DISCOVERY HEALTH MEDICAL SCHEME CHANGES FOR 2014

Transcription

1 Dear Edcon Discovery Health member October 2013 DISCOVERY HEALTH MEDICAL SCHEME CHANGES FOR 2014 This letter provides you with details on various changes announced by Discovery Health for This is your opportunity to change your plan option with effect from 1 January To make the right choice, you need to consider your healthcare needs and ensure you choose the right level of cover for You don t have to make a change, but if you want to amend your current plan option, you need to submit your option change form to the Edcon Medical Aid Department before 29 November CHANGING YOUR PLAN OPTION You have until 29 November 2013 to change your plan NEED ASSISTANCE? Who to call for information, advice and questions CONTRIBUTION INCREASE Discovery Health announced a 8.9% average increase for 2014 HOSPITALISATION CHANGES Changes to networks and deductibles COMPASSIONATE CARE BENEFIT The Terminal care benefit amended and limits increased CHRONIC ILLNESS BENEFIT Formulary changes and new benefits OTHER CO-PAYMENTS AND LIMIT CHANGES Changes in co-payment amounts and limits DAY TO DAY BENEFITS Changes on the Insured Network Benefit and new preferred medicine list (acute medication) KEYCARE BENEFIT CHANGES Changes to income bands and limits VITALITY CHANGES Extended HealthyFood benefit, travel benefit and new hotel collection, Livewell and Smartphone and fitness devices GAP COVER Increase and benefit changes to AdmedAdd+

2 CHANGING YOUR PLAN OPTION Please refer to the Edcon letter enclosed in this pack for your 2013 vs 2014 premium comparison based on your current option. You can also access the subsidy tool on the Edcon intranet to determine how you will be subsidised on the various options. The website address is: How to change your plan Please note that if you do not notify the Edcon Medical Aid Department of your plan option change prior to the deadline, by completing the enclosed plan option change form, you will remain on your current plan until ASSISTANCE WITH CHOOSING YOUR PLAN OPTION Contact the Discovery Health Medical Scheme for general plan information by: Browsing the website Making use of the national walk-in centres; Discovery magazine (spring edition); Alexander Forbes Health consultants will also be available to assist you to make the right plan option choice. Name Telephone number address Emma Mosete Alexander Forbes Health Service Unit CONTRIBUTION INCREASE The average contribution increase, effective 1 January 2014, of 8.9% reflects a view of the current industry scenario and the scheme s sound operating position. The increase is applicable to all plan options. However as a result of the rounding of numbers a few variations do exist. Please refer to Annexure A of this letter for the 2014 contributions as well as the increased threshold levels on the Priority, Comprehensive and Executive Plans. HOSPITALISATION CHANGES Networks Refer to Annexure C for the list of hospitals applicable to the KeyCare series and Delta plan options. KeyCare Core and KeyCare Plus members must go to one of the listed KeyCare network hospitals for planned hospital admissions. If you do not use these hospitals for planned hospital admissions, you ll need to pay the bill. The same hospital network list applies to KeyCare Access members in case of life threatening admissions and defined trauma events only. The KeyCare Access Hospital Network list applies to KeyCare Access members, but only for childbirth and care for newborns. Other approved hospital admissions for KeyCare Access members are covered in Discovery s network of state facilities. The Delta Hospital Network applies to all Delta plans for planned admissions. The deductible is not applicable in case of life threatening admissions. Deductibles Priority plan members should note that the defined deductibles for in-hospital procedures will range from R2 150 to R in Please refer to Annexure B for more details. Delta plans members should note that the deductible has increased from R5 000 to R5 450, if you do not use the Delta Hospital Network for planned procedures.

