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Overall, the KeyHealth Origin Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and alternatives to hospitalization to up to 3 Family Members. The KeyHealth Origin Medical Aid Plan starts from R2,250 ZAR.
👤 Main Member Contribution | R2,250 |
👥 Adult Dependent Contribution | R1,603 |
🍼 Child Dependent Contribution | R733 |
🌎 International Cover | ☑️ Yes |
🔁 Gap Cover | ☑️ Yes |
⚕️ Hospital Cover | Unlimited |
📉 Prescribed Minimum Benefits | ☑️ Yes |
💙 Screening and Prevention | ☑️ Yes |
💳 Medical Savings Account | None |
👶 Maternity Benefits | ☑️ Yes |
The KeyHealth Origin medical aid plan is one of 6 plans, starting from R2,250 and includes endoscopic procedures, specialized dentistry, alternatives to hospitalization, renal dialysis, radiology, pathology, and more. Gap Cover is available on the KeyHealth Origin Plan, along with 24/7 medical emergency assistance. According to the Trust Index, KeyHealth has a trust rating of 4.1.
KeyHealth offers 6 medical aid plans:
👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
R2,250 | R1,603 | R733 |
📌 Hospitalization Varicose vein surgery Facet joint injections Rhizotomy Reflux surgery Back and neck surgery (incl. spinal fusion) Joint replacement | Only PMB. Hysterectomies are covered by up to 100% of the agreed tariff. |
🏥 Private Hospital Admissions | Unlimited cover. Covered up to 100% of the agreed tariff. Subject to using DSP hospitals. A 30% co-payment will apply when using a non-DSP hospital. |
🚑 State Hospital Admissions | Unlimited covers up to 100% of the agreed tariff. |
⚕️ Specialist and Anesthetist Services | Covered up to 100% of the medical scheme tariff. Unlimited cover, subject to using a DSP. |
💊 Medication upon discharge | Covered up to 100% of the medical scheme tariff. Limited to R575 per admission. |
🍼 Maternity | Covered up to 100% of the medical scheme tariff. Private ward access for three days for natural birth. |
🩹 Sub-acute facilities and wound care Hospice Private Nursing Rehabilitation Step-down Facilities Wound Care | Covered up to 100% of the medical scheme tariff. Pre-approval is needed. Subject to case management and scheme protocols. Only PMBs are covered. |
❤️ Organ Transplants (Solid Organs, Tissue, and Corneas) Hospitalization Harvesting Drugs for Immuno-Suppressive Therapy | Covered up to 100% of the medical scheme tariff. Pre-approval is needed. Subject to case management. Only PMBs are covered in DSP hospitals. |
📈 Renal Dialysis | Covered up to 100% of the medical scheme tariff. Pre-approval is needed. Subject to case management and scheme protocols. Only PMBs are covered. |
📉 Oncology | Covered up to 100% of the medical scheme tariff. Covered up to R180,000 per family per year. Pre-approval is needed. Subject to case management and scheme protocols. Must use a DSP for treatment. |
📊 Palliative Care | Covered up to 100% of the medical scheme tariff. Available instead of hospitalization. Pre-approval is needed. Subject to case management and scheme protocols. |
📈 Radiology | Covered up to 100% of the medical scheme tariff. Pre-approval is needed for specialized radiology (MRI, CT) Hospitalization is not covered if hospitalization admission is for investigative purposes. Day-to-day benefits cover investigative admissions. |
⚙️ MRI and CT scans | Limited to R17,800 per family per year. Combined in and out-of-hospital cover. |
❎ X-Rays | Unlimited cover. |
➡️ Pathology | Covered up to 100% of the medical scheme tariff. Unlimited cover. Not covered if admission is for investigative purposes. |
📌 Routine Medical Expenses GP and Specialist Consultations Radiology Prescribed and OTC medicine Optical and Auxiliary services | Covered up to 100% of the medical scheme tariff. Limited to the following: Main Member – R2,815 per year Adult Dependent – R1,640 per year Child Dependent – R865 per year |
💊 Over-the-counter medicine | Covered up to 100% of the medical scheme tariff. Subject to the day-to-day benefit and limit. |
👓 Over-the-counter reading glasses | Limited to R120 per family per year. Limited to one pair per year. Subject to the day-to-day benefit and limit. |
📈 Pathology | Covered up to 100% of the medical scheme tariff. Subject to the day-to-day benefit and limit. |
🤓 Optical Services | Covered up to 100% of the medical scheme tariff. Subject to the day-to-day benefit and limit. |
🔎 Frames | Subject to the day-to-day benefit and limit. |
