The KeyCare Series

 

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

Your cover in hospital

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:

Adenoidectomy
Arthrocentesis (joint injection)
Cautery of vulva warts
Cataract surgery
Circumcision
Colonoscopy
Cystourethroscopy
Diagnostic D & C
Gastroscopy
Hysteroscopy
Myringotomy
Myringotomy with intubation (grommets)
Prostate biopsy
Proctoscopy
Removal of pins and plates
Sigmoidoscopy
Simple abdominal hernia repair
Simple nasal procedure for nose bleeding (ie nasal plugging and nasal cautery)
Tonsillectomy
Treatment of Bartholin’s cyst/abscess
Vasectomy
Vulva/cone biopsy

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.

Your cover for healthcare professionals

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.

Your cover for investigations

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).

Unlimited healthcare services

Most of your in-hospital healthcare services have no overall limit. These are:

  • GPs
  • Specialists
  • Pathology
  • Radiology
  • Allied healthcare professionals, like physiotherapists
  • HIV cover
Limited healthcare services

Only the following healthcare services have a limit:

Mental health benefit21 days for each person
Alcohol and drug rehabilitation21 days for each person
Terminal care benefitR20 000 for each person in their lifetime
Chronic dialysisWe 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.
DiscoveryCare looks after you in times of need

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.

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

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.

Basic x-rays

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.

Casualty visits

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.

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

Specialist Benefit

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. 

Antenatal Benefit

If you are pregnant, the Antenatal Benefit covers you at 100% of the Discovery Health Rate for the following healthcare services:

  • four visits to a gynaecologist at a KeyCare Network Hospital
  • one routine scan (between 10 and 20 weeks)
  • selected blood tests requested by your gynaecologist or GP.
Exclusions on the KeyCare Plans

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:

  1. Hospital admissions related to:
    • dentistry
    • 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. Bunionectomy
  3. Arthroscopy
  4. Removal of varicose veins
  5. Brachytherapy for prostate cancer
  6. Refractive eye surgery
  7. Non-cancerous breast conditions
  8. 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 any of these excluded conditions and treatments.

2012 Monthly contributions
KeyCare Core
Family sizeR0 - R6 250R6 251 - R8 300R8 301 +
Main memberR465R579R894
AdultR465R579R894
Child*R117R144R202
KeyCare Plus
Family sizeR0 - R3 900R3 901 - R6 250R6 251 - R8 300R8 301 +
Main memberR485R581R813R1 211
AdultR485R581R813R1 211
Child*R129R168R228R324

* We count a maximum of three children when we work out the monthly contribution.

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 2012

Click here for the KeyCare hospital network for 2012.

KeyCare Day Surgery network
NamePractice NumberRegionProvince
Johannesburg   
Fordsburg Day Clinic 7700083Fordsburg - JohannesburgGauteng
Visiomed7700857Blackheath - JohannesburgGauteng
Mayo Clinic7700164Constantia Kloof - JohannesburgGauteng
Fauchard Clinic7700415Florida - JohannesburgGauteng
Johannesburg Eye Clinic7700334Northcliff - JohannesburgGauteng
Sandton Surgical Centre7700237Morningside - JohannesburgGauteng
Brenthurst5803349Parktown - JohannesburgGauteng
Garden City Clinic5805988Mayfair - JohannesburgGauteng
Rand Clinic5804620Berea - JohannesburgGauteng
Gauteng Surgical Eye Centre Facility 0060941 Mulbarton - Johannesburg Gauteng 
Sandhurst Eye Centre7700881Sandhurst – JohannesburgGauteng
Lenmed Clinic5808324Lenasia - JohannesburgGauteng
    
East Rand   
Karibu Day Clinic7700644BenoniGauteng
The Healthy Eye0052493BenoniGauteng
Mercidoc Day Clinic7601131Kempton ParkGauteng
Zamokhule Private Hospital5709180TembisaGauteng
Metamorphosis Day Clinic0216763BenoniGauteng
Boksburg Medical & Dental Centre7700741BoksburgGauteng
Germison Medical & Dental Centre7700768GermistonGauteng
Birchmed Day Clinic7700504Kempton ParkGauteng
Glynnwood Nursing Home5807743BenoniGauteng
Dalview Clinic5808146BrakpanGauteng
Roseacres Clinic5806968GermistonGauteng
Springs Parkland Clinic5807034SpringsGauteng
St Mary's Maternity Hospital5706408SpringsGauteng
Suikerbosrand Clinic5808987HeidelburgGauteng
Arwyp Medical Centre5807891Kempton ParkGauteng
Sunshine Hospital5808774ActonvilleGauteng
Botshelong Empilweni Clinic Vosloorus)5808685VosloorusGauteng
    