3 The 2014 deductibles for in-hospital or in day-clinic dentistry treatment are as follows: Category of members In-hospital treatment Treatment in Day-clinic Members younger than 13 years R1 550 R 750 Members older than 13 years R4 000 R2 600 COMPASSIONATE CARE BENEFIT The Terminal Care Benefit will be renamed to the Compassionate Care Benefit. It provides access to extended home-based holistic care, including services such as pain relief, hydration, nursing and support care such as hospice services. A benefit of R for each person in their lifetime will be applicable to all plan options, except for the KeyCare plans where a limit of R for each person in a lifetime will apply. CHRONIC ILLNESS BENEFIT (CIB) Discovery s CIB medicine list and Chronic Drug Amounts (CDA) for 2014 have been reviewed based on annual pricing movements. From next year, members of the Delta plan options will have to use the scheme s courier pharmacy (MedXpress) to obtain their chronic medication. If you don t use MedXpress a 20% co-payment will apply. Funding Ordered through MedXpress Not ordered through MedXpress On formulary Full Cover 20% co-payment + Any additional dispensing fees Off formulary Co-payment above CDA 20% co-payment + Any additional dispensing fees + Copayment above CDA Above-mentioned changes will be implemented on 1 January 2014 for all new members and on 1 July 2014 for existing members. Managing diabetes digitally The ifora Diamond Mini Telemetric Glucometer will be funded by the scheme from January 2014 via MedXpress or at Dischem pharmacies for all diabetic members registered on the Chronic Ilness Benefit (except KeyCare Plan members). This device captures blood glucose readings (replaces home diary), insulin medicine levels, and logs exercise and meals in real time. This data integrates seamlessly with HealthID and LivingVitality and can be accessed remotely by doctors. The ifora app can be downloaded free of charge for ios and Android devices (in development for Blackberry devices). The offer is valid for one device per member for OTHER CO-PAYMENTS AND LIMIT CHANGES Co-payments and deductibles will increase in line with the overall increase (kindly refer to the Discovery Health brochure for various limits per plan) The co-payment for MRI/CT scans will remain constant at R2 450 per scan, where applicable Limits for surgical devices will increase by surgical inflation Limits for Oncology will remain constant: Benefit option Executive and Comprehensive plans Priority, Saver, Core plans KeyCare Oncology Limit R per member for approved cancer treatment in a 12-month cycle, a co-payment of 20% applies after the limit has been reached R per member for approved cancer treatment in a 12-month cycle, a co-payment of 20% applies after the limit has been reached Cover according to the Prescribed Minimum Benefits and cancer specialists within Discovery s network for KeyCare members

4 DAY TO DAY BENEFITS Medical Savings Account (MSA), Insured Network Benefit (INB) and Above Threshold Benefit (ATB) Members registered on Core plans do not have access to day to day benefits. KeyCare Plus and KeyCare Access plan options, offer defined unlimited benefits through network providers. All other options provide day to day cover through the Medical Savings Account, Insured Network Benefit and Above Threshold Benefit (where applicable). Medical Savings Account (MSA) Day-to-day expenses are initially paid from the MSA All unused funds are carried over to the following year The funds in the MSA is available upfront to the member and dependants The funds in the MSA will be prorated if the member joins mid year The allocated amount will be based on the members plan and family size and the the percentage allocation is based on a stipulated percentage of the total contribution: o Classic 25% of contribution (except Classic Comprehensive Zero MSA, which has no MSA) o Essential 15% of total contribution o Coastal 25% of total contribution Insured Network Benefit (INB) Day-to-day expenses are paid from the INB once the annual MSA allocation has been depleted The benefits can only be accessed through Discovery network providers The 2014 INB will consists of: GP Consultations, Pathology (blood tests), Acute Medication and a new Maternity and External medical items benefit: Networks Description GP Consultations DH GP Network only Consultations fees Pathology Maternity Benefit Acute Medicine External Medical items At Dischem, Gynaecologist and At Dischem, Clicks A network of Clicks and obstetrician within Discovery and MediRite, independent providers MediRite network of providers (All MedXpress and a pharmacies Classic and Premier network of only Gynaecologists and independent Blood tests Obstetricians) Antenatal consultations and 2D pregnancy scans; 2D scans will be covered in the INB if a member has already claimed for 2 scans while in their MSA Consultations 2D pregnancy scans pharmacies Preferentially priced, generic and brand medicines (Scheduled 3+); Acute medicine benefit has been re-designed to offer members preferential cover for medicines beyond a generic or brand innovator medicine status A defined list of durable external medical items subject to external medical items sub-limit are included, for example Mobility aids: wheelchairs and walkers Breathing devices: CPAP machines, APAP machines, VPAP machines and portable oxygen concentrators Insulin pumps Executive Unlimited Unlimited Unlimited 2 Unlimited Unlimited Classic Comprehensive Unlimited Classic Delta Comprehensive Unlimited Classic Comprehensive Zero No Benefit No Benefit No Benefit No Benefit No Benefit No Benefit MSA Essential Comprehensive Unlimited Unlimited Essential Delta Comprehensive Classic Priority Unlimited Unlimited up to the ATB 2 Essential Priority No Benefit No Benefit No Benefit

