KeyHealth Silver 2026

What Silver 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. Varicose vein and reflux surgery at PMB level of care only. Oncology capped at R230,500/family/year. MRI/CT capped at R22,800/family with a R1,710 co-payment per scan. Prosthetics/implants capped at R8,350/family. Sub-acute/hospice/step-down care capped at R39,100/family (incl. R12,500 wound care). In-room procedures covered at 150% with a R5,000 co-payment per admission. Medication on discharge R695/admission.

Day-to-day

None — no MSA. A larger day-to-day Fund covers GP/specialist consultations, radiology, medicine and optical/auxiliary services: R9,665 (main member), R7,025 (adult dependant), R1,955 (child dependant) per year, plus 3 extra GP consultations/year per child dependant (up to age 21) once the Fund is depleted.

Chronic medication

Category A (CDL) unlimited, subject to reference pricing/protocols and compulsory Chronic Disease Risk Programme registration. Category B adds the same 4 non-PMB conditions as Equilibrium: acne, ADHD/ADD (children to 21), rhinitis, major depression.

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

Full day-to-day dental via DENIS/Fund: 1 check-up/year, intraoral X-rays, 1 extra-oral X-ray/3 years, scale-and-polish, fillings, 1 set of plastic dentures every 4 years, orthodontics (non-cosmetic, ages 9-18, 80%). In-hospital dental via DENIS pre-authorisation, R2,060 co-payment per admission.

Optical

Eye test/consultation R600 every 2 years; combined materials benefit R2,050 every 2 years for spectacles or contact lenses via Iso Leso Optics. No refractive surgery benefit. OTC reading glasses R160/year (within a R2,170/year OTC medicine sub-limit).

Mental health

Psychiatric hospitalisation limited to R26,100/family (in-hospital benefit only); out-of-hospital psychiatric treatment at PMB level of care only.

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 largest Fund-only allocation in the range reduces but doesn't eliminate specialist shortfall risk, since there's still no real MSA.

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

Similar plans to compare

Other hospital only plans close to R5 857 a month.

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