KeyHealth Gold 2026

What Gold covers

Hospitals you can use

KeyHealth DSP network — Netcare and Life Healthcare hospitals nationally, plus selected Mediclinic hospitals in Western Cape, Bloemfontein and Polokwane. Same shared network across all 6 KeyHealth plans, confirmed directly from the official 2026 brochures.

In hospital

Unlimited private hospital cover at 100% of agreed tariff via DSP hospital (30% co-payment at non-DSP hospital); state hospitals unlimited. No procedures restricted to PMB-only level (full cover for varicose vein/reflux surgery etc. at this tier). Oncology capped at R527,000/family/year. MRI/CT capped at R22,900/family with R1,710 co-payment per scan; 2 PET scans/year up to R52,100/scan. Prosthetics/implants capped at R61,400/family. Sub-acute/hospice capped at R52,900/family (incl. R17,400 wound care). Psychiatric hospitalisation combined in/out-of-hospital, capped at R52,900/family (out-of-hospital portion limited to R21,700). In-room procedures at 175% with R5,000 co-payment.

Day-to-day

Real Annual Medical Savings Account (MSA): R9,156 (main member), R6,192 (adult dependant), R1,800 (child dependant) per year. Plus an additional day-to-day Fund: R6,255 / R4,655 / R1,495 per year.

Chronic medication

Category A (CDL) unlimited, subject to reference pricing/protocols and compulsory Chronic Disease Risk Programme registration. Category B (non-PMB conditions) covered up to R11,200/family/year.

Maternity

12 antenatal visits + dipstick urine test, subject to Health Booster benefits; 2 pregnancy ultrasounds; short-payments/birthing fees R1,570/pregnancy; antenatal vitamins R2,650/pregnancy; antenatal classes R2,650 (first pregnancy); RSV vaccine once per pregnancy; private ward for 3 days for natural birth. Smart Baby Programme support included.

Dental

Richer day-to-day dental via DENIS/MSA: 2 check-ups/year, intraoral + extra-oral X-rays, 2 scale-and-polish/year, fillings, 1 set of plastic dentures every 4 years, partial chrome-cobalt frame dentures (80%), crowns/bridges (80%, max 2/tooth every 5 years, 30% co-payment on the 2nd crown), orthodontics (80%, ages 9-18), periodontics (80%, root planing only). No implants benefit. In-hospital dental via DENIS pre-authorisation, R2,060 co-payment per admission.

Optical

Eye test included in the combined optical benefit (subject to MSA/Fund); combined materials benefit R4,100 every 2 years for spectacles and/or contact lenses via Iso Leso Optics. Refractive surgery available, pre-authorisation compulsory, subject to the overall optical benefit. OTC reading glasses R245/year.

Mental health

Combined in- and out-of-hospital psychiatric benefit capped at R52,900/family; out-of-hospital treatment specifically limited to R21,700 within that. Pre-authorisation compulsory.

PMBs (prescribed minimum benefits)

Full PMB cover (legally required)

Emergencies

Covered at any hospital (PMB); ambulance services unlimited via Netcare 911 (082 911), subject to protocols.

Gap cover

Optional — a generous MSA plus Fund combination covers most routine and specialist costs; mainly useful for elective/cosmetic exclusions and above-tariff specialist rates.

Summarised from KeyHealth's official 2026 brochure. Always confirm the details with the scheme or an accredited broker before you join.

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Other hospital + savings plans close to R8 675 a month.

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