🔍 Lenses | Subject to the day-to-day benefit and limit. |
🦷 Contact Lenses | Subject to the day-to-day benefit and limit. |
🪥 Conservative Dentistry | Subject to the day-to-day benefit and limit. Scheme rules and protocols will apply. |
➡️ Consultations | Covered up to 100% of the medical scheme tariff. One check-up per beneficiary per year. Three specific (emergency) consultations per beneficiary per year. |
❎ Intra-oral X-Rays | Covered up to 100% of the medical scheme tariff. Four intra-oral radiographs per beneficiary per year. |
📍 Extra-oral X-Rays | Covered up to 100% of the medical scheme tariff. One extra-oral x-ray per beneficiary per year. |
😷 Preventative Care | Covered up to 100% of the medical scheme tariff. One scale and polish treatment per beneficiary per year. |
🩺 Fillings | Covered up to 100% of the medical scheme tariff. One per tooth every 720 days. Multiple fillings require a treatment plan and X-rays. Retreatment is subject to clinical protocols. |
🔁 Tooth Extractions | Covered up to 100% of the medical scheme tariff. Subject to the day-to-day benefit and limit. |
😊 Maxillo-Facial and Oral Surgery | DENIS protocols and Scheme rules apply. |
➡️ Surgery in Dental Chair | DENIS pre-authorization is required. Only covers the removal of impacted teeth. |
💤 Surgery in-hospital with general anesthesia | DENIS pre-authorization is required. Only covers the removal of impacted teeth. |
😴 Hospitalization and Anaesthesia | DENIS protocols and Scheme rules apply. |
🅰️ Hospitalization and general anesthesia | DENIS pre-authorization is required. Only covers the removal of impacted teeth. |
🅱️ Inhalation sedation in dental rooms | DENIS pre-authorization is required. Only covers the removal of impacted teeth. |
📌 Moderate/deep sedation in dental rooms | DENIS pre-authorization is required. Only covers the removal of impacted teeth. |
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🅰️ Category A CDL | Covered up to 100% of the medical scheme tariff. Unlimited cover. Subject to reference pricing and protocols. Beneficiaries must register on the Disease Risk Program. |
Origin Plan falls within Category A of the CDL of KeyHealth and covers a selection of conditions, including:
🧠 Psychiatric Treatment | Covered up to 100% of the medical scheme tariff. Limited to R21,500 per family per year. Pre-approval is required. Subject to case management. Out-of-hospital is only covered for PMB. |
🩸 Blood Transfusions | Covered up to 100% of the medical scheme tariff. Unlimited cover. Pre-approval required. |
🦾 Prostheses Internal External Fixation Devices Implanted Devices | Covered up to 100% of the medical scheme tariff. Only PMBs are covered. Pre-approval is required, and it is subject to case management. Covered according to reference pricing. Scheme protocols will apply, and beneficiaries must use a preferred provider. |
⚕️ Document-Based Care (DBC) for back and neck | Covered up to 100% of the medical scheme tariff. Covers conservative back and neck treatment instead of surgery. Requires pre-authorization and will be subject to case management and scheme protocols. Only approved DBC facilities can be used. Only PMBs are covered. |
📌 HIV/AIDS | Covered up to 100% of the medical scheme tariff. Unlimited cover. Must be registered with the Chronic Disease Risk Program (LifeSense) |
🚑 Ambulance Services | Covered up to 100% of the medical scheme tariff. Subject to protocols. |
👩🏻🦼 Wheelchairs Orthopaedic Appliances Incontinence Equipment | Covered up to 100% of the medical scheme tariff. Limited to R7,900 per family per year. Combined benefits for in and out-of-hospital. Subject to quantities and protocols. |
🫁 Oxygen Nebulizers Glucometer Blood Pressure Monitor | Pre-approval is required and will be subject to approval. |
🩺 Colonoscopy or gastroscopy | Covered up to 100% of the medical scheme tariff. Pre-approval is required. Co-payments do not apply when using a DSP hospital and specialist for out-of-hospital services for PMB. |
✅ All other procedures | Covered up to 100% of the medical scheme tariff. Pre-approval is required. Co-payments do not apply when using a DSP hospital and specialist for out-of-hospital services for PMB. |
The KeyHealth health booster provides members additional benefits for preventative treatment. This includes free screening tests, among several other features, as seen in the benefits table below.