5 Classic Saver Classic Delta Saver Single: 3 Family:6 Essential Saver Single: 2 Essential Delta Saver Family:4 Coastal Saver Single: 3 Family:6 8 2 No Benefit No Benefit No Benefit Above Threshold Benefit (ATB) The Executive, Comprehensive and Priority plans include an ATB that provides further day to day cover once claims have accumulated up the to applicable annual threshold levels. The ATB is unlimited on the Executive and Comprehensive series whilst there is a limited ATB on the Priority plan. The Saver plans do not offer an ATB. Please refer to Annexure A for the applicable threshold levels. Preferred Medicine List for acute medication The 2013 medicine list has been amended to include both generic and non generic (brand items). The generic medicines which have been removed from the list (28 generic items) have a generic or brand equivalent on the new list, 22 brand names items have been added. Certain brand name items will be covered from 2014 such as: Symbicord no generic equivalent Logynon 35% more affordable than generic equivalent Discovery Health will pay up to 100% of the DHR for medicines included on their preferred medication list, from MSA. Those medicines not included on the preferred medication list, will be reimbursed at and accumulate at 75% of the Discovery Health rate Day to Day 2014 Generic Medicine 100% accumulation Cover from INB and ATB Preferred Medicine list Non-generic medicine 75% accumulation Cover from ATB only Medicine not on Preferred Medicine list Discovery Health will pay and accumulate up to 90% of the DHR on the Executive Plan. Netcells Biosciences Stem Cell Banking From 2014, all members will be entitled to an upfront discount of up to 25% on umbilical cord blood and tissue stem cell banking through Netcells Biosciences. KEYCARE PLANS KeyCare income bands have been increased by an average inflationary amount of 6.3%. Kindly refer to Annexure A for the new income bands; The Specialist benefit amount will increase from R2 550 to R2 750 per person; The Casualty benefit co-payment (facility fee) will increased from R205 to R225 per casualty visit; The KeyCare plan option specific exclusions have been listed in Annexure B VITALITY CHANGES HealthyFood Benefit In 2014 all Vitality members will have access to HealthyFood from Woolworths and Pick n Pay, irrespective of their plan choice On activating the benefit Vitality members can get up to 10% cash back at Pick n Pay and Woolworths Vitality members can get up to 15% cash back at Pick n Pay or Woolworths once they completed the online Vitality Health review to obtain their Vitality age Vitality members can get up to 25% cash back at Pick n Pay or Woolworths once they completed the Vitality Health Check at a preferred provider Members have to select a preferred partner, either Pick or Pay or Woolworths for the 25% cash back Members will also qualify for 10% when shopping at the other partner

