2026 Rules Active
2026 Validated
Upfront savings-first day-to-day control.
Actuarial Objective
Optimises for predictable routine spend funded from the Medical Savings Account (MSA), with hospital PMB cover via DSP.
Running Actuarial Simulation...
More Plan Options
Save R2175 pm
Bestmed
Rhythm1
Strategy: Rhythm1 Entry-Level Earner (<R9k)
Upgrade for +R69 pm
Discovery Health Medical Scheme
KeyCare Plus
Strategy: KeyCare Plus Income‑Banded Network Plan
Key Terms for this Strategy
- Medical Savings Account (MSA)
- A fund of R11,733 included in your premium. You use this for day-to-day expenses like GP visits and scripts.
People Also Ask
If I get cancer, am I fully covered or is there a yearly cap I could hit?
This plan has a stated oncology utilisation threshold of R297,079.18 per beneficiary per year, and once you go above that amount a 20% co-payment applies for non-PMB oncology-related costs (and oncology is subject to using the oncology DSP and scheme rules).
Do I have to use a specific oncology network, or can I go to any oncologist I want?
Oncology is subject to using the Oncology DSP, and pre-authorisation / scheme rules apply, so using a non-aligned provider may affect how the claim is paid.
If my doctor recommends a prosthesis (like a hip/knee/shoulder component), what is the maximum this plan will pay in a year?
There is an annual overall prosthesis limit of R39,048.35 per family per year, and prostheses are also subject to pre-authorisation, managed care protocols, and PMB rules where applicable.
If my prosthesis costs more than the family prosthesis limit, will I be stuck paying the shortfall myself?
If the prosthesis costs exceed the stated annual overall prosthesis limit of R39,048.35 per family per year, the amount above the limit would not be covered under that prosthesis limit and would typically remain for the member’s account, subject to scheme rules.
If I choose a hospital that is not part of the scheme’s DSP arrangements, will my admission still be covered?
Hospital benefits are stated as only available at the Designated Service Providers (DSPs), and admissions are subject to pre-authorisation and scheme rules, so non-DSP usage is a major risk point.
If I forget to pre-authorise an elective admission, what happens to my claim?
All admissions (including PMBs) are subject to pre-authorisation and scheme rules, and the brochure indicates a penalty for non-emergency late pre-authorisations.
When my savings (MSA) runs out, do I still get any GP consultations covered?
GP consultations are paid from the MSA, and once depleted the brochure describes a limited additional GP consultation benefit (with a family cap) rather than unlimited ongoing cover.
When my savings (MSA) runs out, do I still get any specialist consults covered?
Specialist consultations are paid from the MSA, and once depleted the brochure describes a limited additional specialist consultation benefit (restricted to certain specialist types) rather than unlimited cover.
If I need an MRI/CT scan, could I still end up paying a co-payment even if I’m approved?
Advanced specialised radiology is described as subject to clinical protocols and pre-authorisation, and the brochure indicates a percentage co-payment for non-PMB scans (so out-of-pocket costs are possible depending on PMB status).
Are there any procedures where I automatically pay a co-payment even if I’m admitted properly?
The brochure notes a percentage co-payment for certain laparoscopic procedures done in-hospital (with stated exceptions), and also references co-payments for day procedures done at certain acute hospitals.