Chronic Conditions

Being told you have a chronic condition or disease can be difficult and even scary. The good news is that KeyHealth is committed to helping members with chronic conditions and diseases to receive the best quality healthcare treatment and medication.

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A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than 3 months, for example, diabetes, HIV /AIDS and heart conditions.

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Our Chronic Condition Benefits

ESSENCE

Essence is the ideal ‘just-in-case’ medical cover for individuals starting out and for those who only need that crucial cover for emergencies and unexpected medical expenses.

Members on Essence are covered for:

  • 26 PMB CDL conditions

ORIGIN

Origin is the comprehensive medical cover for anyone who has basic in and out of hospital needs for themselves or the people they care for.

Members on Origin are covered for:

  • 26 PMB CDL conditions 

EQUILIBRIUM

Equilibrium is the peace-of-mind-and-body medical cover for those looking for stability with extra security.

Members on Equilibrium are covered for: 

  • 26 PMB CDL conditions 
  • 3 additional chronic conditions

SILVER

Silver is the step-up medical cover for individuals and families who expect more than the usual.

Members on Silver are covered for:

  • 26 PMB CDL conditions 
  • 3 additional chronic conditions

GOLD

Gold is the superior medical cover for individuals and families who demand both substantial cover and security from their plans.

Members on Gold are covered for:

  • 26 PMB CDL conditions
  • 18 additional chronic conditions 

PLATINUM

Platinum is the top tier of medical cover for people who want it all taken care of, now and in the future.

Members on Platinum are covered for:

  • 26 PMB CDL conditions
  • 27 additional chronic conditions 

ESSENCE

Essence is the ideal ‘just-in-case’ medical cover for individuals starting out and for those who only need that crucial cover for emergencies and unexpected medical expenses.

Members on Essence are covered for:

  • 26 PMB CDL conditions

ORIGIN

Origin is the comprehensive medical cover for anyone who has basic in and out of hospital needs for themselves or the people they care for.

Members on Origin are covered for:

  • 26 PMB CDL conditions 

EQUILIBRIUM

Equilibrium is the peace-of-mind-and-body medical cover for those looking for stability with extra security.

Members on Equilibrium are covered for: 

  • 26 PMB CDL conditions 
  • 3 additional chronic conditions

SILVER

Silver is the step-up medical cover for individuals and families who expect more than the usual.

Members on Silver are covered for:

  • 26 PMB CDL conditions 
  • 3 additional chronic conditions

GOLD

Gold is the superior medical cover for individuals and families who demand both substantial cover and security from their plans.

Members on Gold are covered for:

  • 26 PMB CDL conditions
  • 18 additional chronic conditions 

PLATINUM

Platinum is the top tier of medical cover for people who want it all taken care of, now and in the future.

Members on Platinum are covered for:

  • 26 PMB CDL conditions
  • 27 additional chronic conditions 

PMB chronic benefits

Members across all benefits options are covered for the 26 PMB CDL conditions (below).

26 PMB CDL conditions
  1. Addison’s Disease
  2. Asthma
  3. Bipolar Mood Disorder
  4. Bronchiectasis
  5. Cardiac Failure
  6. Cardiomyopathy Disease
  7. Chronic Renal Disease
  8. Coronary Artery Disease
  9. Crohn’s Disease
  10. Chronic Obstructive Pulmonary Disorder
  11. Diabetes Insipidus
  12. Diabetes Mellitus Type 1 & 2
  13. Dysrhythmias
  14. Epilepsy
  15. Glaucoma
  16. Haemophilia
  17. Hyperlipidaemia
  18. Hypertension
  19. Hypothyroidism
  20. Hormone Replacement Therapy (HRT)*
  21. Multiple Sclerosis
  22. Parkinson’s Disease
  23. Rheumatoid Arthritis
  24. Schizophrenia
  25. Systemic Lupus Erythematosus
  26. Ulcerative Colitis

*An additional chronic condition approved by the Scheme

Additional chronic conditions

These are additional chronic conditions that the Scheme has added to help its members.

Equilibrium and Silver – 3 additional chronic conditions

For child dependants up to the age of 21 years

  1. Acne
  2. Hyperkinesis / Attention Deficit Disorder (ADD)
  3. Rhinitis
Gold – 18 additional chronic conditions
  1. Allergic Rhinitis
  2. Benign Prostatic Hypertrophy
  3. Diverticulitis and Irritable Bowel Syndrome
  4. Gastroesophageal Reflux Disease
  5. Hypoparathyroidism#
  6. Hyperkinesis / Attention Deficit Disorder (ADD)
  7. Hyperthyroidism
  8. Iron deficiency anaemia
  9. Major Depression#
  10. Meniere’s Disease
  11. Migraine
  12. Osteoarthritis
  13. Paraplegia, Quadriplegia#
  14. Peripheral Vascular Disease#
  15. Rheumatic fever
  16. Testosterone deficiency
  17. Urinary incontinence

#Chronic medication for these PMB conditions (only for severe, life-threatening cases and motivated by the appropriate specialist), above the PMB level of care, will be paid at 100% of the cost

Platinum – 27 additional chronic conditions
  1. Acne
  2. Allergic Rhinitis
  3. Alzheimer’s Disease
  4. Ankylosing Spondylitis
  5. Benign Prostatic Hypertrophy
  6. Clotting Disorders (additional)
  7. Cystic Fibrosis
  8. Deep Vein Thrombosis#
  9. Stroke#
  10. Gastro-Oesophageal Reflux Disease
  11. Hypoparathyroidism#
  12. Hyperkinesis / Attention Deficit Disorder (ADD)
  13. Hyperthyroidism
  14. Interstitial Fibrosis
  15. Iron Deficiency Anaemia
  16. Major Depression#
  17. Meniere’s Disease
  18. Testosterone Deficiency
  19. Menopausal Disorder (Calcium only)#
  20. Migraine
  21. Myasthenia Gravis
  22. Osteoarthritis
  23. Osteoporosis
  24. Paraplegia, Quadriplegia#
  25. Peripheral Vascular Disease#
  26. Psoriasis
  27. Urinary Incontinence

#Chronic medication for PMB conditions (only for severe, life-threatening cases and motivated by the appropriate specialist), above the PMB level of care, will be paid at 100% of the cost.