South   
Optimed7700903AlbertonGauteng
Ocumed7700830VereenigingGauteng
Midvaal5808898VereenigingGauteng
Clinix Private Hospital Sebokeng5808944VereenigingGauteng
Vaalpark Medical Centre5708745 SasolburgGauteng
Medivaal Hospital (Emfuleni MC)5808375VanderbijlparkGauteng
    
West Rand   
Medgate Day Clinic7700016RoodepoortGauteng
Protea Clinic7700369KrugersdorpGauteng
Constantia Clinic7700547FloridaGauteng
Wilgeheuwel Day Hospital0150010RadiokopGauteng
Robinson Hospital5804655RandfonteinGauteng
Sir Albert Medical Centre 5708052RandfonteinGauteng 
Clinix Soweto (Tshepo Themba)5808782Dobsonville – Orlando Gauteng  
Lesedi Clinic5807816SowetoGauteng
    
Pretoria   
Cure Day Clinic - Medkin7700121PretoriaGauteng
Kilnerpark Narko Clinic7700172Kilnerpark - PretoriaGauteng
Centurion Eye Hospital0236837CenturionGauteng
Cure Day Clinic - Midstream0423556MidrandGauteng
Pretoria North Day Clinic7700156PretoriaGauteng
Brooklyn Surgical Centre7700318PretoriaGauteng
Eugene Marais Hospital5806615PretoriaGauteng
Carstenhof Clinic5808170MidrandGauteng
Louis Pasteur Hospital5808820PretoriaGauteng
Zuid Afrikaans Hospital5805112PretoriaGauteng
Cure Day Clinics - Erasmuskloof0448087ErasmuskloofGauteng
Jakaranda Hospital5804116 PretoriaGauteng
Bouganville Private Hospital5808952PretoriaGauteng
Legae Private Clinic5808499Pretoria Gauteng
Medforum Medi Clinic5807867PretoriaGauteng
Muelmed Hospital5808065PretoriaGauteng
Intercare Day Hospital Hazeldean0472395PretoriaGauteng
Silverton Medical And Dental Centre7700776Silverton – PretoriaGauteng
    
Free State   
Citymed Day Theatre7700938Dan Pienaar - BloemfonteinFree State
Welkom Medical Centre0399337WelkomFree State
Bethlehem Medical Center7700792BethlehemFree State
Rosepark Hospital5808014BloemfonteinFree State
Pasteur hospital5708966BloemfonteinFree State
Ernest Opperheimer Hospital5808545WelkomFree State
St Helena Hospital5708532St HelenaFree State
Universitas Private Hospital0131938BloemfonteinFree State
Pelonomi Privat e Hospital0195340BloemfonteinFree State
Hoogland Medi-Clinic5808707BethlehemFree State 
Hydromed Welkom Medi Clinic5808758WelkomFree State
Bloemfontein Eye Centre 0225681 Bloemfontein Free State
    
Kwazulu Natal   
Shelly Beach Day Hospital0380059Shelly BeachKwazulu Natal
La Verna Hospital5808235LadysmithKwazulu Natal
Bluff medical & Dental Centre7700687DurbanKwazulu Natal
Malvern Medical & Dental centre7700695MalvernKwazulu Natal
Pinetown Medicross Theatre7700954PinetownKwazulu Natal
City Hospital5808367DurbanKwazulu Natal
Chatsmed Garden Hospital5808219DurbanKwazulu Natal
Entabeni Hospital5801982DurbanKwazulu Natal
Isipingo Clinic5708192DurbanKwazulu Natal
Mount Edgecombe5708664PhoenixKwazulu Natal
The Crompton Hospital5808596PinetownKwazulu Natal
Empangeni Clinic5708494EmpangeniKwazulu Natal
Midlands Medical Centre5708605PietermaritzburgKwazulu Natal
Hibiscus Hospital5808901Port ShepstoneKwazulu Natal
St Annes Hospital5808197PietermaritzburgKwazulu Natal
Kingsway Hospital5808200AmanzimtotiKwazulu Natal
The Bay Hospital5808472Richards BayKwazulu Natal
Kokstad Private Hospital0174602KokstadKwazulu Natal
Newcastle Private Hospital5808871Newscastle Kwazulu Natal
Victoria Private Hospital (Tongaat)5708567TongaatKwazulu Natal
Nu-Shifa Hospital5808464DurbanKwazulu Natal
McCord Hospital 5703808 Durban Kwazulu Natal
    
