From Essence Essential to Comprehensive Cover Medical Aid
Comprehensive insurance, be it for a motor vehicle or other asset, is arguably the best of its type. Because it is comprehensive, you have the peace of mind that the majority – if not all – of eventualities are covered. The same holds true of comprehensive medical aid. A comprehensive plan provides cover for almost all medical conditions and their treatments, acute or chronic. In the latter instance, this may be for a very long time, providing that the person remains on the same plan and that their medical condition continues to require the same or similar treatment.
As medical science and technology advance and new medicines and therapies are discovered and developed, these are also likely to receive medical aid coverage, once all clinical trials and tests have been satisfactorily performed, subject to official approval and acceptance as being effective and safe. It’s impossible for any medical aid scheme to have unlimited funds and resources at its disposal to offer totally comprehensive, unrestricted cover for anything and everything. No scheme or its members could possibly afford such a Utopian, all-encompassing scheme.
KeyHealth’s Options and Benefits
Nevertheless, at KeyHealth Medical Aid, we strive to keep our members’ contributions as affordable as possible, throughout all our options, from the most basic to the most comprehensive plan, and without compromising on giving members fair and reasonable value and cover in return for their monthly contributions. In accordance with South African legislation, all KeyHealth options offer unlimited cover for Prescribed Medical Conditions (PMBs), and all include three additional free benefits: Easy-ER, Health Booster, and Smart Baby. Depending on the selected plan, certain exclusions apply. All options include Chronic Disease List cover (for 26 listed chronic conditions).
Essence is the most affordable KeyHealth option. Although disaster and certain major medical expenses caused by accidents (in hospital) are covered (unlimited), some exclusions apply, including day-to-day medical expenses, dentistry, prosthetics, and hospitalisation benefits for some surgical procedures. Essence ensures that members of this plan have basic, essential medical cover that includes chronic medication, as mentioned above. Equilibrium is next in line and is also affordable. Day-to-day medical cover is offered, but some hospital benefits are not included.
Our Silver plan only excludes two in-hospital procedure benefits and specialised dentistry. Gold is KeyHealth’s penultimate, relatively comprehensive option; member contributions are higher, but the benefits increase accordingly. Both dental and specialised dentistry procedures receive unlimited cover, whilst there are no in-hospital benefit exclusions. The Platinum option tops the list of KeyHealth options, as the most comprehensive medical aid plan. Benefits include those for routine, day-to-day expenses, and a Threshold Zone that funds additional expenses, once the defined Self-Payment Gap has been bridged. This comprehensive option’s additional benefits also include 29 extra chronic conditions, over and above the previously mentioned, defined 26 Chronic Disease List illnesses.
It should be borne in mind that you get that for which you pay, as always, in all things. Consequently, KeyHealth’s medical aid options, as listed above, are in ascending order, beginning with the least expensive/basic benefit plan, through to the more expensive and most comprehensive medical aid cover. The choice, cost, and degree of cover that best meets your criteria is up to you.
