KeyHealth Platinum 2026

What Platinum 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. Oncology unlimited. MRI/CT capped at R32,400/family (combined in/out-of-hospital, no stated co-payment). 2 PET scans/year up to R52,100/scan. Prosthetics/implants capped at R156,000/family. Sub-acute/hospice capped at R65,100/family (incl. R22,500 wound care). Psychiatric hospitalisation combined in/out-of-hospital capped at R73,100/family (out-of-hospital portion limited to R30,400). In-room procedures at 200% with R5,000 co-payment. Transplants unlimited via DSP.

Day-to-day

No simple MSA. Structured as a day-to-day allocation (R14,200 main / R13,775 adult / R3,370 child per year) followed by a Self-Funding Gap the member pays first (R4,970 / R4,420 / R1,630), then a Threshold zone with its own limits (R19,170 / R18,195 / R5,000, with separate sub-limits for prescribed medicine, physiotherapy and pathology at R18,550/family each).

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 R24,900/beneficiary, capped at R50,900/family/year — the richest non-PMB chronic benefit in the range.

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

The most comprehensive KeyHealth dental benefit: 2 check-ups/year, intraoral + extra-oral X-rays, 2 scale-and-polish/year, fillings, 1 set of plastic dentures every 4 years, 2 partial chrome-cobalt frames every 5 years, crowns/bridges (80%), implants (80%, capped at R5,700/year), orthodontics (80%, ages 9-18), periodontics (80%). In-hospital dental via DENIS pre-authorisation, R2,060 co-payment per admission.

Optical

Eye test included in the combined optical benefit; combined materials benefit R6,850 every 2 years for spectacles and/or contact lenses via Iso Leso Optics. Refractive surgery R26,080 once per lifetime, pre-authorisation compulsory. OTC reading glasses R270/year.

Mental health

Combined in- and out-of-hospital psychiatric benefit capped at R73,100/family; out-of-hospital treatment limited to R30,400 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 — the most comprehensive KeyHealth plan, but the Self-Funding Gap must be paid out-of-pocket by the member before Threshold benefits activate, which is the main real-world cost risk.

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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