Keyhealth Equilibrium: dentistry, optometry and wellness (2024)

Monthly Costs:

Equilibrium 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R2,778	R1,716	R854 Only pay for 3 children
Savings:	R2,424	R1,500	R744
Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account	R3,455	R2,380	R1,055
Children Rates:	Under 21yrs, unless student. Then, under 27yrs. Spouses/partners who are under 27 and full time students pay child rates. Only pay for 3 children
Note:	Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list. All treatments and procedures are subject to authorisation and protocols All benefits are listed as an indication only. Please verify with your broker and scheme
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Keyhealth plans, with costs and brief summary
.

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Dentistry benefits (2024):

Keyhealth: Equilibrium
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:	Consultations::1 check up + 3 emergencies, per person Extra-oral x-ray: 1 per person, every 3 years Fillings, tooth extractions, root canals: Covered Plastic dentures: 1 set per person, every 4 years Above paid by scheme, otherwise From day-to-day benefit
Specialised Dentistry:	Wisdom teeth: Covered, in chair
In-Hospital Dentistry:	Wisdom teeth: R1,890 co-payment, unless in day hospital Childen <5yrs: R1,890 co-payment, unless in day hospital	PMBs are always covered by the scheme, and cannot have sublimits or co-payments imposed. These include fracture of face bones, orbit and/or jaw. You can see a full list of maxillo facial PMB benefits here.
Orthodontics:	80% scheme rate 9-18yrs only. Only one person per family may start per year
Note:	PMBs: Prescribed Minimum Benfits. To read more about PMBs click here DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit. Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Keyhealth plans, with costs and brief summary
.

Optometry benefits (2024):

Keyhealth: Equilibrium
Assume scheme pays all these costs, unless otherwise stated
Optometry:	R1,425 per person, every 2 years From day-to-day benefit
Note:	This section does not apply to opthamology benefits, which fall under "in-hospital" benefits. Some of those are PMBs, and are paid for in full by your scheme. You can read more about PMBs here.
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Keyhealth plans, with costs and brief summary
.

Wellness/Preventative benefits (2024):

Keyhealth: Equilibrium
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:	Covered
Pneumonia vaccines:	Covered
Biometric Screening:	Covered
Child Immunisation:	Covered , up to 6yrs
Pap Smear:	1 per year, females 15yrs+
Mammogram:	1 per year, females 40yrs+
PAS Test:	1 per year, males 40yrs+
HIV Test:	1 per year
Other:	Tetanus injection: Covered as required Malaria medication: R440 Colon screening
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Keyhealth plans, with costs and brief summary
.

Other benefits for 2024:

Equilibrium
International Insurance:	No benefit
Other:	.
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Keyhealth plans, with costs and brief summary
.

Important!

Unless specified, assume that all benefits are paid are paid at 100% scheme rate
No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
"Unlimited" benefits are still subject to authorisation, protocols and sublimits
Assume that all benefits need to be pre-authorised

All the medical aid jargon explained (2024)

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How do I make a medical aid plan change (2024)?

A quick guide to how you can change your medical aid plan, including the resignation procedure, and things to look out for, such as imposed waiting periods from your new scheme

Medical Aid waiting periods: what you need to know (2024)

Waiting periods can prevent you from getting the cover that you need – but they are not always applied. Find out rules here.

Keyhealth Equilibrium: dentistry, optometry and wellness (2024)

Monthly Costs:

Dentistry benefits (2024):

Optometry benefits (2024):

Wellness/Preventative benefits (2024):

Other benefits for 2024:

All the medical aid jargon explained (2024)

How do I make a medical aid plan change (2024)?

Medical Aid waiting periods: what you need to know (2024)

Also see these:

Sizwe Value Core:
cancer, maternity and mental health (2024)

Sizwe Value Core:
prosthetic benefits (2024)

Sizwe Value Core:
in-and-out of hospital benefits (2024)

Sizwe Value Core:
dentistry, optometry and wellness (2024)

Sizwe Silver Hospital:
prosthetic benefits (2024)