Discovery KeyCare Start B medical aid: 2020

View all plans in this scheme.
Always consult with your broker before making final decisions regarding your healthcare cover.

KeyCare Start B
2020 Costs:
Total Cost pm:

Main member:

R1,538

Adult:

R1538

Child:

R601
Savings (per year):
  • No savings option on this plan
Income band:



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
IN HOSPITAL PROCEDURES:
KeyCare Start B
Scheme Benefits: Notes and Links:
non-Network Specialists:
network Specialists:
  • Full cover, for contracted specialists
non-Network GPs:
  • Up to 100% scheme rate
network GPs:
  • Full cover, for contracted specialists
Hospital Choice:
  • Full Cover Hospital Network: hospital account covered in full, if you use your chosen hospital
  • Partial Cover Hospital Network: no cover
  • Non-network hospital: no cover unless PMB, then 80% of scheme rate
  • Day procedures: KeyCare Start day surgery network
Penalty for using other hospital:
  • See above
  • n/a
Specialised Radiology:
Supplementary Services: (Physio, etc)
  • The Blue Plan gap cover will increase this to 500% scheme rate
Transplants:
Co-payments:
  • N/A
Alternatives to hospitals:
  • Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
  • Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
  • Terminal care: R44,050 per person, per lifetime
  • Cancer: Unlimited palliative care cover for approved care at home
Casualty:
    li>After hours care at your chosen GP or network provider
  • Both the Blue Plan and Red Plan gap cover will pay up to R10,000 per person for unpaid casualty costs in event of emergency
Other:
    Excluded unless PMB:
  • Dentistry
  • nail disorders
  • skin disorders
  • investigations
  • functional nasal surgery
  • elective caesarean section
  • reflux surgery
  • hiatus hernia
  • back and neck treatment or surgery
  • knee or shoulder surgery
  • joint replacements
  • endoscopic procedures
  • cochlear implants
  • bunions
  • varicose veins
  • refractive eye surgery
  • non cancerous breast conditions
Note:
  • Gap cover is an add-on to your medical aid, not a stand alone product
  • Gap cover has a maximum benefit payout of R165,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R165,000 limit)
  • Gap only supplements payment for procedures approved or authorised by your medical aid, and does not cover “penalties” (such as if, for example, you choose a non-DSP doctor for your procedure when the plan required a DSP doctor)



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme.
The gap benefits listed are for AskAdam gaps, unless otherwise stated. Actual benefits depend on gap choice option.

.
.
OUT OF HOSPITAL BENEFITS (non-PMB):
KeyCare Start B
Scheme Benefits Notes and Links:
Main Member: Adult: Child:
Savings /yr: No savings option on this plan
General info:
GP consultations:
  • Chosen network GP: Unlimited
  • Non-network GP: 2 consults per person
  • Consult includes selected blood tests and x-rays, as well as medicine
Childcare:
Specialists consultations:
  • 2 consults upto R2,200 per person, if referred by chosen GP
Pathology:
  • Some blood, urine and other fluid and tissue tests, as asked for by GP
General radiology:
  • Basic X-rays covered, if done at a network provider and asked for by the GP
Specialised radiology:
  • No benefit, unless PMB
Supplementary Services: (Physio, etc)
  • No benefit, unless PMB



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
MATERNITY BENEFITS:
KeyCare Start B
Scheme Benefits Notes and Links:
Hospital stay:
  • Up to 100% scheme rate
  • Elective caesareans: not covered
  • The Blue Plan gap cover will increase this to 500% scheme rate
Consultations:
    Discovery pays for:
  • 8 consults, paid by scheme
  • Nuchal translucency or Non-Invasive Prenatal Test, paid by scheme
  • Certain blood tests, paid by scheme
  • Five pre- or postnatal classes with registered nurse
  • One lactation consult
Scans:
    Discovery pays for:
  • 2 x ultrasound scans



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
CANCER (ONCOLOGY):
KeyCare Start B
Scheme Benefits Notes and Links:
Overall coverage (in and out of hospital):
  • PMBs only, in State Facilities



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
DENTISTRY:
KeyCare Start B
Scheme Benefits Notes and Links:
Standard Dentistry:
  • Standard dentistry: includes consults, fillings and tooth removals at dentist in network
Specialised Dentistry:
In-Hospital Dentistry:
Orthodontics:
Maxillo Facial Surgery:



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
MEDICATION:
KeyCare Start B
Scheme Benefits: Notes and Links:
Chronic:
  • Chronic medicine is covered in a State facility
Acute (presrcibed) medication:
  • Medicines that are on medicine list and are prescribed by Network GP are paid for by scheme
Over-the-counter:
  • No benefit
Birth Control:
  • No benefit
On Discharge:
  • No benefit
Biological:
  • No benefit, unless PMB level of care



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
OPTOMETRY:
KeyCare Start B
Scheme Benefits: Notes and Links:
Optometry:
Limit:Paid by scheme
Consult:1 per person
Frames:1 per person, incl lenses
Single lensessee above
Bifocals:
Multifocals
ContactsOption of contacts or glasses
Refractive Surgery:n/a
Notes:From network providers



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
MENTAL HEALTH:
KeyCare Start B
Scheme Benefits Notes and Links:
In-hospital:
  • Major affective disorders, anorexia and bulimia: 21 days for admissions or 15 out-of-hospital consultations
  • Acute stress disorder accompanied by recent significant trauma: 21 days for admissions or 12 out-of-hospital consultations
  • Other mental health admissions: 21 days in-hospital
  • Alcohol and drug rehab: 21 days in-hospital
  • All admissions are covered in full at a network facility, or at 80% scheme rate at a non-network facility
Out-of-hospital:
  • See above
Trauma:



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
OTHER BENEFITS:
KeyCare Start B
Scheme Benefits Notes and Links:
General Appliances:
  • No benefit
1.1. Hearing Aids:
  • No benefit
1.2. Wheelchairs:
  • No benefit
Dialysis:
  • State facilities
International Insurance:
Other:



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
WELLNESS/PREVENTATIVE BENEFITS:
KeyCare Start B
Scheme Benefits: Notes and Links:
Flu vaccination:
Pneumonia vaccines:
Biometric Screening:
Child Immunisation:
Pap Smear:
Mammogram:
PAS Test:
HIV Test:
Other:



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
PROSTHETICS:
KeyCare Start B
Scheme Benefits: Notes and Links:
Overal Limit:
  • Covered at network hospitals, subject to authorisation
Sub-limits:



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)

    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