Keyhealth Gold:
dentistry, optometry and wellness (2025)

This page has information on: Costs, Dentistry, Optometry, Wellness and Preventative and Other benefits for Keyhealth Gold

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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 Providers. Where stipulated, you must use 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.

Monthly Costs (2026)

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

Dentistry benefits (2025):

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

Keyhealth: Gold
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child: Savings: R9,156 R6,192 R1,800 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account R6,255 R4,655 R1,495 Other Day-to-Day Funds:
Standard Dentistry:	Consultations: 1 check up and 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:	In case of dental emergency (broken or knocked out tooth), scheme will cover costs to restore tooth to functional use Partial chrome cobalt frame dentures: 1 partial frame per person every 5 years Crowns and bridges: 2 crowns, with 30% co-payment for second crown Periodontics: Covered, with protocols Paid by scheme, at 80% scheme rate Implants: No benefit	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
In-Hospital Dentistry:	Wisdom teeth: R1,980 co-payment in-hospital. No co-payment if done in chair or day hospital. Children <5yrs: R1,980 co-payment in-hospital. No co-payment if done in chair or day hospital. Maxillo-facial surgery PAid by scheme, with protocols	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Orthodontics:	Paid by scheme at 80% scheme rate 9-18yrs only. Only one person per family may start per year

Optometry benefits (2025):

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

Keyhealth: Gold
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child: Savings: R9,156 R6,192 R1,800 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account R6,255 R4,655 R1,495 Other Day-to-Day Funds:
Optometry:	R3,950 per person, every 2 years From day-to-day benefit Frame: R1,260, from above limit Contact lenses: R1,870, from above limit Refractive Surgery: From above limit
Note:	This section does not apply to ophthalmology 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.

Wellness/Preventative benefits (2025):

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

Keyhealth: Gold
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 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 Keyhealth plans, with costs and brief summary. Find all other open medical aid plans here.

Other benefits for 2025:

Gold
International Insurance:	No benefit
Other:	.

Important!
• Unless specified, assume that all benefits 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.