• Benefits, in-hospital, Keyhealth Plan, out-hospital, Scheme Plans

Keyhealth Origin:
in-and-out of hospital benefits (2025)

Contents:

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

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)

Keyhealth:Origin (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R2,633
  • R1,876
  • R859
Savings:
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • R3,425
  • R1,990
  • R1,050
Children Rates:
  • Under 21yrs, unless student. Then, under 27yrs. Spouses/partners who are under 27 and full time students pay child rates.
  • Pay for all children

In-hospital Procedures (2025):

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

Keyhealth: Origin
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:
  • 100% scheme rate
Gap Cover:
Can push payout up to 700% scheme rate
(Plans coming soon)
Hospital Choice:
  • Choose any Netcare or Lifecare, and Mediclinic in Western Cape, Bloemfontein and Polokwane
Penalty for using other hospital:
  • Use of non-Network hospital: 30% penalty
 Gap Cover:
Can cover the penalty in full
(Plans coming soon)
Co-payments: . Note:
  • 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, especially if you don't use a DSP for a PMB or when buying medicine.
 Gap Cover:
Can cover most co-payments
(Plans coming soon)
Specialised Radiology:
  • MRI and CT Scans: R20,900 per family. In and out of hospital.
  • PET Scans: PMBs only
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Scopes:
  • Colonoscopy and gastroscopy: No co-payment if done in DSP hospital, or with DSP specialist out of hospital, or for PMB conditions
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Supplementary Services: (Physio, etc)
  • 100% scheme rate
Transplants:
  • PMBs only
Dialysis:
  • PMBs only
Exclusions:
  • Varicose vein surgery
  • Facet joint injections
  • rhizotomy
  • Reflux Surgery
  • Back and Neck surgery, incl spinal fusion
  • Joint replacement
  • NB: See scheme's rules for all exclusions. All schemes have plenty!
 Gap Cover:
Coming soon
Alternatives to hospitals:
  • Hospice, private nursing, rehab, step-down facilities and wound care: PMBs only
Casualty/ER:
  • PMBs only
Gap Cover:
Can cover ER claims
(Plans coming soon)
Other:
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

Out-of-hospital Procedures (2025):

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

Keyhealth: Origin
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.
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • R3,295
  • R1,915
  • R1,010
Other Day-to-Day Funds:
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:
  • From day-to-day benefit
Childcare:
  • Growth Assessments: 3 growth assessments, 0- 7yrs
  • Paediatrician: 2 consults 0-1yr, and 1 consult 1-2yrs
  • Immunisations: Up to 6yrs
  • Hearing test: Newborns
  • Eye test: 0-7yrs
 Gap Cover:
Can pay for child ER visits
(Plans coming soon)
Specialist consultations:
  • From day-to-day benefit
Pathology:
  • From day-to-day benefit
General radiology:
  • From day-to-day benefit
Specialised radiology:
  • MRI and CT Scans: R20,000 per family. In and out of hospital.
  • PET scans: No benefit
 Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
Scopes:
  • Colonoscopy and gastroscopy: No co-payment if done in DSP hospital, or with DSP specialist out of hospital, or for PMB conditions
 Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
Supplementary Services: (Physio, etc)
  • From day-to-day benefit
General Appliances:
  • Wheelchairs, orthopaedic appliances, incontinence equipment, contraceptive devices: R9,200 per family, in and out of hospital.
1.1. Hearing Aids:
  • No benefit
1.2. Wheelchairs:
  • See "General Appliances" limit
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

Medication Benefit (2025):

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

Keyhealth: Origin
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.
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • R3,295
  • R1,915
  • R1,010
Other Day-to-Day Funds:
Chronic: .
Acute (prescribed) medication:
  • From day-to-day benefit
Over-the-counter:
  • From day-to-day benefit
Birth Control:
  • Contraceptive device: From "Appliances" benefit, R9,200 per family
  • Tablets: R185 every 20 days
  • Injectables : R285 every 72 days
On Discharge:
  • R670 per admission
Biological:
  • PMBs only
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

More Information