Mpumalanga   
eMalahleni Day Clinic7700520WitbankMpumalanga
Lowveld Day Clinic0042668NelspruitMpumalanga
Kriel Clinic Trust7700229KrielMpumalanga
Cosmos Hospital5807980WitbankMpumalanga
Middelburg Private Hospital5808243MiddelburgMpumalanga
Barberton Medi-Clinic (Eureka)5709148BarbertonMpumalanga
Ermelo Private Hospital5808863ErmeloMpumalanga
Highveld Medi-Clinic (Tichardt)5807956TrichardtMpumalanga
Nelspruit Private Hospital5808340NelspruitMpumalanga
    
North West   
Potchefstroom Medical & Dental Centre7700784PotchefstroomNorth West
Anncron Clinic5700159KlerksdorpNorth West
Peglarae Hospital5808359RustenburgNorth West
Vryburg Private Hospital5808553VryburgNorth West
Leslie Williams Hospital5708648CarletonvilleNorth West
Victoria Private Hospital (Mafikeng)0223891MafikengNorth West 
Potchefstroom Medi-Clinic5808057PotchefstroomNorth West
Duff Scott Memorial hospital5707838StilfonteinNorth West
Lichtenburg Clinic 7601468 Lichtenburg North West
    
Limpopo   
Limpopo Medi-Clinic5808189PolokwaneLimpopo
Curamed Thabazimbi Hospital5709202ThabazimbiLimpopo
Tzaneen Private Hospital132454TzaneenLimpopo
    
Northern Cape   
Kimberley Medi-Clinic5808049KimberleyNorthern Cape
Kathu Medi-Clinic5706009KathuNorthern Cape
Upington Private Hospital5808804UpingtonNorthern Cape
    
Western Cape   
Parow Medicross7700717Parow - Cape TownWestern Cape
Wesfleur Private Clinic7700814AtlantisWestern Cape
Khangela Eye Theatre0251364BellvilleWestern Cape
Kango Clinic7700431OudtshoornWestern Cape
Monte Vista Clinic7700059Monte VistaWestern Cape
Kraaifontein Medical & Dental Centre7700709KraaifontienWestern Cape
Tokai Medical & Dental Centre7700725KuilsriverWestern Cape
Bayview Hospital5808790MosselbayWestern Cape
West Coast Private Hospital5808979VredenburgWestern Cape
Mitchells Plain Medical Centre5807948Mitchells PlainWestern Cape
Gatesville Medical Centre5808103GatesvilleWestern Cape
Bellville Medical Centre5802881BellvilleWestern Cape
Ceres Private Hospital5709032CeresWestern Cape
Christiaan Barnard Memorial Hospital5807778Cape TownWestern Cape
Kuilsrivier Private Hospital0088978KuilsriverWestern Cape
UCT Medical Centre0071730ObservatoryWestern Cape
Geneva Clinic5709059 GeorgeWestern Cape
George Medi-Clinic5807905GeorgeWestern Cape
Hermanus Medi-Clinic5709091HermanusWestern Cape
Klein Karoo Medi Clinic5808928OudtshoornWestern Cape
Louis Leipold5806860BellvilleWestern Cape
Milnerton Medi Clinic5808669MilnertonWestern Cape
Paarl Medi-Clinic5808251PaarlWestern Cape
Worcester Medi-Clinic5808006WorcesterWestern Cape
The Surgical Institute0472859DurbanvilleWestern Cape
George Surgical Centre 0472522 Western Cape Western Cape 
Cure Day Clinics ST Stephens Paarl0468541Western CapeWestern Cape
John Hill Eye Laser Centre        0382264Western CapeWestern Cape
Somerset Aesthetic Clinic0377929Somerset WestWestern Cape
    
Eastern Cape   
Medical Forum Theatre7700873Port ElizabethEastern Cape
Beacon Bay0357669East LondonEastern Cape
St Dominics5808294East LondonEastern Cape
St James Operating Theatre5703816East LondonEastern Cape
Isivivana Private Hospital0168386HumansdorpEastern Cape
New Mercantile Hospital5808626Port ElizabethEastern Cape
Queenstown Private Hospital5709156QueenstownEastern Cape
St Mary's Private Hospital5700167UmtataEastern Cape
Cuyler Clinic5808642UitenhageEastern Cape