KeyHealth is a medical scheme in South Africa that offers many cover options offering its clients a promise of transparency and honesty. Included in every medical aid option are three free additional benefits that all members get, regardless of the premium they pay, or the size of the medical insurance cover taken out.
These are the Smart Baby Programme, Easy ER and Health Booster. This article covers the third benefit, so keep reading if you’re interested to find out more.
Health Booster – Made Easy
This free additional benefit is aimed at the prevention of certain conditions and, therefore, offers members a set amount of coverage for the relevant medical practices. Conditions that form part of the KeyHealth Health Booster programme include the following:
- Immunisation of babies
- General health assessment (HA)
- Mammogram
- Pap smear
- Medication for malaria
- Flu vaccination
- Testing for HIV
- Prostate test
- Weight loss-, contraceptive- and maternity benefits
Special terms and conditions apply to getting the coverage for some of the benefits listed.
What Do You Need To Qualify?
The Health Booster is automatically included in all medical aid packages. It means there is no extra step for qualifying to make claims if the medical condition and service are included in the option and the right requirements are met.
Maternity benefits are an exception to the rule and require pre-authorisation, which can be done by getting in touch with the relevant department. If beneficiaries neglect to get the pre-approval needed, the expenses will be taken from their day-to-day benefits instead.
For those new to the world of medical schemes and industry terms, pre-authorisation is typically related to hospital costs. It means that the scheme’s go-ahead is required before receiving treatment, medication or a procedure done by a medical practitioner. This is to ensure that the costs will be covered by the scheme and not paid out of your pocket because the expense is higher than what your plan allows, or the circumstances are not according to the rules of the scheme.
Screening Tests for Prevention and Early Diagnosis
The KeyHealth programme also allows members to get various screening tests done as a result of the Health Assessment (HA) benefit. BMI, blood sugar, cholesterol, blood pressure, and prostate phlebotomy for PSA testing are all included in the available screening tests.
The HA can be performed once in a calendar year at a pharmacy with no pre-approval necessary. This means one assessment per individual of a medical aid, including the child and adult dependants along with the principal member.
When and How do Health Booster Benefits Apply?
Under preventative care for this programme at KeyHealth, you will find nine types of treatment of which four are applicable to all beneficiaries. These are the flu vaccine, tetanus diphtheria injection, when needed, malaria medication up to a certain amount and only once per year, and, lastly, a pneumococcal vaccination.
Furthermore, three preventative care treatments for women are included, each with its own criteria to be met. These are the HPV vaccine, contraceptive medication tablets or patches and contraceptive injection medication.
Last, on the list for preventative care are two benefits targeting babies. These are immunisations for children under and equal to six years of age, as well as three baby growth assessments for infants younger than 35 months of age – subject to the medical aid package selected.
KeyHealth’s free additional benefit programme also includes five types of early detection tests with three applying to all beneficiaries. The HIV/AIDS test and a general HA are both available to all members with a dental consultation being the third, but only for those on the Essence option.
Male members of and over 40 years get a free PSA test once per year and females of the same age a free mammogram. Additionally, females 15 years of age and over have access to two more early detection tests, both relating to pap smears.
The weight-loss programme is available to all members with a body mass index of or higher than 30, with pre-approval being a prerequisite. This includes three dietician consultations, once weekly, with a further three consultations if the dietician provides proof that the individual has lost weight after the initial three weeks.
Additionally, there are six more benefits included, all relating to maternity, which are explained in detail on the KeyHealth Health Booster page on our website.
For more information on any of the free additional benefits that KeyHealth offers – chat with one of our representatives online.
