Benefit enhancements for 2019

1. Most benefit limits for 2019 will increase to accommodate yearly inflation and cost increases.

2. LA KeyPlus covers a defined list of procedures or treatment when performed at facilities in the Scheme’s day surgery network. In 2019, the list will be extended to include additional procedures. To ensure the Scheme pays for these procedures, it will have to be performed at one of these day surgery facilities.

3. Endoscopic procedures will from 2019 only be covered if the investigation is related to a Prescribed Minimum Benefit condition.

4. When you want to make use of the services of a Specialist in the KeyCare Network, you will have to be referred to that Specialist by your chosen KeyCare Network GP. The KeyCare Specialist working in a KeyCare Network Hospital must in turn refer you to the Hospital for any planned in-hospital procedures.