Medical Aid Plan - Discovery KeyCare

Discovery KeyCare

While Discovery Health’s 2019 premiums will increase by an average of 9.2 percent, the Discovery KeyCare product series remains very affordable.

Increased tariffs for this medical aid product have been cut to the minimum and will cost a family of four in the region of R2 148 monthly in 2019.

Despite current medical inflation rates of more than 12 per cent, Discovery has managed to trim price hikes for KeyCare medical aid at below seven per cent.

This move underlines the undisputed fact that Discovery is the giant of South African medical schemes.

Discovery KeyCare

With about three million beneficiaries, Discovery enjoys the lion’s share of the medical aid market.

So, while you may not be able to afford Discovery’s rich-in-benefits comprehensive cover, KeyCare will provide your family with essential medical

There are three different products available in the KeyCare Series. These are KeyCare Plus, KeyCare Access and KeyCare Core. All three plans offer:
Ø Hospital Cover
• Full cover with network-appointedspecialists
• 100% cover for non-network specialists based on the Discovery Health tariff rate   
• 100% cover for other non-network healthcare professionals based on the Discovery health tariff rate
Ø Chronic Illness Cover
• Cover for 27 Chronic Disease conditions listed in the Prescribed Minimum Benefits schedule, subject to approval   
• Full cover for approved chronic medication at a designated network pharmacy
Ø Cancer Cover
• Cover based on Prescribed Minimum Benefits at a network-appointed oncology specialist
Ø Day-To-Day Cover
• Primary GP care
• Day-to-day medication based on Discovery’s medicine list
• Basic radiology and pathology from a network-appointed service provider

More Discovery KeyCare Benefits

Depending on the product selected, other Keycare benefits include:

  • Unlimited emergency and trauma cover in network-designated KeyCare hospitals for any one of the three plans
  • Unlimited hospital cover in a network hospital for members of KeyCare Core and KeyCare Plus
  • Unlimited cover for childbirth, emergencies and trauma forKeyCare Access members
  • Guaranteed hospital coverfor specialists in the KeyCare network
  • Up to a maximum of 100% of the Discovery Health Rate for non-network healthcare professionals
  • Essential antenatal care
  • Childbirth and care of new-born baby cover
  • Essential cover for approved chronic medication for all KeyCare-approved Chronic Diseases
  • Cover for medical emergencies within South Africa’s borders

Who is Discovery KeyCare Suitable For?

The affordable KeyCare Series is ideal for those consumers who are willing to use specified network service providers for both in-and-out of hospital treatments and procedures.
Hospital benefits vary in the three plans as follows:
Unlimited coverin a network hospital and outside surgery procedures as listed in the KeyCarenetwork.
KeyCare Access
This offers unlimited cover for emergencies, trauma and childbirth in a network hospital.
KeyCare Core
This offers unlimited cover in a network hospital as well as listed day surgery procedures.
Day-to-daymedical cover
Cover for primary care through your personally selected GP and day-to-day medication according to Discovery’s medicine list for the Plus and Access series. This benefit is excluded from the Core plan.
It also includes cover for specialists, limited to R3 860 per person for Plus and Core members.
Access series members receive private specialist cover not exceeding R3 860for emergencies, trauma, childbirth and babies up to the age of 12 months.
Casualty visits
Plus series members are covered in any network-appointed hospital casualty unit. Members must pay R325 for the first consultation, subject to pre-authorisation.
Access members enjoy cover for emergencies and trauma in any casualty unit of a network hospital, limited to one event annually. They too must pay R325 for the first consultation, subject to pre-authorisation.
These benefits are excluded from the Core series.
Chronic medicines and prescriptions
Plus and Access members must receive their chronic medicines from an approved network pharmacy.
However, Core members can obtain their medication from any GP.
Plus and Core members are only covered for treatment if their illness is on the Prescribed Minimum Benefit list and will be allocated a network provider.
Access members are only covered for treatment if their illness is on the Prescribed Minimum Benefit list and will be allocated a state facility.

Spotlight on Chronic Conditions

Medical cover for chronic conditions and dread diseases is a vitally important aspect of any medical cover.
With Discovery’s KeyCare range members are covered for a large variety of illnesses, including:

• Addison’s disease and asthma
• Bipolar and 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 and dysrhythmia
• Epilepsy
• Glaucoma
• Haemophilia, HIV,hyperlipidaemia, hypertension and hypothyroidism
• Multiple sclerosis
• Parkinson’s disease
• Rheumatoid arthritis
• Schizophrenia and systemic lupus erythematosus
• Ulcerative colitis


Patients diagnosed with cancer must obtain approval from Discovery to undergo oncology treatment. Those patients who are covered by the OncologyCare Programme will receive treatment in a network or state facility. Patients who seek treatment elsewhere will receive 80% of the cover benefits. Benefits are based on 100% of Discovery’s tariff rate. Co-payments are applicable.



Medical Aid QuoteNOTES:

Your medical aid quote will include options to suit your pocket. Please ensure that the cover you select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to ask questions about the medical aid or hospital cover you choose.