Keyhealth Platinum medical aid plan: 2019

View all plans in this scheme.
Please note that these benefits are still being updated as more information is made available to us. Always consult with your broker before making final decisions regarding your healthcare cover.

Platinum
2018 Costs:
Total Cost pm:

Main member:

R7,408

Adult:

R5,193

Child: (Pay for all)

R1,562
Savings Account:
  • No savings option on this plan
Extended Fund: R9,660 R9,370 R2,290
Self Payment Gap:
R3,380 R3,010 R1,110
Above Threshold:
  • Once your savings are depleted, and you have paid the self payment gap, scheme will cover most out of hospital expenses at scheme rate, with sublimits for some benefits.
2019 Costs:
Total Cost pm:

Main member:

R8,112
(9.50%)

Adult:

R5,687

Child: (Pay for all)

R1,711
Savings (per year):
  • No savings option on this plan
Extended Fund: R10,180 R9,875 R2,415
Self Payment Gap:
R3,565 R3,175 R1,170
Need help?
NEW! Are you on this plan?

We can help you determine whether this is still the best plan for you, and offer you some options to consider, if applicable. This is a free, online and personalised service, available to members who do not have a broker. Please click here to start.
In brief (2018): See full benefits below

IN HOSPITAL PROCEDURES:
Platinum
Scheme Benefits: Gap Benefits:
Specialists: 2019 Benefits coming soon! 2019 Benefits coming soon!
Hospital Choice: 2019 Benefits coming soon! 2019 Benefits coming soon!
Specialised Radiology:
  • MRI and CT scans: R22,000 per family with R1,480 co-payment, in and out of hospital
  • PET scans: 2 per person. Maximum R16,300 per scan
  • Co-payment paid
  • Sublimit increased as necessary, for approved procedures
  • No benefit for exclusions
Supplementary Services: (Physio, etc) 2019 Benefits coming soon! 2019 Benefits coming soon!
Transplants: 2019 Benefits coming soon! 2019 Benefits coming soon!
Co-payments: 2019 Benefits coming soon! 2019 Benefits coming soon!
Alternatives to hospitals: 2019 Benefits coming soon! 2019 Benefits coming soon!
Casualty: 2019 Benefits coming soon! 2019 Benefits coming soon!
Other: 2019 Benefits coming soon! 2019 Benefits coming soon!
Note:
  • Gap cover is an add-on to your medical aid, not a stand alone product
  • Gap cover has a maximum benefit payout of R150,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R150,000 limit)
  • Gap only supplements payment for procedures approved or authorised by your medical aid, and does not cover “penalties” (such as if, for example, you choose a non-DSP doctor for your procedure when the plan required a DSP doctor)
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme.
The gap benefits listed are for AskAdam gaps, unless otherwise stated. Actual benefits depend on gap choice option.

.
.
.
.
OUT OF HOSPITAL BENEFITS (non-PMB):
Platinum
Scheme Benefits Gap benefits
Main: Adult: Child:
Savings /yr: No savings option on this plan
Extended Fund: R9,660 R9,370 R2,290
Self Payment:
(per year, if you use up all your savings)
R3,380 R3,010 R1,110
Above Threshold: Once your savings are depleted, and you have paid the self payment gap, scheme will cover most out of hospital expenses at scheme rate, with sublimits for some benefits.
General info: 2019 Benefits coming soon! 2019 Benefits coming soon!
GP consultations: 2019 Benefits coming soon! 2019 Benefits coming soon!
Childcare: 2019 Benefits coming soon!
  • No extra benefit available
Specialists consultations: 2019 Benefits coming soon! 2019 Benefits coming soon!
Pathology: 2019 Benefits coming soon! 2019 Benefits coming soon!
General radiology: 2019 Benefits coming soon! 2019 Benefits coming soon!
Specialised radiology: 2019 Benefits coming soon! 2019 Benefits coming soon!
Supplementary Services: (Physio, etc) 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
MATERNITY BENEFITS:
Platinum
Scheme Benefits Gap benefits
Hospital stay: 2019 Benefits coming soon! 2019 Benefits coming soon!
Consultations: 2019 Benefits coming soon! 2019 Benefits coming soon!
Scans: 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
CANCER (ONCOLOGY):
Platinum
Scheme Benefits Gap benefits
Overall coverage (in and out of hospital): 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
DENTISTRY:
Platinum
Scheme Benefits Gap benefits
Standard Dentistry: 2019 Benefits coming soon!
Specialised Dentistry: 2019 Benefits coming soon! 2019 Benefits coming soon!
In-Hospital Dentistry: 2019 Benefits coming soon!
Orthodontics: 2019 Benefits coming soon!
Maxillo Facial Surgery: 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
MEDICATION:
Platinum
Scheme Benefits Gap benefits
Chronic: 2019 Benefits coming soon! 2019 Benefits coming soon!
Acute (presrcibed) medication: 2019 Benefits coming soon! 2019 Benefits coming soon!
Over-the-counter: 2019 Benefits coming soon! 2019 Benefits coming soon!
Birth Control: 2019 Benefits coming soon! 2019 Benefits coming soon!
On Discharge: 2019 Benefits coming soon! 2019 Benefits coming soon!
Biological: 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
OPTOMETRY:
Platinum
Scheme Benefits Gap benefits
Optometry: 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
MENTAL HEALTH:
Platinum
Scheme Benefits Gap benefits
In-hospital: 2019 Benefits coming soon! 2019 Benefits coming soon!
Out-of-hospital: 2019 Benefits coming soon! 2019 Benefits coming soon!
Trauma: 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
OTHER BENEFITS:
Platinum
Scheme Benefits Gap benefits
General Appliances: 2019 Benefits coming soon!
  • No benefit
1.1. Hearing Aids: 2019 Benefits coming soon!
  • No benefit
1.2. Wheelchairs: 2019 Benefits coming soon!
  • No benefit
Dialysis: 2019 Benefits coming soon! 2019 Benefits coming soon!
HIV: 2019 Benefits coming soon!
  • No benefit
Emergency Transport: 2019 Benefits coming soon!
  • No benefit
International Insurance: 2019 Benefits coming soon!
  • No benefit
Other: 2019 Benefits coming soon! 2019 Benefits coming soon!
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
WELLNESS/PREVENTATIVE BENEFITS:
Platinum
Scheme Benefits Gap benefits
Flu vaccination: 2019 Benefits coming soon!
  • No benefit
Pneumonia vaccines: 2019 Benefits coming soon!
  • No benefit
Back Rehabilitation Programme: 2019 Benefits coming soon!
  • No benefit
Biometric Screening: 2019 Benefits coming soon!
  • No benefit
Child Immunisation: 2019 Benefits coming soon!
  • No benefit
Pap Smear: 2019 Benefits coming soon!
  • No benefit
Mammogram: 2019 Benefits coming soon!
  • No benefit
PAS Test: 2019 Benefits coming soon!
  • No benefit
HIV Test: 2019 Benefits coming soon!
  • No benefit
Other: 2019 Benefits coming soon!
  • No benefit
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.
.
.
PROSTHETICS:
Platinum
Scheme Benefits Gap benefits
Overal Limit: 2019 Benefits coming soon!
  • Sublimit increased by up to R150,000 per person
  • No benefit for procedures excluded by medical aid
Sub-limits: 2019 Benefits coming soon!
  • Sublimit increased by up to R150,000 per person
  • No benefit for procedures excluded by medical aid
We will email you a quote for this and two other comparable plans. FREE.
We can help you with unpaid claims, finding a gap, general advice, plan changes, cheaper options and more. FREE.

    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