The cover you need, when you need it
We cover you in any 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. If you need an ambulance or helicopter, call 0860 999 911. We will send the help you need. It is important that you, a loved one or the hospital let us know of your admission as soon as possible.
Cover for planned hospital admissions
You have cover in a private hospital in the KeyCare Hospital Network. Call us two days before you go to hospital. You will not have cover if you do not call us.
We cover these procedures in our day surgery network only:
Arthrocentesis (joint injection)
Cautery of vulva warts
Diagnostic D & C
Myringotomy with intubation (grommets)
Removal of pins and plates
Simple abdominal hernia repair
|Simple nasal procedure for nose bleeding (ie nasal plugging and nasal cautery)
Treatment of Bartholin’s cyst/abscess
Click here to view a list of the KeyCare hospitals
No overall limit
There is no overall hospital limit on your plan. This means that even if you have to stay in hospital for a long time, or if your treatment is very expensive, your cover won’t run out. Some healthcare services and procedures have a limit or we may have rules on how we pay for them.
Full cover for specialists who we have an agreement with
We will cover approved treatment at healthcare professionals who we have an agreement with in full. These healthcare professionals are also the designated providers for Prescribed Minimum Benefits.
You may have to pay an amount if you use other specialists
If you are treated by a specialist who we don’t have an agreement with, we cover you up to 100% of the Discovery Health Rate. If the specialist charges more than the Discovery Health Rate, you must pay the rest.
Other healthcare professionals
We cover GPs, radiology, pathology and other healthcare services up to 100% of the Discovery Health Rate.
MRI and CT scans
MRI and CT scans are like x-rays but show much more detail. They are used when an x-ray doesn’t show enough. If your scan is related to an approved hospital stay, we pay it from your Hospital Benefit. If it is not, we pay it from your Specialist Benefit, up to R2 300 for each person. We do not pay for MRI or CT scans that are related to conservative back or neck treatment (this is treatment for your back or neck that is not surgery).
Most of your in-hospital healthcare services have no overall limit. These are:
Only the following healthcare services have a limit:
|Mental health benefit||21 days for each person|
|Alcohol and drug rehabilitation||21 days for each person|
|Terminal care benefit||R20 000 for each person in their lifetime|
|Chronic dialysis||We cover these expenses in full as long as we have approved your treatment. You are only covered if you use a doctor in our network.|
Your cover for chronic conditions
You have cover for a list of chronic conditions if your medicine is on the KeyCare medicine list. You must get your approved medicine from one of our network pharmacies or from your chosen GP. If you get your medicine anywhere else, you have to pay a 20% co-payment.
On the KeyCare Plus Plan, your chosen GP must prescribe the chronic medicine. We need to approve your chronic condition before we can 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 our network. Please call us to register on the Oncology Programme.
Cover for GP visits
When joining KeyCare Plus, you must choose a GP from the KeyCare GP network. You must go to your chosen GP for us to cover your consultations and some minor procedures.
We pay for a list of basic x-rays at a network provider. Your chosen GP must ask for the x-rays to be done.
Blood, urine and other fluid and tissue tests
We pay for a list of blood, urine and other fluid and tissue tests. Your chosen GP must ask for these tests by filling in a Discovery Health pathology form.
Medicine to treat conditions that don’t last long
We pay for medicines from our medicine list if they are prescribed by your chosen KeyCare network GP. Click here to view the KeyCare acute medicine formulary 2012.
You get one out-of-network GP visit
If you need to see a doctor and your chosen GP from our network is not available, each person on your membership can go to any GP once. We will cover the GP visit, with selected blood tests and x-rays and medicines on our medicine list.
Cover for dentistry
We cover consultations, fillings and tooth removal at a dentist in our dentist network. Click here to view the KeyCare dental formulary 2012.
Cover for eye care
We cover one eye test for each person but you must go to an eye doctor in our network. The eye doctor will have a specific range of glasses that you can choose from. You can get a set of contact lenses instead of glasses if you choose to. You can get new glasses or contact lenses every 24 months.
You can go to any casualty unit at one of the KeyCare network hospitals. You have to pay the first R185 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. We’ll cover you for the rest of the year in which the trauma took place, and in the year after your trauma.
