Keyhealth Platinum: dentistry, optometry and wellness (2024)

Monthly Costs:

Platinum 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R11,308	R7,929	R2,388 Pay for all children
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	R13,065	R12,675	R3,100
Self Payment Gap: (What you need to pay out of pocket before you can access the "Above Threshold" benefit)	R4,575	R4,070	R1,500
"Above Threshold" benefit (ATB): Additional cover the scheme makes available to you, once you've paid* the self payment gap.*	Unlimited	Unlimited	Unlimited
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
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: Platinum
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:	Consultations:2 check-ups, per person Extra-oral x-ray: 1 per person, every 3 years Fillings: Covered Plastic dentures: 1 set per person, every 4 years Above paid by scheme, otherwise From day-to-day benefit
Specialised Dentistry:	Partial chrome cobalt frame dentures: 2 partial frame per person every 5 years Crowns and bridges: 1 per tooth, every 5 years Implants: R4,700 per person Periodontics: Covered, with protocols
In-Hospital Dentistry:	Limited to children under 5yrs and removal of impacted teeth	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:	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: Platinum
Assume scheme pays all these costs, unless otherwise stated
Optometry:	R1,890 per person, every 2 years From day-to-day benefit Frame: R630, from above limit Contact lenses: R845, from above limit Refractive Surgery: No 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: Platinum
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:

Platinum
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

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Keyhealth Platinum: 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)

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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)