The KeyCare Series

 

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

 

You have access to additional benefits

Hospital Benefits

We cover you in hospital for emergency and planned hospital admissions. In an emergency, go straight to hospital but call us or get someone to call us within 12 hours. For planned hospital admissions, please call us 48 hours before you go to hospital to confirm your admission.

KeyCare Series
Overall limitThere is no overall hospital limit on the KeyCare Plans
Limits apply to some healthcare services and procedures
Choice of hospitalsThe KeyCare Plans cover you in any hospital in the KeyCare network*
Procedures and consultations by specialists participating in direct payment arrangementsThe KeyCare Plans cover you in full if you consult a specialist who charges according to the KeyCare payment arrangement
Other healthcare professionalsYour plan covers you up to 100% of the Discovery Health Rate
DentistryNo benefit
Endoscopies (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy)As part of an approved hospital admission: no overall limit
MRI and CT scansAs part of an approved hospital admission: no overall limit
If admitted for conservative back or neck treatment: no benefit
Terminal care benefitR16 950 for each person
DialysisWe cover these expenses in full as long as we have approved your treatment plan and you use a provider in our network
Mental health benefit21 days for each person
Alcohol and drug rehabilitation21 days for each person

For more detailed information on how we cover specific healthcare services go to Do We Cover

* If you don’t use KeyCare network hospitals, you will need to pay your claims. This does not apply in an emergency.

The benefits described in this section are subject to clinical guidelines and policies.

KeyCare hospitals for 2010

Eastern Cape

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

Humansdorp
• Life Isivivana Private Hospital*

Port Elizabeth
• Life New Mercantile Hospital

Queenstown
• Life Queenstown Private Hospital**

Uitenhage
• Cuyler Clinic*

Umtata
• Life St Marys Private Hospital

Free State

Bethlehem
• Hoogland Medi-Clinic

Bloemfontein
• Bloemfontein Eye Centre
• Life Pasteur Hospital*
• Pelonomi Private Hospital
• Life Rosepark Clinic**
• Universitas Private Hospital

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

Sasolburg
• Vaalpark**

Gauteng

Benoni
• Life The Glynwood Hospital**

Boksburg
• Clinix Vosloorus
• Botshelong-Empilweni**
• Sunshine Centre

Brakpan
• Life Dalview Clinic*

Germiston
• Life Roseacres Clinic**

Heidelberg
• Life Suikerbosrand Clinic**

Johannesburg
• Rand Clinic
• Garden City Clinic**
• Life Brenthurst Clinic**

Kempton Park
• Arwyp Hospital
• Optiklin Eye Hospital

Lenasia
• Lenmed Clinic**

Midrand
• Life Carstenhof Clinic**

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

Randfontein
• Life Robinson Hospital**
• Sir Albert Medical Centre

Soweto
• Clinix Soweto**
• Lesedi Clinic**

Springs
• Life Springs Parkland Clinic**
• Life 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 Hospital (Emfuleni Medi-Clinic)

KwaZulu Natal

Amanzimtoti
• Kingsway Hospital

Chatsworth
• Life Chatsmed Garden Hospital**

Durban
• Life City Hospital Ltd**
• Life Entabeni Hospital
• McCord 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 Hospital**

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 Vincents 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
• Life Cosmos Hospital**
• Palm Day Clinic

North West

Carletonville
• Leslie Williams Private Hospital
• Western Deep Clinic

Klerksdorp
• Life Anncron Clinic**

Mafikeng
• Victoria Private Hospital (Mafikeng 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
• Kuils River 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

Vredenburg
• Life West Coast Private Hospital

Worchester
• Worchester Medi-Clinic

* These KeyCare network hospitals do not have casualty units. ** Preferred casualty units. Please note that this list of hospitals and casualty units is subject to change. Go to www.discovery.co.za for an updated list.

DiscoveryCare offers specific benefits to help you manage chronic conditions

You have flexible cover for chronic diseases. You have full cover for approved medicine on the Discovery Health medicine list or up to an allocated amount for medicine not on our list. We pay medicine up to a maximum of the Discovery Health medication rate. We need to approve your chronic condition before it is covered from the Chronic Illness Benefit.

Additional benefits
SpecialistsWe cover consultations at specialists up to R2 000 for each person for each year. You must conf rm your benefits with us. On KeyCare Plus, your chosen GP must refer you.
Antenatal benefitsWe cover:
  • four visits to the gynaecologist when you are pregnant. Your selected GP must refer you
  • one routine scan by your gynaecologist (between 10 and 20 weeks of pregnancy)
  • selected antenatal blood tests if requested by your gynaecologist
Screening BenefitIf you go for certain preventive screening tests, we will cover the claim. The screening tests include the following group of tests: 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.
Day-to-day benefits - KeyCare Plus only
CasualtyYou must visit a casualty unit at a KeyCare network hospital. If you go to one of our preferred casualty units in the KeyCare network of hospitals, you pay R95 of the casualty unit’s account. You can also visit other casualty units in the KeyCare network of hospitals that are not part of the preferred casualty units. In this case you will pay the R210 of the casualty unit’s account.
Trauma Recovery Extender BenefitWe 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.
Cover for GPsConsultations and minor procedures at your chosen KeyCare network GP
X-rays and blood testsSelected basic x-rays and blood tests only if requested by your chosen KeyCare network GP
MedicineAcute medicines (according to the KeyCare acute medicine list) only if prescribed by your chosen KeyCare network GP
DentistrySelected basic dentistry (consultations, fillings and extractions) only at a dentist within the KeyCare dentist network
Glasses and eye testsOne eye test and one pair of clear single vision, bifocal or multifocal lenses with a basic frame, or a basic set of contact lenses for each person, every 24 months from your last date of service. Cover only at an optometrist within the KeyCare optometry network

Exclusions on the KeyCare Plans

The Discovery Health Medical Scheme does not cover certain healthcare services.

In addition to the general Discovery Health Medical Scheme exclusions applicable on all plans, KeyCare Plans have the following exclusions, except as stipulated in the Prescribed Minimum Benefits:

  1. In-hospital management of
    • dentistry
    • obesity
    • skin disorders
    • diagnostic work-up
    • conservative back and neck treatment
    • functional nasal problems
    • elective caesarean section, except if medically necessary
    • surgery for oesophageal reflux
    • back and neck surgery
    • hip and knee replacements
    • cochlear implants, auditory brain implants and internal nerve stimulators. This includes procedures, devices and processors.
  2. Brachytherapy for prostate cancer
  3. Refractive eye surgery
  4. Fibroadenosis
  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 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.

2010 Monthly contributions

 
KeyCare PlanMain memberAdultChild*
KeyCare Plus (R8 001 +)R171R1 030R275
KeyCare Plus (R6 001 – R8 000)R692R692R193
KeyCare Plus (R3 751 – R6 000)R494R494R143
KeyCare Plus (R0 – R3 750)R412R412R110
KeyCare Core (R8 001 +)R761R761R171
KeyCare Core (R6 001 – R8 000)R492R492R123
KeyCare Core (R0 – R6 000)R396R396R99

* 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.