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Discovery Health KeyCare Core R0-R8100 2017

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Medical Aid Year: 
2017
Income Level: 
0 – 8 100
Day to day Benefits: 

Unlimited emergency and trauma cover in our KeyCare network of hospitals and planned hospital cover on KeyCare Core, KeyCare Plus and KeyCare Access. Full cover in the Full Cover Hospital Network and up to 70% of the DHR in the Partial Cover Hospital Network Guaranteed full cover in hospital for specialists on the KeyCare network, and up to 100% of the DHR for other healthcare professionals Unlimited cover for medically appropriate GP consultations, blood tests, X-rays or medicine in our KeyCare Network on the KeyCare Plus and KeyCare Access plans Essential cover for chronic medicine on the KeyCare medicine list for all CDL conditions Cover for medical emergencies in South Africa

In Hospital Benefits
Are you prepared to use designated hospitals?: 
Yes
Hospitals: 

Full cover in the Full Cover Hospital Network, and up to 70% of the DHR in the Partial Cover Hospital Network. Unlimited cover in the KeyCare Hospital Network. A list of procedures are covered in the day surgery network.

Upfront Payments to hospitals: 

If you use a hospital in the Partial Cover Network, we pay up to 70% of the DHR. If you do not use hospitals in the networks, you will have to pay all costs. This does not apply in an emergency.

Specialists: 
Full cover
Other healthcare professionals eg. Physio, Occupational, Dietician: 
100% of the DHR
Radiology and pathology: 
100% of the DHR
Scopes (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy): 
We cover scopes at our day-surgery network.
MRI and CT scans: 
If done as part of an approved admission, we will pay up to 100% of the DHR from the Hospital Benefit. If not related to your admission, we pay it from the Specialist Benefit up to a limit of R3 570 each person each year. Hospital cover Summary Compare ou
Treatment for Mental Health: 
21 days for admissions or up to 15 outof- hospital consultations for each person for major affective disorders, anorexia and bulimia, and up to 12 out-of-hospital consultations for acute stress disorder accompanied by recent significant trauma. 21 days fo
Day-to-day benefits
MRI and CT Scans (Out of Hospital): 
MRI and CT scans are paid from the Specialist Benefit up to a limit of R3 570 each person each year.
Chronic Conditions
Additional Chronic Conditions: 
You have cover for the 27 CDL conditions according to the Prescribed Minimum Benefits list. Your condition needs to be approved for it to be covered.
Preventative Care Benefits
Preventative Benefits: 

Covers certain tests at one of our wellness network providers, like blood glucose, blood pressure, cholesterol and body mass index. We also cover a mammogram every 2 years, Pap smear every 3 years, PSA (a prostate screening test) once a year and HIV screening tests. Members 65 years or older and members registered for certain chronic conditions are also covered for a seasonal flu vaccine. Additional, and/or more frequent screening is available for those who meet our clinical criteria. Kid’s screening: Covers growth assessment and health and milestone tracking at any one of our wellness network providers.

Total Contributions
Total Contribution Main Member: 
731.00
Total Contribution Adult: 
731.00
Total Contribution Child*: 
190.00
Core
Risk Contributions
Risk Contribution Main Member: 
731.00
Risk Contribution Adult: 
731.00
Risk Contribution Child: 
190.00
Benefit: 
We cover cancer treatment according to the Prescribed Minimum Benefits and if you go to a cancer specialist in our network.
How many times per annum do you and your dependants visit a doctor?: 
0
How much do you spend on Acute medication per annum?: 
0
How much do you spend on Chronic medication per annum?: 
R1000 - R4999
Will you or any of your dependants require specialised Dentistry: 
No