🍼 Baby Immunisation | Child dependents <6 years. According to the Department of Health schedule. |
💉 Flu Vaccination | All beneficiaries are covered. |
😷 COVID-19 Vaccination | All beneficiaries are covered. |
📌 Tetanus-Diphtheria Injection | All beneficiaries are covered when needed. |
📍 Pneumococcal Vaccination | All beneficiaries are covered. |
🦟 Malaria Medication | All beneficiaries are covered. Limited to R440 per year. |
☑️ HPV vaccination | Two doses per lifetime for female beneficiaries between 9 and 14. |
✅ Baby Growth Assessment | Three yearly assessments at a pharmacy or baby clinic for babies <35 months. |
🩹 Contraceptive Medication – Tablets and Patches | Limited to R175 every 20 days. Female beneficiaries 16> |
💉 Contraceptive Medication – Injectables | Limited to R270 every 20 days. Female beneficiaries 16> |
➡️ Pap Smear (Pathology) | Once per year. Female beneficiaries 15> |
🅰️ Pap Smear Consultation Pelvic Organs Ultrasound | Once per year. Female beneficiaries 15> |
🅱️ Mammogram | Once per year. Female beneficiaries 40> |
🩺 Prostate Specific Antigen (PSA) | Once per year. Male beneficiaries 40> |
✳️ HIV/AID Tests | Once per year. All beneficiaries are covered. |
📈 Health Assessment Body Mass Index (BMI) Blood Pressure Measurement Cholesterol Test (Finger prick) Blood Sugar Test (Finger prick) PSA (Finger Prick) | Once per year. All beneficiaries are covered. |
📉 Weight Loss Program | Beneficiaries with a BM of 30> will receive the following: Three dietician consultations (one per week) One biokinetics consultation. Three additional dietician consultations per week if a weight loss chart was received, proving weight loss after the first three weeks. One follow-up with biokinetics. |
👩⚕️ Antenatal Visits to a GP, Gynaecologist, or midwife and a Urine Test | Pre-notification and pre-approval are needed. Twelve visits are covered. |
📊 Ultrasounds – one before the 24th week and one after | Pre-notification and pre-approval are needed. Limited to two scans per pregnancy. |
💶 Short Payments / Co-payments for services rendered and birthing fees | Covered up to 1,290 per pregnancy. |
🚼 Paediatrician Visits | The baby must be registered on the scheme. Limited to 2 visits within the baby’s first year and one in the second year. |
💊 Antenatal Vitamins | Limited to R2,180 per pregnancy. |
📌 Antenatal Classes | Limited to R2,180 for the first pregnancy. |
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The Smart Baby Programme by KeyHealth provides expecting mothers and fathers with general guidance and support on health and well-being throughout the pregnancy while ensuring peace of mind.
The Smart Baby Programme benefits accessible to women (and babies) are distinct from day-to-day benefits and medical savings accounts.
👩⚕️ Antenatal visits | Twelve visits, one of which is after the birth. |
📉 Ultrasounds | Limited to two pregnancy ultrasounds. |
🍼 Paediatrician Visits (after the baby is a registered beneficiary) | Limited to two visits in the baby’s first year. |
💊 Antenatal vitamins | Limited to R2,320 per pregnancy. |
👶 Antenatal classes | Limited to R2,320 per pregnancy. |
READ more: 5 Best Hospital Plans for Pregnancy Coverage
The KeyHealth Origin Plan has the following specific exclusions, including:
If a Principal Member or their dependent is diagnosed with a specific illness, the Scheme reserves the right to exclude benefits for this condition for 12 months. Subject to the regulations, KeyHealth can impose waiting periods on an individual who applies for membership or admission as a dependent and has not been a beneficiary of a medical scheme for a minimum of 90 days before the application date. Such waiting periods may include the following:
If an individual who applies for membership or admission as a dependent was previously a beneficiary of a medical scheme for a continuous period of up to 24 months, which ended less than 90 days before the application date, Keyhealth could impose the following:
If the previous medical scheme had imposed a general or condition-specific waiting period on such an individual, and the waiting period had not expired at the time of termination, Keyhealth could impose a waiting period for the remaining duration as imposed by the previous medical scheme. However, any child born into the Scheme during membership will not be subject to waiting periods.
