Discovery Keycare Start Regional B:
in-and-out of hospital benefits (2025)

This page has overview information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Discovery KeyCare Start Regional B. Please consult and verify with the scheme or your broker for full benefits, and an explanation of all the "fine print".

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Terminology:

• PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
• 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
• All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

In-hospital Procedures (2026):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Discovery: KeyCare Start Regional B
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:	network Doctors: paid in full	Gap Cover: Can push payout up to 700% scheme rate (Plans coming soon)
Hospital Choice:	Chosen KeyCare Start Regional Network hospital: Covered in full Otherwise, no cover unless emergency Day procedures: KeyCare Start Regional Day Surgery Network
Penalty for using other hospital:	See above	Gap Cover: Can cover the penalty in full (Plans coming soon)
Co-payments:	Admission that meet criteria for home-based care: R5,250 co-payment Note: A co-payment is a fee your medical aid can insist you pay, regardless of how much the doctor/charges. It's not the same as an "excess" payment (which is when a doctor charges more than the medical aid rate). If you use a DSP (designated service provider), you never have to pay a co-payment for protocol treatment of a PMB (Prescribed Minimum Benefit). More info here There might be other co-payments if you don't use a DSP, especially if you are being treated for a PMB or when buying medicine.	Gap Cover: Can cover most co-payments (Plans coming soon)
Specialised Radiology:	MRI and CT scans, Part of approved admission: Covered by scheme MRI and CT scans, Not part of approved admission: R2,850, from specialist benefit	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Scopes:	PMBs only	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Supplementary Services: (Physio, etc)	Covered in full
Transplants:	Covered
Dialysis:	Covered in State facilities
Exclusions:	Hospital admissions related to, among others: Dentistry Nail disorders Skin disorders, including benign growths and lipomas Investigations Functional nasal surgery Elective C section Surgery for oesophageal reflux and hiatus hernia Back and neck treatment or surgery Knee and shoulder surgery Arthroscopy Joint replacements, including but not limited to hips, knees, shoulders and elbows Cochlear implants, auditory brain implants and internal nerve stimulators (this includes procedures, devices, processors and hearing aids) Healthcare services that should be done out of hospital and for which an admission to hospital is not necessary Endoscopic procedures Also: Correction of hallux valgus (bunion) and Tailor’s bunion (bunionette) Removal of varicose veins Refractive eye surgery Non-cancerous breast conditions Tonsillectomies, myringotomies and adenoidectomies NB: See scheme's rules for all exclusions. All schemes have plenty!	Gap Cover: Coming soon
Alternatives to hospitals:	Palliative care at home: Unlimited, as approved Physical and virtual 24-hour care for services such as postnatal care, end-of-life care, IV infusions (drips), COVID-19 and wound care. Home monitoring device: up to R4,500 per person
Casualty/ER:	After hours care at your chosen GP or network provider	Gap Cover: Can cover ER claims (Plans coming soon)
Other:	Available in these locations: Tzaneen, Limpopo Polokwane, Limpopo Mbombela, Mpumalanga Trichardt, Mpumalanga Pretoria, Gauteng Johannesburg Central, Gauteng Bellville, Western Cape George, Western Cape Also: International Second Opinion for life-threatening and life-changing condition: members can obtain second opinion from Cleveland Clinic, with a 25% co-payment
PMBs= Prescribed Minimum Benefits (more info) | DSP= Designated Service Provider

Out-of-hospital Procedures (2026):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Discovery: KeyCare Start Regional B
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
Main Member: Adult: Child: Savings (per year): No savings account option on this plan The scheme might still cover some or all day-to-day claims. See below, and see benefits. Other Day-to-Day Funds: Discovery awards you with money if you complete personalised health and lifestyle actions You need to activate the benefit on the app, and fulfill the personalised pathways These can be things like: get a mammogram, complete a dental checkup etc Personal Health Fund: Up to R500 per adult and R250 for child. Maximum R1,000 per family. Personal Health Fund Boost: Up to an additional R250 per adult, per completed challenge. Maximum 2 challenges per adult, and R1,000 per family. Challenges take 5-10 weeks to complete, and are meant to build habits. The fund money can be used for most out-of-hospital claims
PMBs out of hospital:	All schemes must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here. This can include consults with specialists, blood or other tests, radiology and medicine PMB benefits must never be paid from your savings account Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here. See our Guide to PMBs for more information.
GP consultations:	Chosen KeyCare Network GP: Unlimited. Must be referred through KeyCare Online Practice Consult includes selected blood tests and x-rays, as well as medicine Virtual Urgent Care: 1 session per family, paid by scheme
Childcare:	GP/Paediatrician/ENT consults: 2 consults, for children 0-2yrs. Paid by scheme. Child assessment: height, weight, head circumference and health and milestone tracking	Gap Cover: Can pay for child ER visits (Plans coming soon)
Specialists consultations:	Two consults up to R2,850 per person, if referred by chosen GP Shared with out-of-hospital specialised radiology benefit
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:	R2,850 per person, if referred by chosen GP Shared with specialist benefit	Gap Cover: Can pay co-payments and increase sublimits (Plans coming soon)
Scopes:	PMBs only	Gap Cover: Can pay co-payments and increase sublimits (Plans coming soon)
Supplementary Services: (Physio, etc)	PMBs only
General Appliances:	No benefit
1.1. Hearing Aids:	No benefit
1.2. Wheelchairs:	No benefit
PMBs= Prescribed Minimum Benefits (more info) | DSP= Designated Service Provider

Medication Benefit (2026):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Discovery: KeyCare Start Regional B
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child: Savings (per year): No savings account option on this plan The scheme might still cover some or all day-to-day claims. See below, and see benefits. Other Day-to-Day Funds: Discovery awards you with money if you complete personalised health and lifestyle actions You need to activate the benefit on the app, and fulfill the personalised pathways These can be things like: get a mammogram, complete a dental checkup etc Personal Health Fund: Up to R500 per adult and R250 for child. Maximum R1,000 per family. Personal Health Fund Boost: Up to an additional R250 per adult, per completed challenge. Maximum 2 challenges per adult, and R1,000 per family. Challenges take 5-10 weeks to complete, and are meant to build habits. The fund money can be used for most out-of-hospital claims
Chronic:	27 PMB conditions: Covered. You can see the full PMB list here. .
Acute (prescribed) 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:	PMBs only
View other benefits for this plan: In-hospital | 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 Discovery plans, with costs and brief summary. Find all other open medical aid plans here.
PMBs= Prescribed Minimum Benefits (more info) | DSP= Designated Service Provider