Medical specialists
A specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency. Medical practitioners who engage in a medical specialty are known as medical specialists.
Cover for Specialists is dependent on your plan type. For more details select your plan type below:
Executive Plan
There is no limit to the number of specialist visits or services provided.
We pay and add up 300% of the Discovery Health Rate for the consultation fee or up to the Premier Rate where applicable.
Comprehensive Series
If your specialist sees you in hospital
Classic Comprehensive (including Classic Delta Comprehensive)
We pay up to 200% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
Essential Comprehensive (including Essential Delta Comprehensive)
We pay up to 100% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
If your specialist sees you out of hospital
We pay for specialist consultations from your available day-to-day benefits.
Priority Series
If your specialist sees you in hospital
Classic Priority
We pay up to 200% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
Essential Priority
We pay up to 100% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
If your specialist sees you out of hospital
We pay for specialist consultations from your available day-to-day benefits.
Saver Series
If your specialist sees you in hospital
Classic Saver (including Classic Delta Saver)
We pay up to 200% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
Essential Saver (including Essential Delta Saver) and Coastal Saver
We pay up to 100% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
If your specialist sees you out of hospital
We pay for specialist consultations from your available Medical Savings Account.
Core Series
If your specialist sees you in hospital
Classic Core (including Classic Delta Core)
We pay up to 200% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
Essential Saver (including Essential Delta Core) and Coastal Core
We pay up to 100% of the Discovery Health Rate or the Premier Rate, where applicable. We pay this from your Hospital Benefit as long as you have confirmed your hospital admission.
If your specialist sees you out of hospital
As the Core Series does not have day-to-day benefits, you need to pay for these costs.
KeyCare Series
If your specialist sees you in hospital
We cover your specialist claim in full if you are treated by a specialist who we have an agreement with. If you are treated by a specialist who we do not have an agreement with, you may need to pay for some of the costs yourself.
If your specialist sees you out of hospital
If you visit a specialist at a KeyCare Network hospital and you have a valid reference number, you will be covered up to R2 300 for each person each year. (This is for both the KeyCare Core and KeyCare Plus plans). On KeyCare Plus, your chosen GP must refer you. Any x-rays, blood tests and medicine on the KeyCare acute medicine list will add up to the (R2 300) limit.
KeyCare hospitals
See full list of hospitals on the KeyCare network.
* These hospitals do not have a casualty unit.
Please note that this list of hospitals can change at anytime.
