Cover for Kidney Disease on your Medical Aid

What is Kidney Disease?

Chronic kidney disease occurs when the kidneys function less than expected. The kidneys are important and are responsible for excreting waste products, for electrolyte balance and for the production of certain hormones. Due to several causes of chronic kidney disease, many of the above functions can be affected. Kidney disease can be present from birth (congenital) or acquired as a result of high blood pressure, diabetes, HIV or aging.

Symptoms of chronic kidney disease

Chronic kidney disease is often a silent disease because the patient might not experience many symptoms. This is why many people are only diagnosed when the condition is already established, and not in the early stages when further progression can be prevented. Signs and symptoms may include:

Nausea and vomiting

Decreased mental sharpness

Loss of appetite

Muscle twitches and cramps

Swelling of feet and ankles

Persistent itching

Changes in how much you urinate

Chest pain, if fluid builds up around the lining of the heart

High blood pressure (hypertension) that's difficult to control

Fatigue, weakness and sleep problems

How to register

CIB Application Form (PDF)

Registering

When you are first diagnosed with kidney disease, you should apply for the Chronic Illness Benefit (CIB). Your doctor will fill in the CIB application form and send it off for you to ensure that your approved treatments are covered. Alternatively, your doctor can apply electronically through HealthID.

Note to KeyCare plan members:

If you are a KeyCare member, your specialist (a nephrologist or specialist physician) must also complete the KeyCare application form for chronic renal dialysis. Please also refer to the KeyCare Renal Network List to find a suitable provider to help manage your condition.

Cover for renal dialysis services

The level of cover for renal dialysis services depends on your chosen plan.

Please select a plan series

You can receive dialysis at any dialysis provider. We will pay your claims up to the Discovery Health Rate as long as you have preauthorised your treatment. A co-payment will apply should your chosen service provider bill more than the Discovery Health Rate.

You can make use of our Dialysis network to enjoy full cover and to avoid a co-payment.

You can receive dialysis at any dialysis provider. We will pay your claims up to the Discovery Health Rate as long as you have preauthorised your treatment. A co-payment will apply should your chosen service provider bill more than the Discovery Health Rate.

You can make use of our Dialysis network to enjoy full cover and to avoid a co-payment.

We will cover these expenses in full if we have approved your treatment plan and you go to a network provider for your dialysis treatment. If you go to another provider, we will pay up to 80% of the Discovery Health Rate (DHR).

Classic Smart

We will cover these expenses in full if we have approved your treatment plan and you use a provider in our network. If you go to another provider, we will pay up to 80% of the Discovery Health Rate (DHR).

Essential and Essential Dynamic Smart

You have cover at a provider in a state facility.

KeyCare Plus and KeyCare Core

In order to be covered, you must meet the clinical entry criteria and you must go to a network provider or you can go to a state facility for your dialyss treatment. If you go elese where, we will pay up to 80% of the Discovery Health Rate (DHR). For any other services related to your dialysis treatment such as consultations, blood tests and x-rays you are covered in a state facility.

KeyCare Start

You have cover at a provider in a state facility

The Kidney Care Programme

We understand that living with chronic kidney disease is a lifelong journey, often made difficult because of the need for regular care, complex medicine, restrictive diets, and many tests and investigations.

The Discovery Health Medical Scheme Kidney Care Programme is designed to make it a bit easier for our members on chronic dialysis to manage their condition. The programme is based on international best practice guidelines, to make sure you get the best quality of care and quality of life.

What do you get?

A calendar-based blood test schedule that your treating doctor and dialysis provider will need to follow in order to manage your condition. To obtain benefits related to these blood tests, you need your doctor to complete a PMB application form stating what type and frequency of chronic dialysis you require. Application for out-of-hospital treatment of a Prescribed Minimum Benefit condition (PDF)

Request for additional cover for out-of-hospital Prescribed Minimum Benefit conditions form

Yearly reports based on these tests and other important clinical information. We send the reports to you, your dialysis provider and your doctor to help in the management of your condition.
An information booklet to help you better understand and manage your condition.

Additional support

For additional information on managing your condition, please refer to the:

Kidney Care pre-dialysis booklet

Kidney Care member booklet

Kidney Care post-transplant booklet

Alternatively, the following organisations serve to offer additional support in managing your kidney condition:

Terminology explained Procedure information library

Tools you may also be interested in

Benefit and limit tracker

Track the usage of your benefits

Do we cover

Check your cover for treatments, procedures, medical devices and medicine

Get help tool

Have any questions? Use our Get Help tool to answer them or log a query

Find a healthcare provider

Find a doctor or hospital near you

Kidney Disease