Healthcare Programmes

Through its Managed Healthcare Programmes, KeyHealth links members with healthcare experts for ongoing management of their conditions and compliance with treatment.
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Members must register to be part of the Managed Healthcare Programmes and get pre-authorisation before receiving treatment.

Oncology (Cancer) Programme

Under this programme, members diagnosed with cancer can access benefits for the treatment and management of their disease.

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Programme Benefits

The KeyHealth oncology programme offers support and comprehensive cover for cancer.

The oncology programme includes doctor / specialist consultations, chemotherapy treatment, oncology medication, radiotherapy, MRI scans (to diagnose brain conditions), CT scans (to diagnose muscle and bone disorders), PET scans (to diagnose diseases in the body), and blood tests, among others.

Important details

If a member is diagnosed with cancer, the member needs to register for the Oncology Programme.

Cancer treatment plans are to be sent to:

  • Fax 012 679 4469 or email to oncology@keyhealthmedical.co.za
  • For authorisation, call 0860 671 060

HIV / AIDS Programme

The HIV / AIDS Programme is managed on behalf of KeyHealth by skilled, professional consultants at LifeSense Disease Management (LifeSense).

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This programme gives members access to healthcare benefits that include support, lifestyle adjustments, counselling, medication, and other treatments that enable them to live quality lives despite having the disease.

Programme Benefits

The KeyHealth HIV / AIDS Programme benefits include confidential, high-quality, cost-effective, and co-ordinated healthcare. The programme allows for active management for the best health outcomes for the individual member.

Important details

If a member is diagnosed with HIV / AIDS, the member needs to register for the HIV / AIDS Programme.

  • To register on the programme, contact LifeSense on 0860 506 080
  • For HIV / AIDS claims, contact the Client Service Centre on 0860 671 050

Smart Baby Programme

Expecting a baby is one of the most exciting and special times in any family’s life. 

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Smart Baby is there to make this experience even more special by offering great maternity benefits, support, general advice on health and wellness, and simply making the journey as enjoyable as possible for you.

Programme Benefits

  • Access to antenatal visits and classes, maternity vitamins, ultrasounds, and more
  • R1 440 towards medical expenses or certain items for baby
  • The New Baby & Childcare Handbook by Marina Petropulos to provide valuable information to first-time mothers

Important details

A member can register as soon as the pregnancy is confirmed by calling 0860 671 060.

Document Based Care Programme

The Documentation Based Care (DBC) Programme offers a holistic, multi-disciplinary, conservative solution for the treatment of chronic, painful back and neck conditions to avoid the need for surgery.

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The patient is linked with healthcare experts comprising of doctors, physiotherapists and biokineticists to help with pain management treatment protocols that include exercises and muscle development techniques. These methods have proven to be successful.

Programme Benefits

The DBC Programme equips the member with a better understanding of their pain and helps to remove the fear and threat of the pain. The programme is individualised and assists in reducing pain and improving the member’s core strength. It offers KeyHealth members an alternate solution to surgery, and by avoiding surgery, members can avoid the risks associated with spinal surgery.

Important details

If a member requires treatment for back and neck conditions, the member needs to register for the DBC Programme.

  • Contact the Pre-authorisation Department on 0860 671 060.

Disease Risk Management Programme

KeyHealth helps members manage their chronic conditions under the Disease Risk Management (DRM) Programme.

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The programme links members and beneficiaries with experts to help them with the ongoing management of their chronic condition, which includes providing relevant health information, guidance, and a treatment plan to avoid complications and hospitalisation.

Programme Benefits

Included in the DRM Programme are the 26 Prescribed Minimum Benefit (PMB) chronic conditions that each has a chronic treatment plan. DRM consultants are there to support and encourage members to lead healthier lives and optimise the management of their chronic conditions.

The programme assists members with chronic medication and claims queries, explains the chronic treatment plans, and helps members keep chronic conditions well-controlled and managed on an ongoing basis.

Important details

If a member with a chronic condition requires chronic medication, the member needs to register for the DRM Programme.

  • Pre-authorisation is required before treatment
  • To register for the DRM programme, the member’s doctor or pharmacist must contact MediKredit on 0800 132 345.

Integrated Care and Remote Monitoring

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KeyHealth has launched an innovative offering for our members with multiple chronic conditions.

This includes a referral for home monitoring to ensure control of your chronic disease, giving your medical team a good understanding of your condition. This will also trigger assistance if values are abnormal.

These services will be covered from the risk benefit and appliance benefits where applicable. 

Important details

Should you be eligible for home monitoring, our Integrated care team will reach out to you to ensure that you have access to the required benefits.

  • Contact the Disease Risk Management (DRM) Programme Department on 0860671060 for more information.

Hospital@Home

Gives members the choice of treatment in the comfort of their home.

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KeyHealth has launched a hospital at home offering, whereby members can receive treatment for certain acute conditions in the comfort and privacy of their homes, while able to receive the loving support of their families.

Part of this benefit is continuous remote vital signs monitoring, daily virtual visits, an in-person visit by a clinician for the first three days at home, medication, pathology tests, wound care and short-term oxygen if required.

These services will be covered from the risk-benefit in the same way as an in-hospital stay would be covered.

Some examples of conditions that may be treated at home include (but are not limited to):

  • Community-acquired pneumonia
  • Dehydration
  • Urinary tract infections
  • Cellulitis
  • Acute exacerbation of asthma
  • Syncope/collapse
  • Post-surgery care
  • DVT (blood clots)

Speak to your GP about this innovative, patient-centered, value-based offering.

Important details

Pre-authorisation is required and subject to case management and Scheme protocols.

  • Contact the Disease Pre-authorisation Department on 0860671060 for more information.