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KeyHealth Medical Scheme

KeyHealth is an open scheme with a compact range of six plans: Essence, Origin, Silver, Equilibrium, Gold and Platinum. All six use the same designated hospital network, so the choice comes down to how much day-to-day and savings cover you want.

Plans: 6
From: R2 393
Up to: R13 840

Monthly premium for the main member, 2026.

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KeyHealth plans for 2026

Hospital only (3)

Covers you when you're admitted. Day-to-day costs are mostly yours.

Essence

Hospital onlyCheapest KeyHealth option

R2 393

per month, main member

Best for: Members wanting the cheapest possible unlimited private hospital cover, comfortable relying on PMBs for GP/specialist visits and with no day-to-day fund.

Hospitals: 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.
Day-to-day: None — no MSA or day-to-day Fund. Out-of-hospital GP/specialist consultations covered at PMB level of care only; pathology has no benefit except for PMB conditions.
Chronic meds: Category A (CDL) conditions unlimited, subject to reference pricing/protocols and compulsory registration on the Chronic Disease Risk Programme. No Category B (non-PMB) chronic cover on this plan.

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Origin

Hospital onlyEntry-level with a day-to-day Fund

R2 633

per month, main member

Best for: Budget members who still want a modest day-to-day Fund for GP/specialist visits alongside unlimited hospital cover.

Hospitals: 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.
Day-to-day: None — no MSA. A day-to-day Fund covers GP/specialist consultations, radiology, medicine and optical/auxiliary services: R3,425 (main member), R1,990 (adult dependant), R1,050 (child dependant) per year — a family benefit, so one member can use the full allocation.
Chronic meds: Category A (CDL) conditions unlimited, subject to reference pricing/protocols and compulsory Chronic Disease Risk Programme registration. Category B (non-PMB conditions): no benefit.

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Silver

Hospital onlyBiggest Fund-only allocation

R5 857

per month, main member

Best for: Families wanting the biggest day-to-day Fund KeyHealth offers without a real MSA — a step up from Equilibrium in Fund size without paying Gold's premium.

Hospitals: 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.
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 meds: 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.

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Hospital + savings (2)

Hospital cover plus a savings pot for GP visits, meds and more.

Equilibrium

Hospital + savingsBest real-MSA value

R3 296

per month, main member

Best for: Members wanting a real Medical Savings Account plus a separate day-to-day Fund at a mid-range premium, with somewhat richer dental (dentures, orthodontics) and chronic (2 extra conditions) cover than Origin.

Hospitals: 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.
Day-to-day: Real Annual Medical Savings Account (MSA): R2,880 (main member), R1,776 (adult dependant), R888 (child dependant, max 3) per year. Plus an additional day-to-day Fund on top: R3,755 / R2,585 / R1,150 per year for the same categories.
Chronic meds: Category A (CDL) unlimited, subject to reference pricing/protocols and compulsory Chronic Disease Risk Programme registration. Category B adds 4 non-PMB conditions: acne and ADHD/ADD (children up to age 21), rhinitis, and major depression (all beneficiaries).

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Gold

Hospital + savingsRich MSA + Fund combination

R8 675

per month, main member

Best for: Members wanting a substantial MSA and Fund combination with richer chronic, dental and optical benefits than Silver or Equilibrium, one step below Platinum.

Hospitals: 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.
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 meds: 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.

Hospital cover: 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.
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.
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.
Family pricing: Adult dependant R5 867 · Child R1 705

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Comprehensive (1)

The most cover: hospital, day-to-day and extras.

Platinum

ComprehensiveMost comprehensive KeyHealth plan

R13 840

per month, main member

Best for: Top-tier KeyHealth members wanting the highest hospital sub-limits (unlimited oncology, R156k prosthetics, unlimited transplants) and the richest out-of-hospital/dental/optical range, accepting a Self-Funding Gap structure instead of a simple MSA.

Hospitals: 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.
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 meds: 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.

Hospital cover: 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.
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.
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.
Family pricing: Adult dependant R9 704 · Child R2 924

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