How we cover medical equipment
We cover wheelchairs, wheelchair batteries and cushions, transfer boards and mobile ramps, commodes, long-leg calipers, crutches and walkers on the medical equipment list, if you get them from a network provider. There is an overall limit of R3 800 for each family.
Screening and Prevention Benefit
If you go for certain tests to check your health, we will cover them. These screening tests include blood glucose, blood pressure, cholesterol and body mass index at a Discovery Wellness Network provider. We also cover a mammogram, Pap smear, PSA and HIV screening tests. Members 65 years or older and members registered for certain chronic conditions are also covered for a seasonal injection to prevent flu.
Cover for other types of healthcare professionals
We do not cover other types of healthcare professionals, like physiotherapists, psychologists, speech therapists, audiologists, homeopaths or chiropractors.
Your GP must call us to get a reference number before your consultation with the specialist. You are covered up to R2 300 for each person on your membership.
If you are pregnant, the Antenatal Benefit covers you at 100% of the Discovery Health Rate for the following healthcare services:
We do not cover certain healthcare services. You can find a full list of these exclusions here. In addition to the general exclusions that apply to all plans, KeyCare Plans do not cover the following, except if the Prescribed Minimum Benefits says we must:
We also do not cover the cost of treatment for any complications or the direct or indirect expenses related to any of these excluded conditions and treatments.
|Family size||R0 - R6 250||R6 251 - R8 300||R8 301 +|
|Family size||R0 - R3 900||R3 901 - R6 250||R6 251 - R8 300||R8 301 +|
|Main member||R485||R581||R813||R1 211|
* We count a maximum of three children when we work out the monthly contribution.
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.
Click here for the KeyCare hospital network for 2012.
|Fordsburg Day Clinic||7700083||Fordsburg - Johannesburg||Gauteng|
|Visiomed||7700857||Blackheath - Johannesburg||Gauteng|
|Mayo Clinic||7700164||Constantia Kloof - Johannesburg||Gauteng|
|Fauchard Clinic||7700415||Florida - Johannesburg||Gauteng|
|Johannesburg Eye Clinic||7700334||Northcliff - Johannesburg||Gauteng|
|Sandton Surgical Centre||7700237||Morningside - Johannesburg||Gauteng|
|Brenthurst||5803349||Parktown - Johannesburg||Gauteng|
|Garden City Clinic||5805988||Mayfair - Johannesburg||Gauteng|
|Rand Clinic||5804620||Berea - Johannesburg||Gauteng|
|Gauteng Surgical Eye Centre Facility||0060941||Mulbarton - Johannesburg||Gauteng|
|Sandhurst Eye Centre||7700881||Sandhurst – Johannesburg||Gauteng|
|Lenmed Clinic||5808324||Lenasia - Johannesburg||Gauteng|
|Karibu Day Clinic||7700644||Benoni||Gauteng|
|The Healthy Eye||0052493||Benoni||Gauteng|
|Mercidoc Day Clinic||7601131||Kempton Park||Gauteng|
|Zamokhule Private Hospital||5709180||Tembisa||Gauteng|
|Metamorphosis Day Clinic||0216763||Benoni||Gauteng|
|Boksburg Medical & Dental Centre||7700741||Boksburg||Gauteng|
|Germison Medical & Dental Centre||7700768||Germiston||Gauteng|
|Birchmed Day Clinic||7700504||Kempton Park||Gauteng|
|Glynnwood Nursing Home||5807743||Benoni||Gauteng|
|Springs Parkland Clinic||5807034||Springs||Gauteng|
|St Mary's Maternity Hospital||5706408||Springs||Gauteng|
|Arwyp Medical Centre||5807891||Kempton Park||Gauteng|
