Hospital**

Boksburg
Botshelong Empilweni Clinic (Clinix Vosloorus)**
Sunshine Centre*

Brakpan
Life Dalview Clinic

Germiston
Life Roseacres Clinic**

Heidelberg
Life Suikerbosrand Clinic**

Johannesburg
Rand Clinic*
Johannesburg Eye Clinic
Garden City Clinic**
Brenthurst Clinic**

Kempton Park
Arwyp Hospital*

Lakefield
Optiklin Eye Hospital

Lenasia
Lenmed Clinic Limited**

Midrand
Life Carstenhof Clinic**

Pretoria
Bougainville Private Hospital
Centurian Eye Hospital
Life Eugene Marais Hospital**
Jacaranda*
Legae Private Clinic**
Louis Pasteur Hospital*
Medforum Medi-Clinic*
Moot Algemene Hospital**
Muelmed Hospital
Pretoria Eye Institute
Zuid Afrikaans Hospital**

Randfontein
Robinson Hospital**
Sir Albert Medical Centre*

Soweto
Clinix Soweto (Tshepo Themba)**
Lesedi Clinic**

Springs
Springs Parkland Clinic**
St Mary’s Maternity Hospital*

Thembisa
Zamokuhle Private Hospital**

Vanderbijlpark
Emfuleni Medi-Clinic**
Ocumed
Vaalpark**

Westgate
Medgate Day Clinic

Vereeniging
Clinix Private Hospital Sebokeng (Pty) Ltd**
Midvaal

KwaZulu Natal

Amanzimtoti
Kingsway Hospital*

Chatsworth
Life Chatsmed Garden Hospital**

Durban
Life City Hospital Ltd**
Life Entabeni Hospital**
McLord Hospital*

Empangeni
Life Empangeni Garden Clinic (Pty) Ltd**

Isipingo
Life Isipingo Clinic**

Kokstad
Kokstad Private Hospital*

Ladysmith
La Verna Hospital*

Newcastle
Newcastle Private Hospital*

Phoenix
Life Mount Edgecombe*

Pietermaritzburg
Midlands Medical Centre**
St Anne’s**

Pinetown
Life The Crompton Hospital**

Port Shepstone
Hibiscus Hospital**

Richards Bay
The Bay Hospital**

Sydenham
Nu Shifa Hospital*

Tongaat
Victoria Private Hospital*

Lesotho
Maseru Private Hospital*

Limpopo

Bela Bela
St Vincent’s Hospital*

Polokwane
Limpopo Medi-Clinic**

Thabazimbi
Curamed Thabazimbi Hospital*

Tzaneen
Tzaneen Private Hospital*

Mpumalanga

Barberton
Barberton Medi-Clinic*

Ermelo
Ermelo Private Hospital**

Middelburg
Life Middelburg Private Hospital**

Nelspruit
Nelspruit Private Hospital**

Trichardt
Highveld Medi-Clinic**

Witbank
Life Cosmos Hospital**
Emalahleni Day Hospital

North West

Carletonville
Leslie Williams*
Western Deep Clinic*

Klerksdorp
Life Anncron Clinic**

Mafikeng
Victoria Private Hospital (Mafi keng Hospital)*

Orkney
West Vaal Clinic*

Potchefstroom
Potchefstroom Medi-Clinic**

Rustenburg
Life Peglerae Hospital

Northern Cape

Kathu
Kathu Medi-Clinic*

Kimberley
Kimberley Medi-Clinic**

Upington
Upington Private Hospital*

Vryburg
Vryburg Private Hospital*

Western Cape

Bellville
Bellville Medical Centre
Louis Leipoldt**

Cape Town
Christiaan Barnard Memorial Hospital**
UCT Medical Centre (Pty) Ltd*

Ceres
Ceres Private Hospital*

Gatesville
Gatesville Medical Centre**

George
Geneva Clinic*
George Medi-Clinic*

Hermanus
Hermanus Medi-Clinic*

Kuils River
Kuilsriver Private Hospital**

Milnerton
Milnerton Medi-Clinic**

Mitchells Plain
Mitchells Plain Medical Centre**

Mossel Bay
Bayview Hospital**

Oudtshoorn
Cango Day Clinic
Klein Karoo Medi-Clinic*

Paarl
Paarl Medi-Clinic*

West Coast
Life West Coast Private Hospital*

Worcester
Worcester Medi-Clinic*

* These hospitals have a casualty unit, but it is not a preferred casualty unit.

** These hospitals have a preferred casualty unit.

Please note that this list of hospitals is subject to change. Go to www.discovery.co.za for the latest list of hospitals and casualty units or phone us.