A program available on all options to provide Beneficiaries with certain additional benefits, at no extra cost to Members, for preventative care:
- Only the benefits stated in the Benefit Structure under Health Booster, and applicable to that particular benefit option, will be paid by the Scheme; up to a maximum rand value which is determined according to specific tariff codes.
- Members qualify automatically for Health Booster benefits according to the set criteria.
- However, pre-authorisation is required in order to access the Maternity benefits on Health Booster. Contact the Client Service Centre on 0860 671 050 and obtain pre-authorisation.
(Failing to do this will result in the service costs being deducted from day-to-day benefits.);
- When maternity related claims are submitted by providers, these claims should specify the relevant ICD10 code as contained in the pre-authorisation letter;
- Verify the tariff code or maximum rand value with the Call Centre Consultant;
- Inform the relevant service provider accordingly.
- One of the benefits available on the Health Booster program is the Health Assessment.
- This assessment comprises the following screening tests:
- Body Mass Index (BMI);
- Blood sugar (finger prick test);
- Total Cholesterol (finger prick test);
- Blood pressure (systolic and diastolic);
- Prostate Phlebotomy for PSA;
- Rapid Semi-Quantitive Prostate Specific Antigen (PSA) test (finger prick).
- Principal Members and their Dependants are entitled to one Health Assessment per calendar year and must have the screening tests done at any pharmacy.
- A Health Assessment (HA) form can be downloaded from KeyHealth’s website
- No authorisation is required for these screening tests.
|TYPE||WHO & HOW OFTEN|
|Baby immunisation||Child Dependants ≥ 6 - as required by the Department of Health.|
|Flu vaccinations||All Beneficiaries.|
|Tetanus diphtheria injection||All Beneficiaries - as and when required|
|Pneumococcal vacination||All Beneficiaries.|
|EARLY DETECTION TESTS|
|Pap smear (Pathologist)||Female Beneficiaries aged ≥ 15 - once per year|
|Pap smear (consultation; GP or Gynaecologist)||Female Beneficiaries aged ≥ 15 - once per year|
|Mammogram||Female Beneficiaries aged ≥ 40 - once per year|
|Prostate specific antigen (Pathologist)||Male Beneficiaries aged ≥ 40 - once per year|
|HIV/AIDS test (Pathologist)||Beneficiaries aged ≥ 15 - once per year|
|Health Assessment (HA)||All Beneficiaries per year|
|Body mass index, Blood pressure measurement, Cholesterol test (finger prick), Blood sugar test (finger prick)||For all Beneficiaries when the Health Assesments BMI is ≥ 35:|
|Weight Loss Program||
For all Beneficiaries when the Health Assesments BMI is ≥ 35:
|Antenatal visits (GP or Gynaecologist) & urine test (dipstick)||Female Beneficiaries. Pre-notification of and pre-authorisation by the Scheme compulsory. Twelve (2) pregnancy scans.|
|Scans (one before the 24th week and one there-after)||Female Beneficiaries. Pre-notification of and pre-authorisation by the Scheme compulsory. Two (2) pregnancey scans.|
|Paediatrician visits||Baby registered on Scheme. Two (2) visits in baby's 1st year.|
|*Pre-authorisation essential to access benefits|