Search
Close this search box.

KeyHealth Member Information

Member Services

Electronic Communication

origin heros 1
Origin2

Origin Option

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.

Delivering unbeatable value-for-money, this option includes an unlimited private hospital plan, specified day-to-day benefits, and covers the basic 26 chronic medical conditions.

It’s affordable day-to-day cover for you and yours.

Our original complete-value-for-money cover.

Origin
2022 Monthly Contributions

Principal Member: R1 939
Adult Dependant: R1 381
Child Dependant: R631

Medical Benefits

  • Hospital

  • Accidents

  • Specialists

  • Oncology

  • MRI & ICT Scans

  • Routine Expenses

  • Pathology

  • Optical

  • Dental

  • Chronic Medication

  • Ambulance

  • Medical Appliances

  • Scopes

  • PMB's

Click on the tabs below to see a full description of the option benefits.

Major medical expenses cover

All costs related to treatment at any Netcare, Life Healthcare hospitals (countrywide) and Mediclinic (Western Cape, Polokwane, Bloemfontein) – hospitals that are part of our Designated Service Provider (DSP) network – will be paid in full. A list of hospitals in areas where DSP hospitals are not present is available on request. There is no restriction on the number of hospital admissions, but all in-hospital procedures must be pre-authorised prior to admission.

*If a non-DSP hospital is voluntarily used, a 30% co-payment will be applicable on the hospital account.

Benefits value
Unlimited

Injuries suffered as result of an accident

Treatment for almost all accidents is regarded as a Prescribed Minimum Benefit (PMB). Treatment of such injuries, including hospitalisation, is therefore covered in full by the Scheme, subject to Scheme rules and clinical protocols.

Benefit value
Unlimited 

Specialist services in-hospital

The services provided by specialists while the member is in hospital are covered by the Scheme.

Any service falling within the Scheme rules and rendered by the Scheme’s Specialist Network (DSP) or preferred provider for PMB conditions will be covered in full.

Benefit value
Unlimited*
*Conditions apply

Oncology

The diagnosis and treatment of cancer-related conditions.

Benefit value
R169 000
Per family per annum.

MRI & CT scans

Includes scans done for diagnostic reasons both in and out of hospital.

Benefit value
R17 800
Per family per annum*
*Conditions apply

Day-to-day medical expenses cover (out of hospital)

Routine medical expenses

Includes day-to-day medical expenses for GP and specialist consultations, X-rays; prescribed (acute) and over-the-counter medication, blood tests, physiotherapy, optical, dentistry, etc. This benefit is a family benefit, which means that one member of a family can use the total benefit allocation.

Benefit value: 

  • Principal Member: R2 815 per annum
  • Adult Dependant:  R1 640 per annum
  • Child Dependant: R865 per annum
Pathology

Blood tests done out of hospital as requested by a GP or specialist are paid from the day-to-day benefit amount.

Benefit value
Subject to amount available in routine benefit allocation.

Optical services

Optical services, including eye tests, frames, lenses and contact lenses, are paid from the day-to-day benefit amount.

Benefit value
Subject to amount available in routine benefit allocation*
*Conditions apply

Dentistry

Dental treatment

The provision of conservative dental treatment to members which include the consultation at the dentist, any X-rays, oral hygiene treatment, fillings and extractions.

Benefit value
Subject to amount available in routine benefit allocation.

Chronic medication

Chronic medication for CDL conditions

Prescribed medication used continuously for 3 months or more for one of the 26 PMB CDL conditions.

Benefit value
Unlimited

Supplementary services cover

Psychiatric Treatment
  • In-hospital benefit only.
  • Pre-authorisation compulsory.
  • Case Management applies.
  • Out-of-hospital: PMB entitlement.

Benefit value:
R21 500 per family per annum  

Prosthetics/ Prosthesis

(Internal, external, fixation devices and implanted devices)

  • PMB entitlement only.
  • Pre-authorisation compulsory.
  • Subject to case Management, reference pricing, preferred provider, and Scheme protocols.

Benefit value
*Conditions apply

Emergency transport by ambulance

Netcare 911 (DSP) provides members with emergency transport from an accident scene by road or air ambulance and medically justified inter-hospital transfers.

Benefit value
Unlimited

Medical appliances

The provision of medical equipment used for the treatment and cure of medical conditions or procedures, including equipment such as wheelchairs, crutches and contraceptive devices.

Benefit value
R7 900
per family per annum
*Conditions apply

Endoscopic procedures (scopes)

All scopes are covered in full if done at a DSP hospital – Netcare, Life Healthcare hospitals (countrywide) and Mediclinic (Western Cape, Polokwane, Bloemfontein) and other selected hospitals – or if done in the doctor’s rooms, subject to the use of a KeyHealth Specialist Network.

Benefits value:
Unlimited

Prescribed Minimum Benefits (PMB)

Prescribed Minimum Benefits

Prescribed Minimum Benefits (PMBs) are a set of legislated, defined benefits to ensure that all medical scheme members are entitled to certain minimum health services, regardless of the benefit option they have selected on their scheme.

Benefit value
Unlimited

Additional Benefits

Easy-ER

Health Booster

Smart Baby

Not Included on Origin - Click here
  • Hospitalisation benefits for the following procedures:
    • Varicose vein and reflux surgery
    • Facet joint injections
    • Rhizotomy
    • Back surgery (including spinal fusion)
    • Joint replacements (e.g. hip and knee)
  • Specialised dentistry
  • Prosthesis benefits