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KeyCare – Is this an option worthy of serious consideration? I’d say yes, so keep reading.

Here’s where KeyCare fits in.

The focus at Discovery Health has always been on giving you ownership of your medical expenses. I discussed Discovery Health in a nutshell in part one of this series.

With their new generation plans, a budget is allocated to you every year. Spend more than that, and they punish you. Spend less, and then they reward you by allowing you to carry over the money not spent to the next year, and the next, and the next.

But some people either don’t want to budget or have sickly families and just can’t afford the more comprehensive plans. Discovery Health came up with the KeyCare range.

With KeyCare the focus is on offering you an unsophisticated product whereby they take away the necessity to self-manage your expenses, but in return make all the decisions as to:

  • Which doctors you may see
  • Which hospitals you may use, and
  • The level of benefits you get to enjoy.

This means you may visit the doctor as often as you need to although after 15 visits you need authorisation). The KeyCare networked doctor then prescribes medicine off a specific formulary, or refers you to a KeyCare specialist who then uses a KeyCare networked hospital if need be. In other words, the decision to ‘do as you please’ is taken away from you.

Interested in the nuts and bolts?

The person most advantaged by these plans is your lower income earner. That’s because the cost is broken down into income bands with the lower earner enjoying the same benefits as the higher income earner. Discovery Health tends to discourage the higher income earner from belonging to this plan type.

Take the KeyCare Plus plan for instance:

  • Someone earning less than R8, 101 a month pays R914 a month as main member in 2017
  • Compare this to the individual earning more than R11, 551 a month who pays R1, 906 a month for exactly the same benefit. That’s more than double.

You can immediately see the advantages for a company with staff unfamiliar with medical aid.
No more complaints about having no medical savings left after March and then demanding to know why they’re paying for something that has stopped paying.
If you think about it, it’s a pretty good question they’re asking.

If ‘bells and whistles’ are what you’re looking for then this is definitely not the plan for you.
Things like physiotherapists, psychologists, speech therapists, audiologists, homeopaths, and chiropractors are not covered at all. Dentistry is limited to the cost of consultation, fillings, and tooth removals.

There are three plan types available from most to least comprehensive:

  • KeyCare Plus
  • KeyCare Access, and
  • KeyCare Core

KeyCare Plus allows:

  • a KeyCare networked doctor,
  • a KeyCare dentist,
  • to grab a pair of spectacles from a KeyCare optometrist every two years,
  • to visit a KeyCare networked private hospital.
  • There is also limited access to private specialists.

KeyCare Access is really focused on mothers to be.
It allows:

  • a KeyCare networked doctor,
  • a KeyCare dentist,
  • the spectacles from a KeyCare optometrist,
  • a hospital stay at either a KeyCare access hospital (for childbirth and trauma) OR certain state hospitals for anything else.
  • Private specialists are covered when seen for emergencies, trauma, childbirth, and for your baby up to 12 months after childbirth.

KeyCare Core allows:

  • Hospital stays in a KeyCare networked private hospital, and
  • Limited access to private specialists.

Is KeyCare for you?

Three things which could sway you towards KeyCare:

  • Do you fall into one of the income bands where this option suddenly becomes value for money?
  • Do you have a large family who tend to see the doctor more than their hairdresser?
  • Does the prospect of landing up in a state hospital scare the pants off of you?

Since the cost difference between KeyCare Plus and KeyCare Access is negligible, I’d say KeyCare Plus is the better option if you’re undecided between the two. KeyCare Core is much cheaper so its not a fair comparison.

We’ll get into specifics of KeyCare at a later stage. Look out for the next article wherein I’m going to unravel the Executive plan.

Do you need assistance with your medical aid?

Until next time.

The InsuranceFundi Team

 
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