KeyHealth vs. Medihelp
Keyhealth Medical Scheme versus Medihelp compared and revealed.
We tested them side by side and verified their medical aid plans benefits, affordability, and much more.
This is a complete guide to Keyhealth and Medihelp in South Africa.
In this in-depth guide you’ll learn:
- What is a Medical Scheme?
- Which medical aid is the best for young families?
- Which medical aid is best for a young person?
- How to compare medical aids against each other?
- Which should you choose: Keyhealth or Medihelp?
So if you’re ready to go “all in” with the Keyhealth versus Medihelp in South Africa, this guide is for you.
Let’s dive right in…
KeyHealth vs. Medihelp Summary
Overall Comparison
| ℹ️ Feature | 🥇 KeyHealth | 🥈 Medihelp |
| General comparison | 4/5 | 5/5 |
| Number of plans | 6 | 9 |
| Lowest premium | R1 990.00 (Essence) | R894.00 (MedElect Student) |
| Highest premium | R11 308.00 (Platinum) | R12 792.00 (MedPlus) |
| Student Plan | No | Yes |
| Gap Cover | No | Yes with another provider |
| Hospital plans | Yes | Yes |
| Maternity benefits | Yes | Yes |
| Number of members | 69 000+ | 200 000+ |
Plan benefits
| ℹ️ Feature | 🥇 KeyHealth | 🥈 Medihelp |
| Name of Plan | • Essence • Origin • Equilibrium • Silver • Gold • Platinum | • MedElect Student • MedMove! • MedVital! • MedAdd • MedSaver • MedElect • MedPrime • MedElite • MedPlus |
| Price per plan | • Essence: R1 990.00 • Origin: R2 250.00 • Equilibrium: 2 778.00 • Silver: R4 799.00 • Gold: R7 036.00 • Platinum: R11 308.00 | • MedElect Student: R894.00 • MedMove!: R1 476.00 • MedVital: R2 598.00 • MedAdd: R3 354.00 • MedSaver: R3 516.00 • MedElect: R2 820.00 • MedPrime: R4 782.00 • MedElite: R7 368.00 • MedPlus: R12 792.00 |
| GP Visits | Yes | Network and Non Network |
| GP in room visits | Yes | Network and Non Network |
| Specialist visits | Yes | Yes |
| Acute medication | Yes | Yes |
| Chronic medication | Yes | Yes |
| Basic pathology | Yes | Yes |
| Basic and emergency dentistry | Yes on basic dentistry | Yes and differs from plan to plan |
| Basic optometry | Yes | Yes, with exception of the Student plan |
| HIV benefit | Yes | Yes |
| Maternity benefit | Yes | Yes |
| Road accident claims | No | Will give assistance |
KeyHealth vs. Medihelp
Both KeyHealth and Medihelp are known medical aid schemes in South Africa that provide a comprehensive selection of tailored plans. Here, we compare in these two medical aid schemes to help you decide on the best option for your healthcare needs in 2024.
Which offers more affordable cover – KeyHealth or Medihelp?
Medihelp has the lowest premium of the two medical aids with its MedElect Student and MedMove! plans. It also offers a wider variety of plans of the two medical aids. While KeyHealth only offers a choice between six different plans, both medical aids offer affordable medical aid plans designed for singles, couples, families, and pensioners.
Do both schemes offer gap cover?
A gap coverage policy is a temporary insurance plan that fills up the financial gaps left when patients visit doctors and specialists who charge more than the patient’s medical aids would pay for. Your medical aid and gap insurance will work together to protect you from financial hardship.
The gap cover provider will reimburse you for a specified percentage of the difference between the full cost of your medical care and the amount your health insurance policy would cover in exchange for a regular premium payment. It is common practice for private hospitals to charge patients more for the identical procedures if they are performed by a healthcare provider who is not included in the medical plan’s network.
Although KeyHealth does not make specific provision for Gap Cover options, it has adopted two approaches to tackle this issue. The first is to keep its products as affordable as possible. Equilibrium includes a savings account which could be used to meet co-payments or day-to-day expenses if necessary.
Medihelp does not offer direct Gap Cover within the medical scheme either, but advise its members to take out gap cover from an independent insurer. Anyone who is an up to date member of Medihelp and who meets the age requirement can apply for cap cover for Medihelp.
Do both schemes offer hospital plans?
Yes, both KeyHealth and Medihelp offer hospital plans. All six plans offered by KeyHealth include hospital plans to cover the treatment costs if you’re admitted to hospital such as ward costs, theatre fees, and accounts from other in-hospital providers such as anesthetists or radiologists. All its hospital plans are subject to Scheme rules, pre-authorization, case management, clinical protocols and the benefit option you have chosen.
All Medihelp’s plans give you access to quality care at private hospitals with no overall annual limit. Some Medihelp plans offer you a choice between using any hospital or a network hospital when you join the network version of the plan at a considerably lower premium, which is made possible by negotiating tariffs with efficient networks of hospitals and day procedure facilities.
Who is KeyHealth?
KeyHealth is a well-known medical plan and health insurance company in South Africa. The Scheme, which is managed by PPS Healthcare, places a high value on transparency in the way it presents its health advantages, steering clear of “nice to haves” and emphasising the provision of “pure” medical aid benefits.