6 DiscoveryCard holders (credit card) could qualify for up to 25% cash back at both partners Members do not have to pay using their DiscoveryCard; HealthyFood cash back also applies to Woolworths online purchases but not to Engen Woolworths store purchases Identification mechanisms o Pick n Pay: HealthyFood card or your DiscoveryCard o Woolworths: Woolworths Difference card or MySchool card (MySchool card members must first go to and give permission to share their personal details) Travel Benefit (Flights) All international flights must be booked at least six weeks in advance and members may book a maximum of two international flights per person per year; The following eight Quantas destinations have been added: Auckland, Perth, Sydney, Adelaide, Brisbane, Christchurch, Melbourne and Wellington; 101 additional new Emirates destinations have been added such as Athens, Milan, San Francisco, Rome, Toronto, Seattle and many more, whilst the Maldives and Phuket have been removed from the Emirates destinations for 2014 Maputo has been added by British Airways as a new destination All flights go via Dubai when flying with Emirates, via Sydney or Perth with Quantas and via London with British Airways All tickets must be booked through Kulula.com, through the kulula.com call centre or the Discovery member application Booking fee of R29 per member per booking Hotels A new Vitality Hotel Collection (Tsogo Sun, Protea Hotels, Legacy Hotels, Thorny Bush Game Lodges and others), has been introduced which includes more than 500 top hotels, lodges, resorts and B&Bs Discounts on Hotel Accommodation ranges from 15% to 35% and from 30% to 50% if booked using the DiscoveryCard Accommodation must be booked through kulula.com Booking no longer has to include a Saturday night A booking fee of R25 for each room will apply to bookings made through Vitality; Bookings must be for a minimum of two nights Bookings must be made at least 21 days before the check-in date Members can book for a maximum of 14 nights per year Live Well Programme The Vitality Live Well programme runs in a 12 week cycle and will give members access to individually tailored advice, wellness specialists, support and tools. Smartphone and Fitness Devices Fitness sessions can be logged on the Discovery App or a web-enabled device. Members will receive 50 bonus points for using one of the Fitness Devices. GAP COVER MEDICAL INSURANCE AdmedAdd+ Admed is a specially designed product which provides cover for the shortfall or gap, in the event of hospitalisation involving surgery or medical treatment and for certain procedures performed on an outpatient basis. The contribution for the mentioned policy arrangement will increase from R82 (2013) to R90 per family per month with effect from 1 January The below table summarises the various products offered by Guardrisk. The changes from 2013 to 2014 have been highlighted.

7 Product Premium Description Additional Benefits AdmedAdd + R90 per family per month The shortfall, or gap, is defined as the amount by which the actual cost charged by the medical practitioner exceeds the medical scheme payment subject to a maximum limit of five times (2013: 4 times) the Admed tariff. Personal Accident Cover, RoadCover A once off lump sum of R on diagnosis of Breast and Prostate cancer A stated benefit of R with no sub limits for copayments and deductibles(in-hospital treatment) The following changes will be implemented from January 2014: The overall annual limit has been increased from R per beneficiary per annum (subject to an overall limit of R2 million per family per annum) to R per beneficiary per annum( subject to an overall limit of R2,5 million per family per annum) The stated benefit has increased from R10,000 to R20,000 The Personal Accident cover which was only available to the principal member has now been extended to all insured persons under Admed. Existing employees/medical scheme members who have not yet joined AdmedAdd+ may join on 1 January. The application form enclosed needs to be completed and returned to the Edcon Medical Aid Department on the details indicated below. Please note that certain waiting periods will apply to new members for pre-existing conditions. Details of the benefits, general exclusions and waiting periods can be obtained from Alexander Forbes Health or the Admed website on The proposed demarcation rulings are still pending and may have an impact on these policies once finalised. Alexander Forbes Health is available to help you to make the right choice. Yours in health Alexander Forbes Health To keep your finger on the pulse of the Medical Scheme industry, follow us on Twitter Discovery Health Alexander Forbes Health Edcon Onsite Consultant (Emma Mosete) Tel: healthinfo@discovery.co.za Tel: medicalaid@edcon.co.za Alexander Forbes Health Service Team Tel: hcclientservices@aforbes.co.za Admed/ Guardrisk Tel: Admed@guardrisk.co.za Website: Alexander Forbes Health will endeavour to keep you informed as further information becomes available or changes. This document serves as a simple summary of Discovery Health changes for 2014 and is not a comprehensive description of all changes, nor is it intended as advice. Alexander Forbes Health (Pty) Ltd will not be held liable for any errors herein. E & OE apply.

