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DISCOVERY HEALTH KEYCARE START 9 151-13 050 2019

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Medical Aid Year: 
2019
Day to day Benefits: 

Primary care cover through your

chosen KeyCare Start GP and day-to-
day medicine from our medicine list

In Hospital Benefits
Hospital Rate of Payment: 
Unlimited cover in your chosen KeyCare Start Network Hospital
Hospitals: 

We cover you in full at your chosen
KeyCare Start Network hospital.

Casualty / Emergency Visits: 
After-hours care at your chosen KeyCare Start GP or network provider
Specialists: 
Full cover at a contracted provider in your allocated KeyCare Start network hospital. Other providers within your allocated KeyCare Start network hospital is covered at 100% of the DHR.
Radiology and pathology: 
Full cover at a contracted provider in your allocated KeyCare Start network hospital. Other providers within your allocated KeyCare Start network hospital is covered at 100% of the DHR.
Dialysis: 
You have cover at a provider in a state facility
Oncology / Cancer: 
Your treatment is covered in a state facility
Take home Medicine: 
We pay for medicine from our medicine list if they are prescribed and/or dispensed by your chosen KeyCare Network GP or chosen KeyCare Start network GP, depending on the plan you choose.
Rehabilitation, Hospice and Step-down facilities: 
21 days for each person
Treatment for Mental Health: 
21 days for other mental health admissions.
HIV / AIDS: 
When you register for our HIVCare Programme, you are covered for the care you need, which includes additional cover for social workers. Be assured of confidentiality at all times. You need to get your medicine from a DSP to avoid a 20 % co-payment
Day-to-day benefits
GP consultations: 

You have unlimited cover for medically
appropriate GP consultations. When joining,
you must choose a GP from the KeyCare or
KeyCare Start GP network, depending on the
plan you choose. You must go to your chosen
GP for us to cover your consultations and
some minor procedures. Preauthorisation
is required after your 15th GP visit.

Specialist consultations: 

up to two
visits up to R2 000 on KeyCare Start
per person per year.

Optometry benefits: 
We cover one eye test for each person, but you must go to an optometrist in the KeyCare Optometry Networks.
Basic dentistry: 
We cover consultations, fillings and tooth removals at a dentist in our dentist network. Certain rules and limits may apply.
Pregnancy benefits: 
You are covered for eight consultations with your gynaecologist, chosen KeyCare or KeyCare Start GP or midwife.
Chronic Conditions
Chronic Conditions: 

Addison’s disease, asthma, Bipolar mood disorder, bronchiectasis, Cardiac failure, cardiomyopathy, chronic obstructive pulmonary disease, chronic renal disease, coronary artery disease, Crohn’s disease, Diabetes insipidus, diabetes Type 1, diabetes Type 2, dysrhythmia, Epilepsy, Glaucoma, Haemophilia, HIV, hyperlipidaemia, hypertension, hypothyroidism, Multiple sclerosis, Parkinson’s disease, Rheumatoid arthritis, Schizophrenia, systemic lupus erythematosus, Ulcerative colitis

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. Seasonal flu vaccine during pregnancy, or for members 65 years or older and/or registered for certain chronic conditions. Additional, and/or more frequent screening is available for those who meet our clinical criteria. Kids screening covers growth assessment and health and milestone tracking at any one of our wellness network providers

Total Contributions
Total Contribution Main Member: 
839.00
Total Contribution Adult: 
839.00
Total Contribution Child*: 
505.00
START 9 151-13 050
Risk Contributions
Risk Contribution Main Member: 
1412.00
Risk Contribution Adult: 
1412.00
Risk Contribution Child: 
551.00
Medical Aid Plan Name Term: 
Any