|Botshelong Empilweni Clinic Vosloorus)||5808685||Vosloorus||Gauteng|
|Clinix Private Hospital Sebokeng||5808944||Vereeniging||Gauteng|
|Vaalpark Medical Centre||5708745||Sasolburg||Gauteng|
|Medivaal Hospital (Emfuleni MC)||5808375||Vanderbijlpark||Gauteng|
|Medgate Day Clinic||7700016||Roodepoort||Gauteng|
|Wilgeheuwel Day Hospital||0150010||Radiokop||Gauteng|
|Sir Albert Medical Centre||5708052||Randfontein||Gauteng|
|Clinix Soweto (Tshepo Themba)||5808782||Dobsonville – Orlando||Gauteng|
|Cure Day Clinic - Medkin||7700121||Pretoria||Gauteng|
|Kilnerpark Narko Clinic||7700172||Kilnerpark - Pretoria||Gauteng|
|Centurion Eye Hospital||0236837||Centurion||Gauteng|
|Cure Day Clinic - Midstream||0423556||Midrand||Gauteng|
|Pretoria North Day Clinic||7700156||Pretoria||Gauteng|
|Brooklyn Surgical Centre||7700318||Pretoria||Gauteng|
|Eugene Marais Hospital||5806615||Pretoria||Gauteng|
|Louis Pasteur Hospital||5808820||Pretoria||Gauteng|
|Zuid Afrikaans Hospital||5805112||Pretoria||Gauteng|
|Cure Day Clinics - Erasmuskloof||0448087||Erasmuskloof||Gauteng|
|Bouganville Private Hospital||5808952||Pretoria||Gauteng|
|Legae Private Clinic||5808499||Pretoria||Gauteng|
|Medforum Medi Clinic||5807867||Pretoria||Gauteng|
|Intercare Day Hospital Hazeldean||0472395||Pretoria||Gauteng|
|Silverton Medical And Dental Centre||7700776||Silverton – Pretoria||Gauteng|
|Citymed Day Theatre||7700938||Dan Pienaar - Bloemfontein||Free State|
|Welkom Medical Centre||0399337||Welkom||Free State|
|Bethlehem Medical Center||7700792||Bethlehem||Free State|
|Rosepark Hospital||5808014||Bloemfontein||Free State|
|Pasteur hospital||5708966||Bloemfontein||Free State|
|Ernest Opperheimer Hospital||5808545||Welkom||Free State|
|St Helena Hospital||5708532||St Helena||Free State|
|Universitas Private Hospital||0131938||Bloemfontein||Free State|
|Pelonomi Privat e Hospital||0195340||Bloemfontein||Free State|
|Hoogland Medi-Clinic||5808707||Bethlehem||Free State|
|Hydromed Welkom Medi Clinic||5808758||Welkom||Free State|
|Bloemfontein Eye Centre||0225681||Bloemfontein||Free State|
|Shelly Beach Day Hospital||0380059||Shelly Beach||Kwazulu Natal|
|La Verna Hospital||5808235||Ladysmith||Kwazulu Natal|
|Bluff medical & Dental Centre||7700687||Durban||Kwazulu Natal|
|Malvern Medical & Dental centre||7700695||Malvern||Kwazulu Natal|
|Pinetown Medicross Theatre||7700954||Pinetown||Kwazulu Natal|
|City Hospital||5808367||Durban||Kwazulu Natal|
|Chatsmed Garden Hospital||5808219||Durban||Kwazulu Natal|
|Entabeni Hospital||5801982||Durban||Kwazulu Natal|
|Isipingo Clinic||5708192||Durban||Kwazulu Natal|
|Mount Edgecombe||5708664||Phoenix||Kwazulu Natal|
|The Crompton Hospital||5808596||Pinetown||Kwazulu Natal|
|Empangeni Clinic||5708494||Empangeni||Kwazulu Natal|
|Midlands Medical Centre||5708605||Pietermaritzburg||Kwazulu Natal|
|Hibiscus Hospital||5808901||Port Shepstone||Kwazulu Natal|
|St Annes Hospital||5808197||Pietermaritzburg||Kwazulu Natal|
|Kingsway Hospital||5808200||Amanzimtoti||Kwazulu Natal|
|The Bay Hospital||5808472||Richards Bay||Kwazulu Natal|
|Kokstad Private Hospital||0174602||Kokstad||Kwazulu Natal|
|Newcastle Private Hospital||5808871||Newscastle||Kwazulu Natal|
|Victoria Private Hospital (Tongaat)||5708567||Tongaat||Kwazulu Natal|
|Nu-Shifa Hospital||5808464||Durban||Kwazulu Natal|
|McCord Hospital||5703808||Durban||Kwazulu Natal|
|eMalahleni Day Clinic||7700520||Witbank||Mpumalanga|
|Lowveld Day Clinic||0042668||Nelspruit||Mpumalanga|