8 ANNEXURE A 2014 TOTAL MONTHLY CONTRIBUTIONS BEFORE EDCON SUBSIDY Series Plan Principal Member Adult Dependant* Child Dependant* Executive Executive R4 100 R4 100 R778 Comprehensive Classic Comprehensive R3 362 R3 180 R670 Classic Delta Comprehensive R3 028 R2 864 R602 Classic Comprehensive Zero MSA R2 522 R2 385 R503 Essential Comprehensive R2 825 R2 670 R568 Essential Delta Comprehensive R2 544 R2 403 R509 Priority Classic Priority R2 254 R1 774 R902 Essential Priority R1 937 R1 522 R774 Saver Classic Saver R1 976 R1 556 R790 Classic Delta Saver R1 578 R1 244 R633 Essential Saver R1 570 R1 175 R628 Essential Delta Saver R1 254 R942 R502 Coastal Saver R1 556 R1 166 R625 Core Classic Core R1 471 R1 157 R587 Classic Delta Core R1 177 R925 R471 Essential Core R1 263 R947 R506 Essential Delta Core R1 010 R757 R405 Coastal Core R1 087 R815 R434 KeyCare KeyCare Plus (R8 801+) R1 448 R1 448 R388 KeyCare Plus (R6 651 to R8 800) R973 R973 R272 KeyCare Plus (R0 to R6 650) R695 R695 R251 KeyCare Access (R8 801+) R1 416 R1 416 R381 KeyCare Access (R6 651 to R8 800) R942 R942 R267 KeyCare Access (R4 151 to R6 650) R653 R653 R235 KeyCare Access (R0 to R4 150) R490 R490 R212 KeyCare Core (R8 801+) R1 070 R1 070 R241 KeyCare Core (R6 651 to R8 800) R693 R693 R171 KeyCare Core (R0 to R6 650) R556 R556 R143 *Contributions are charged up to a maximum of 3 children; Dependants 21 years + are considered adult dependants Medical Savings Account (included in the above monthly contribution, where applicable) Series Plan Principal Member Adult Dependant Child Dependant Annual Monthly Annual Monthly Annual Monthly Executive Executive R R1 025 R R1 025 R2 328 R194 Classic R R840 R9 540 R795 R2 004 R167 Comprehensive Classic Delta R9 084 R757 R8 592 R716 R1 800 R150 Essential R5 076 R423 R4 800 R400 R1 020 R85 Essential Delta R4 572 R381 R4 320 R360 R912 R76 Priority Classic R6 756 R563 R5 316 R443 R2 700 R225 Essential R3 480 R290 R2 736 R228 R1 392 R116 Classic R5 928 R494 R4 668 R389 R2 364 R197 Saver Classic Delta R4 728 R394 R3 732 R311 R1 896 R158 Essential R2 820 R235 R2 112 R176 R1 128 R94 Essential Delta R2 256 R188 R1 692 R141 R900 R75 Coastal R4 668 R389 R3 492 R291 R1 872 R156

9 ANNEXURE A 2014 ANNUAL THRESHOLD LEVELS Executive and Comprehensive plans Executive Plan Comprehensive Plans Principal member R R Per adult R R Per child* R2 300 R2 150 * A maximum of three children are counted when calculating the Annual Threshold Priority plans Annual Threshold Above Threshold Limit Principal member R9 990 R8 500 Per adult R7 510 R6 050 Per child* R3 270 R2 920 * A maximum of three children are counted when calculating the Annual Threshold and Above Threshold Limit 2014 VITALITY & KEYFIT CONTRIBUTIONS Single Member Member with one dependant Member with two or more dependants Vitality R169 R199 R225 KeyFIT R36 R44 R55 Vitality & KeyFIT R179 R215 R249 LATE JOINER PENALTIES Please note these rates are the standard Discovery Health rates and do not take into account any late joiner penalties (LJP) that may be applied to an applicant or to the adult dependant of an applicant older than age 35. Depending on the number of years they have not belonged to a registered South African medical scheme, an additional penalty (a percentage of the contribution) may be added to the member's monthly contribution, as shown in the table below: Penalty bands Maximum penalty 1 4 years 0,05 X contributions 5 14 years 0,25 X contributions years 0,5 X contributions 25+ years 0,75 X contributions The LJP is calculated as follows: A = B minus (35 + C) Where: A = the number of years in the first column B = the age of the applicant at the time of application C = the number of years of creditable cover