KeyHealth Medical Aid, strive to keep its members’ contributions as affordable as possible, throughout all its options, from the most basic to the most comprehensive plan. Members are given fair and reasonable value and cover in return for their monthly contributions.
All KeyHealth plans come with three additional complimentary benefits, namely Easy-ER, Health Booster, and Smart Baby, and all provide limitless coverage for Prescribed Medical Conditions (PMBs) in compliance with South African law. Some exclusions apply based on the chosen plan. The Chronic Disease List is covered by all options.
The most affordable option with Health is Essence. Some exclusions apply, such as day-to-day medical costs, dentistry, prostheses, and hospitalisation benefits for some surgical operations. Disaster and other significant medical expenses caused by accidents (in hospitals) are covered. Essence makes sure that users of this plan have access to basic, necessary medical coverage. The next option, equilibrium, is also reasonably priced, but although daily medical coverage is provided, some hospital benefits are excluded.
With the Silver plan two in-hospital treatment benefits and specialised dentistry are excluded. Gold is the recommended plan which offers comprehensive and complete cover. While member contributions are higher, the benefits are also higher. There are no in-hospital benefit exclusions, and coverage is limitless for both general and specialty dentistry operations.
The Platinum option is at the top of the list. A Threshold Zone that funds extra expenses after the predetermined Self-Payment Gap has been closed is one of the benefits. Other benefits include those for routine, daily expenses. The benefits of this complete choice go beyond the 26 ailments on the Chronic Disease List and cover 29 more chronic conditions.
KeyHealth offers 6 medical aid plans:
- ✅ KeyHealth Essence Medical Aid Plan
- ✅ KeyHealth Origin Medical Aid Plan
- ✅ Keyhealth Equilibrium Medical Aid Plan
- ✅ Keyhealth Silver Medical Aid Plan
- ✅ Keyhealth Gold Medical Aid Plan
- ✅ Keyhealth Platinum Medical Aid Plan
Who will benefit from KeyHealth?
KeyHealth offers a fairly comprehensive medical cover that is well-suited towards individuals, families and pensioners. It offers comprehensive plans, with good coverage that is affordable.
Who is Medihelp?
Medihelp is the second largest self-administered medical aid in South Africa and has been serving the interests of members for the past 117 years. It has close to 200 000 beneficiaries, and remain one of the top five choices of medical aids in the industry.
The sole objective of Medihelp, as a self-administered medical aid, is to look after its members and provide for their medical need. All South Africans are welcome to apply, whether they are students, newly employed individuals looking to enrol in a medical insurance plan for the first time, independent business owners searching for a trustworthy healthcare provider for their staff, or parents supporting expanding families.
Medihelp’s reserve level is well above the legal requirement and its ability to pay members’ claims is rated amongst the highest in the industry at AA minus by Global Credit Rating (GCR), the largest independent rating company in Africa.
Medihelp is owned by its members and handles administrative duties as processing and paying claims, pre-authorisation and communication with members in-house.
MediHelp has the following 11 plans to choose from:
- ✅ MediHelp Medprime
- ✅ MediHelp MedPrime Elect
- ✅ MediHelp MedPlus
- ✅ MediHelp MedElite
- ✅ MediHelp MedVital
- ✅ MediHelp MedVital Elect
- ✅ MediHelp MedSaver
- ✅ MediHelp MedMove
- ✅ MediHelp MedElect
- ✅ MediHelpMedAdd
- ✅ MediHelp MedAdd Elect
Who will benefit from Medihelp?
All Medihelp plans are designed to provide solid cover for what is considered essential to preserve and protect your health. It makes provision for students, singles, couples, families and pensioners.
Frequently Asked Questions
Which medical aid offers the cheapest medical plan, KeyHealth or Medihelp?
Medihelp has the cheapest plan between the two medical aids with its MedElect Student plan at R894.00 per month. The plan is specifically aimed at students. The cheapest plan from KeyHealth is its Essence plan at R1 990.00 per month.
Which medical aid, KeyHealth or Medihelp are the most popular?
Medihelp boast the most members at 200 000+ compared to KeyHealth with 69 000+ members. Medihelp also offers a bigger choice between nine plans whereas KeyHealth offers six plans.
Do KeyHealth and Medihelp medical aids offer the option of gap cover?
KeyHealth does not make specific provision for gap cover but opts to rather keep its products as affordable as possible. Neither does Medihelp offer direct gap cover. However, both medical aids advise its members to take out gap cover from an independent insurer.
Do KeyHealth and Medihelp medical aids have a waiting period?
Yes, both KeyHealth and Medihelp have a three-month waiting period during which you are unable to submit a claim.
Which is the best medical aid between KeyHealth and Medihelp?
KeyHealth has been operating since 1968 and has maintained the necessary high membership figures since then. The key to its success has been an unwavering determination to offer its members the best possible value for their hard-earned cash. Medihelp, on the other hand must be one of the oldest medical aid schemes in South Africa. It was founded in 1905 as the Civil Service Medical Benefit Association. Today it is one of the largest open medical aids in South Africa.
