Discovery's KeyCare Range

KeyCare is Discovery's most affordable plan range. It uses a network of providers — GPs, specialists, hospitals and pharmacies — and contributions are based on the member's household income, not on age or family size in the same way as other plans.

What makes KeyCare different

Most medical schemes charge the same contribution to everyone on a given plan, regardless of what you earn. KeyCare doesn't. It uses income bands — the lower your household income, the lower your monthly contribution.

In exchange for affordability, KeyCare uses a tight network of approved providers. You see your nominated GP, you go to network specialists, you fill prescriptions at network pharmacies, and you admit to network hospitals. Step outside the network and most planned care is not covered.

How income-based premiums work

When you apply, Discovery asks for proof of household income — payslips, an IRP5, or in some cases bank statements. They place you in an income band. Each band has its own contribution.

Income is reviewed annually. Earn more next year, and you may move into a higher band with a higher contribution. Don't disclose — and Discovery can charge you the top-band rate retroactively.

The KeyCare plan options

• KeyCare Plus: The richest KeyCare plan. National hospital network, defined day-to-day benefits, chronic cover on the 27 CDL conditions, nominated GP. The most popular KeyCare option.

• KeyCare Core: Hospital and chronic cover only — no day-to-day benefits. Suits members who can self-fund GP visits.

• KeyCare Start: Lower-cost than Plus, with a smaller hospital network and tighter benefit limits.

• KeyCare Start Regional: The most affordable KeyCare. Hospital network restricted to one region — typically Gauteng or the Western Cape — at the lowest contribution.

How the GP and specialist network works

When you join KeyCare you nominate a GP in the Discovery KeyCare network. That GP becomes your gatekeeper — they manage your routine care, prescribe acute medicine, and refer you to specialists when needed.

Out-of-network GP visits are not covered for routine care. Out-of-network specialist visits are not covered. Acute medicine must be prescribed by your network GP and filled at a network pharmacy.

Hospital cover and the emergency exception

Planned hospital admissions must happen at a KeyCare network hospital. Use a non-network hospital and the scheme generally does not pay — the member is liable for the bill.

Emergencies are different. In a true medical emergency, KeyCare covers care at any hospital at 100% of the Discovery Health Rate. Once stabilised, you may be transferred to a network hospital.

Personal Health Fund on KeyCare

Like other Discovery plans, KeyCare members can grow a Personal Health Fund by completing health activities — annual screening, GP visit, immunisations. The PHF unlocks additional benefits during the year and rewards engagement. It's a meaningful uplift for members who use it.

Who KeyCare suits well

• Lower-income employed members who need genuine medical scheme cover (not hospital cash plans or gap cover).

• Members in metros with strong network density — Gauteng, Cape Town, Durban, Tshwane.

• Members happy to use a nominated GP and approved pharmacies.

• First-time medical scheme members under 35 who want to lock in cover before a late joiner penalty would apply.

Who KeyCare is not ideal for

• Members in rural areas where the network is thin.

• Members who already have established specialist relationships outside the network.

• Higher-income households who would pay the top KeyCare band but get richer cover for similar money on a non-KeyCare plan.

• Families with complex chronic conditions outside the 27 CDL conditions — additional disease cover is not as broad as on the higher ranges.