10 ANNEXURE B PRIORITY SERIES (DEDUCTIBLES) AND KEYCARE PLAN OPTION EXCLUSIONS Priority series deductibles Members need to pay an amount upfront to the hospital when the member is admitted for one of the following procedures: DEDUCTIBLE AMOUNT R R R R PROCEDURE Conservative back and neck treatment Myringotomy (grommets) Tonsillectomy Adenoidectomy Colonoscopy Sigmoidoscopy Proctoscopy Gastroscopy Cystoscopy Arthroscopy Functional Nasal Procedures Hysterectomy (except for pre-operatively diagnosed cancer) Laparoscopy Hysteroscopy Endometrial ablation Nissan fundoplication (reflux surgery) Spinal surgery (back and neck) Joint replacements If the procedure can be done out of hospital, for example in the doctor s rooms, and the member doesn t go to hospital, the member won t have to pay a deductible. It is recommended that members contact Discovery Health directly on prior to the procedure to confirm their benefits KeyCare Series exclusions In addition to the general exclusions that apply to all plan options, the KeyCare Series does not cover the following, unless it is a Prescribed Minimum Benefit: 1. Hospital admissions related to: Dentistry Nail disorders Skin disorders Investigations and diagnostic work-up Functional nasal surgery Elective caesarean section, except if medically necessary Surgery for oesophageal reflux and hiatus hernia Back and neck treatment or surgery Joint replacements, including but not limited to hips, knees, shoulders and elbows Cochlear implants, auditory brain implants and internal nerve stimulators this includes procedures, devices and processors Healthcare services that should be done out of hospital and for which an admission to hospital is not necessary 2. Correction of Hallux Valgus/Bunion and Tailor s Bunion/Bunionette 3. Arthroscopy 4. Removal of varicose veins 5. Refractive eye surgery 6. Non-cancerous breast conditions 7. Healthcare services outside South Africa Discovery Health does not cover the cost of treatment for any complications or the direct or indirect expenses related to any of these excluded conditions and treatments.

11 ANNEXURE C DISCOVERY HEALTH HOSPITAL NETWORKS AREA HOSPITALS DELTA KEYCARE Core / Plus* Access** EASTERN CAPE East London Life Beacon Bay Hospital East London Life St James Operating theatres East London Life East London Private Hospital East London Life St Dominic s Private Hospital Humansdorp Life Isivivana Private Hospital Kokstad NetCare Kokstad Hospital Port Elizabeth Life New Mercantile Hospital Queenstown Life Queenstown Private Uitenhage Netcare Cuyler clinic Uitenhage Netcare Uitenhage Hospital Umtata Life St Mary's Private Hospital FREE STATE Bethlehem Hoogland MediClinic Bloemfontein Bloemfontein Eye Centre Bloemfontein Netcare Pelonomi Private Hospital Bloemfontein Life Rosepark Hospital Bloemfontein Life Pasteur Hospital Bloemfontein Netcare Universitas Private Hospital Welkom Ernest Oppenheimer Hospital Welkom Welkom Mediclinic Welkom St Helena Hospital GAUTENG Alberton Clinton Hospital Bedfordview Life Bedford Gardens Hospital Benoni Life The Glynwood Hospital Boksburg Botshelong Empilweni-clinic (Clinix Vosloorus) Boksburg Sunshine Centre Brakpan Life Dalview Clinic Fourways Life Fourways Hospital Germiston Life Roseacres Clinic Heidelberg Life Suikerbosrand Clinic Johannesburg Netcare Rand Clinic Johannesburg Morningside Mediclinic Johannesburg Johannesburg Eye Clinic Johannesburg The Donald Gordon Medical Centre Johannesburg Netcare Garden City Clinic Johannesburg Life Brenthurst Clinic Kempton park Arwyp Medical Centre Krugersdorp Netcare Krugersdorp Hospital Lakefield Netcare Optiklin Eye Hospital Lenasia Lenmed Clinic Midrand Life Carstenhof Clinic Pretoria Netcare Bougainville Private Hospital Pretoria Centurion Eye Hospital Pretoria Netcare Femina Hospital Pretoria Life Little Company of Mary Pretoria Life Eugene Marais Hospital Pretoria Netcare Jacaranda Hospital Pretoria Legae MediClinic Pretoria Louis Pasteur Hospital Pretoria Medforum MediClinic