|Kriel Clinic Trust||7700229||Kriel||Mpumalanga|
|Middelburg Private Hospital||5808243||Middelburg||Mpumalanga|
|Barberton Medi-Clinic (Eureka)||5709148||Barberton||Mpumalanga|
|Ermelo Private Hospital||5808863||Ermelo||Mpumalanga|
|Highveld Medi-Clinic (Tichardt)||5807956||Trichardt||Mpumalanga|
|Nelspruit Private Hospital||5808340||Nelspruit||Mpumalanga|
|Potchefstroom Medical & Dental Centre||7700784||Potchefstroom||North West|
|Anncron Clinic||5700159||Klerksdorp||North West|
|Peglarae Hospital||5808359||Rustenburg||North West|
|Vryburg Private Hospital||5808553||Vryburg||North West|
|Leslie Williams Hospital||5708648||Carletonville||North West|
|Victoria Private Hospital (Mafikeng)||0223891||Mafikeng||North West|
|Potchefstroom Medi-Clinic||5808057||Potchefstroom||North West|
|Duff Scott Memorial hospital||5707838||Stilfontein||North West|
|Lichtenburg Clinic||7601468||Lichtenburg||North West|
|Curamed Thabazimbi Hospital||5709202||Thabazimbi||Limpopo|
|Tzaneen Private Hospital||132454||Tzaneen||Limpopo|
|Kimberley Medi-Clinic||5808049||Kimberley||Northern Cape|
|Kathu Medi-Clinic||5706009||Kathu||Northern Cape|
|Upington Private Hospital||5808804||Upington||Northern Cape|
|Parow Medicross||7700717||Parow - Cape Town||Western Cape|
|Wesfleur Private Clinic||7700814||Atlantis||Western Cape|
|Khangela Eye Theatre||0251364||Bellville||Western Cape|
|Kango Clinic||7700431||Oudtshoorn||Western Cape|
|Monte Vista Clinic||7700059||Monte Vista||Western Cape|
|Kraaifontein Medical & Dental Centre||7700709||Kraaifontien||Western Cape|
|Tokai Medical & Dental Centre||7700725||Kuilsriver||Western Cape|
|Bayview Hospital||5808790||Mosselbay||Western Cape|
|West Coast Private Hospital||5808979||Vredenburg||Western Cape|
|Mitchells Plain Medical Centre||5807948||Mitchells Plain||Western Cape|
|Gatesville Medical Centre||5808103||Gatesville||Western Cape|
|Bellville Medical Centre||5802881||Bellville||Western Cape|
|Ceres Private Hospital||5709032||Ceres||Western Cape|
|Christiaan Barnard Memorial Hospital||5807778||Cape Town||Western Cape|
|Kuilsrivier Private Hospital||0088978||Kuilsriver||Western Cape|
|UCT Medical Centre||0071730||Observatory||Western Cape|
|Geneva Clinic||5709059||George||Western Cape|
|George Medi-Clinic||5807905||George||Western Cape|
|Hermanus Medi-Clinic||5709091||Hermanus||Western Cape|
|Klein Karoo Medi Clinic||5808928||Oudtshoorn||Western Cape|
|Louis Leipold||5806860||Bellville||Western Cape|
|Milnerton Medi Clinic||5808669||Milnerton||Western Cape|
|Paarl Medi-Clinic||5808251||Paarl||Western Cape|
|Worcester Medi-Clinic||5808006||Worcester||Western Cape|
|The Surgical Institute||0472859||Durbanville||Western Cape|
|George Surgical Centre||0472522||Western Cape||Western Cape|
|Cure Day Clinics ST Stephens Paarl||0468541||Western Cape||Western Cape|
|John Hill Eye Laser Centre||0382264||Western Cape||Western Cape|
|Somerset Aesthetic Clinic||0377929||Somerset West||Western Cape|
|Medical Forum Theatre||7700873||Port Elizabeth||Eastern Cape|
|Beacon Bay||0357669||East London||Eastern Cape|
|St Dominics||5808294||East London||Eastern Cape|
|St James Operating Theatre||5703816||East London||Eastern Cape|
|Isivivana Private Hospital||0168386||Humansdorp||Eastern Cape|
|New Mercantile Hospital||5808626||Port Elizabeth||Eastern Cape|
|Queenstown Private Hospital||5709156||Queenstown||Eastern Cape|
|St Mary's Private Hospital||5700167||Umtata||Eastern Cape|
|Cuyler Clinic||5808642||Uitenhage||Eastern Cape|