Keyhealth Platinum: prosthetic benefits (2024)

This page: Costs | Prosthetics Keyhealth Platinum We also show benefits for: In-hospital | Out of hospital | Medicine | Dentistry | Optometry | Maternity | Cancer | Mental Health | Other/Extra Benefits | Wellness and Preventative Find all the open medical aid plans here. Compare any two plans side by side, instantly. 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 . . . Prosthetics benefits (2024): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Keyhealth: Platinum Overal Limit: Prosthetics / prosthesis Internal, external, fixation devices and implanted devices: Unlimited, subject to protocols Prosthetics required for PMB conditions are always paid paid in full by scheme, with no co-payment, if you follow the protocols. More info here Sub-limits: . Note: PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs 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 .

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Always consult with your broker before making final decisions regarding your healthcare cover.

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