Furthermore, Keyhealth can impose the following:
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🔎 Medical Aid Plan | 🥇 KeyHealth Origin | 🥈 Discovery Health Essential Delta Core | 🥉 Bonitas BonEssential Plan |
🌎 International Cover | ☑️ Yes | R5 million | R10 million |
👤 Main Member Contribution | R2,250 | R2,281 | R2,287 |
👥 Adult Dependent Contribution | R1,603 | R1,716 | R1,690 |
💙 Child Dependent Contribution | R733 | R915 | R739 |
Prescribed Minimum Benefits | ☑️ Yes | ☑️ Yes | ☑️ Yes |
➡️ Screening and Prevention | ☑️ Yes | ☑️ Yes | ☑️ Yes |
💳 Medical Savings Account | None | None | None |
⚕️ Home Care | Noone | ☑️ Yes | ☑️ Yes |
🔍 Hospital Cover | Unlimited | Unlimited | Unlimited |
KeyHealth Origin plan is a comprehensive medical aid plan offered by KeyHealth Medical Scheme, designed to meet the healthcare needs of individuals and families. The plan is packed with a wide range of benefits and features that offer peace of mind to the members. One of the most notable features of this plan is that it covers both in-hospital and day-to-day medical expenses, making it an all-in-one solution for members. The KeyHealth Origin plan offers a host of advantages to its members. One of the significant advantages is the flexibility it provides its members when choosing healthcare providers.
Members can choose from a vast network of healthcare providers, including private hospitals, clinics, and doctors, ensuring they receive the best medical care. However, some treatments require that members choose from Designated Service Providers. The plan also covers a wide range of medical services, including chronic medication, pathology tests, and radiology services, ensuring that members have access to comprehensive healthcare. Another advantage of the KeyHealth Origin plan is that it offers its members a range of value-added benefits. These benefits include wellness programs, preventative care, and telemedicine services designed to help members manage their health effectively.
The plan also includes emergency medical services, such as air and road ambulance services, ensuring that members receive timely and efficient medical care during an emergency.
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KeyHealth Origin is a comprehensive medical aid plan offered by KeyHealth Medical Scheme in South Africa, which covers both in-hospital and day-to-day medical expenses.
To join KeyHealth Origin, you can visit the KeyHealth website or contact their customer service team for more information on how to apply.
KeyHealth Origin offers a range of benefits, including flexible healthcare provider options, comprehensive medical services coverage, value-added benefits such as wellness programs and telemedicine services, and emergency medical services.
KeyHealth Origin may be more expensive than other medical aid plans in South Africa. However, depending on their financial circumstances, the plan’s premium rates may be considered affordable for some individuals and families.
To compare medical aid plans in South Africa, you can use online comparison tools, consult a healthcare broker, or research and compare individual plan features and benefits.
The best medical aid plan in South Africa depends on individual healthcare needs and financial circumstances. Therefore, it is vital to research and compares various plans before selecting one.
A hospital plan in South Africa is a medical aid plan that only covers in-hospital medical expenses, such as surgeries, procedures, and hospital stays.
A comprehensive medical aid plan is a type of medical aid plan that covers both in-hospital and day-to-day medical expenses, including consultations, medication, and other healthcare services.
Yes, self-employed individuals in South Africa can apply for medical aid plans. In addition, some plans may be specifically designed for self-employed individuals.
Chronic medication is a medication prescribed for the long-term treatment of chronic conditions. Some medical aid plans in South Africa offer coverage for chronic medication.
Value-added benefits in medical aid plans are additional benefits offered to members, such as wellness programs, preventative care, telemedicine services, and more.
A medical aid scheme in South Africa is a membership-based system that provides healthcare coverage and benefits to its members.
To get medical aid quotes in South Africa, you can visit the websites of various medical aid providers or consult with a healthcare broker.
Yes, some medical aid plans in South Africa offer coverage for families, including dependents such as children and spouses.
Yes, some medical aid plans in South Africa offer coverage for pregnancy and related medical expenses.
Day-to-day medical expenses refer to healthcare services and treatments that do not require hospitalization, such as consultations, medication, and diagnostic tests.
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