12 AREA HOSPITALS DELTA KEYCARE Core / Plus Access GAUTENG CONT. Pretoria Muelmed Hospital Pretoria Pretoria-Eye Institute Pretoria Zuid-Afrikaans Hospital Randfontein Life Robinson Private Hospital Randfontein Sir Albert Medical Centre Roodepoort Life Wilgeheuwel Hospital Sasolburg Netcare Vaalpark Hospital Soweto Clinix Private Hospital - Tshepo Themba Soweto Clinix Private Hospital - Lesedi Springs Life Springs Parkland Clinic Springs Life St Mary s Women s Clinic Springs Netcare N17 Hospital Thembisa Zamokuhle Private Hospital Vanderbijlpark Emfuleni MediClinic Vanderbijlpark Ocumed Vereeniging Clinix Private Hospital - Sebokeng Vereeniging Midvaal Private Hospital Westgate Medgate Day Clinic KWAZULU-NATAL Amanzimtoti Netcare Kingsway Hospital Chatsworth Life Chatsmed Garden Hospital Durban Life City Hospital Durban Life Entabeni Hospital Durban Ethekwini Hospital Durban McCord Hospital Empangeni Life Empangeni Garden Clinic Isipingo Life Isipingo Clinic Kokstad Kokstad Private Hospital Ladysmith La Verna Hospital Newcastle Newcastle Private Hospital Phoenix Life Mount Edgecombe Hospital Pietermaritzburg Midlands Medical Centre Pietermaritzburg Netcare St Anne s Pinetown Life Crompton Hospital Port Shepstone Hibiscus Hospital Richards Bay Netcare The Bay Hospital Sydenham Nu Shifa Hospital Tongaat Victoria Private Hospital Westville Life Westville Hospital LESOTHO Lesotho Willie s Hospital LIMPOPO Bela Bela St Vincent's Hospital Phalaborwa Clinix Phalaborwa Private Hospital Polokwane Limpopo MediClinic Thabazimbi Thabazimbi MediClinic Tzaneen Tzaneen MediClinic MPUMALANGA Barberton Barberton MediClinic Emalahleni/Witbank Life Cosmos Hospital Emalahleni/Witbank Emalahleni Day Hospital Ermelo Ermelo Private Hospital Middelburg Life Middelburg Private Hospital Nelspruit Nelspruit MediClinic Trichardt Highveld MediClinic

13 AREA HOSPITALS DELTA KEYCARE Core / Plus Access NORTH WEST Carletonville Leslie Williams Private Hospital Carletonville Western Deep Clinic Klerksdorp Life Anncron Clinic Mafikeng Victoria Private Hospital Orkney West Vaal Clinic Potchefstroom Potchefstroom MediClinic Rustenburg Life Peglerae Hospital Rustenburg Netcare Ferncrest NORTHERN CAPE Kathu Kathu MediClinic Kimberley Kimberley MediClinic Upington Upington Private Hospital Vryburg Vryburg Private Hospital WESTERN CAPE Bellville Bellville Medical Centre Bellville Louis Leipoldt MediClinic Cape Town Netcare Christiaan Barnard Memorial Cape Town Netcare UCT Medical Centre Cape Town Cape Town Mediclinic Claremont Life Claremont Hospital Claremont Life Kingsbury Hospital Ceres Ceres Private Hospital Gatesville Gatesville Medical Centre George Geneva Clinic George George MediClinic Hermanus Hermanus MediClinic Kuilsriver Netcare Kuilsriver Private Hospital Milnerton Milnerton MediClinic Mitchells Plain Mitchells Plain Medical Centre Mossel Bay Bayview Hospital Oudtshoorn Cango Day Clinic Oudtshoorn Klein Karoo MediClinic Paarl Paarl MediClinic Parow Panorama Mediclinic Somerset West Vergelegen Mediclinic West Coast Life West Coast Private Hospital Worcester Worcester MediClinic * This list applies to the KeyCare Core and Plus plans; The list also applies to KeyCare Access but only for life threatening emergencies and defined trauma event ** This list applies to the KeyCare Access, only for childbirth and care for the newborn Please note that the list of hospitals is subject to change. You can go to for the latest list of hospitals. The list does not include the day clinics where members can get treatment without paying an amount upfront.