Fedhealth

fedhealth

What sets us apart as a scheme is that together with our first-rate medical aid options, we offer unique value-added benefits. With some of these tangible benefits we pay more from Risk than other schemes to ensure that your day-to-day medical spending not only goes further, but also works harder for you. Please remember that all benefits paid from Risk must be pre-authorised with the Authorisation Centre.

Benefits unique to us:

  • Unlimited GP visits to Network GPs paid from Risk and never from Savings on all comprehensive options
  • Child rates for financially dependent children up to 27 years of age – yes, student dependants pay rates applicable to children, provided they’re unmarried and not earning more than the maximum social pension
  • Upgrades to higher options any time of the year within 30 days of diagnosis of a dread disease or life changing event – which means you’re never locked into an option should something dramatic happen that changes your circumstances. *New premiums will apply

Where we pay more from Risk than other schemes:

  • Post-hospitalisation treatment for up to 30 days after discharge from hospital (physiotherapy, pathology, etc) – that means follow-up treatment for a full 30 period paid directly from Risk not to deplete your day-to-day benefit. Requires pre-authorisation 48 hours before treatment
  • 7 days of paid for take-home medication after discharge from hospitalprovided the medication is dispensed by the hospital and reflects on the original hospital account
  • Specialised radiology like MRI and CT scans – paid from Risk and never from Savings – no matter what option you’re on, whether performed in or out-of-hospital. Other schemes will only offer a limited combined benefit for specialised radiology performed either in or out-of-hospital. Requires pre-authorisation 48 hours before the procedure
  • Trauma treatment at a casualty ward – whether admitted to hospital or not, emergency treatment, like stitches, is always paid from Risk and never from your Savings (meaning we don’t deplete your day-to-day benefits). Other schemes cover these costs directly from the member’s day-to-day benefit, or will only provide cover from Risk should the member be admitted to hospital immediately after treatment in the emergency ward is received. Please call the Authorisation Centre within 48 hours of treatment
  • Cover for monthly prescriptions for female contraception – including oral, patches, certain injectables as well as IUDs that include Mirena®, on all comprehensive options.
    * Must be prescribed by a GP or gynaecologist and not applicable to pills prescribed for acne. This benefit does not apply to Maxima Core, Maxima EntryZone or Blue Door

How we add REAL value:

  • The Fedhealth Baby Programme
  • 24-Hour Fedhealth Nurseline
  • FREE trauma counselling for practical and emotional support
  • Emergency transport/ response through Europ Assistance
  • Comprehensive managed care programmes:
    Aid for AIDS (AfA) for those living with HIV/AIDS,
    AsthmaCare ensures that asthma patients still lead a normal life,
    DiabeticCare assists diabetics in managing their blood sugar,
    CardioCare to prevent heart attacks in Coronary Heart Disease sufferers, and
    Oncology Disease Management that supports cancer sufferers with comprehensive care including cover for chemotherapy, radiotherapy, approved medication, related consultations, pathology and general radiology.

And then you also still get:

  • Professional and extreme sports cover – injuries sustained during sporting activities are covered within the benefits and rules of the Scheme, provided the treatment is received within the borders of South Africa
  • In-hospital dentistry for children under 8 – we cover the hospital and anaesthetist costs from the In-Hospital Benefit while the dentist’s account comes from day-to-day benefits (OHEB and Savings).
    *The Authorisation Centre must be contacted at least 48 hours before the procedure. Authorisation will be granted provided no dental authorisation was granted for the same child within at least six months of the required admission date
  • Easy membership for former child dependants – meaning no underwriting required for former child dependants who are at an age and status to afford their own medical aid.

 Fedhealth Products

Blue door:

Blue Door, our entry-level, salary-banded option is only available to previously uncovered lower-income employees.

Maxima Basis:

You’re responsible and thinking of starting a family, so you want the best option in its price-range even if it’s basic…  Maxima Basis is the first of our more comprehensive options available to meet your growing needs. On this option you’ll enjoy unlimited hospital cover at ALL private hospitals together with a small amount for day-to-day healthcare spending (from R2910 for a single member per year).

Maxima Core:

In your mid-20s and more settled you can afford a little more… So from only R1529pm, Maxima Core is for you. This hospital plan is your first step at really being responsible about your health – it provides unlimited hospital cover at ALL private hospitals. And more freedom on important major medical expenses, like a significant amount for oncology treatment and various reduced co-payments.

Maxima Entrysaver:

You’re young and single, and in need of first-rate hospital cover with the added bonus of day-to-day spending… So you need Maxima EntrySaver. This smart-thinking option provides unlimited cover at Network Hospitals, together with  per year. And then still includes FREE annual flu vaccines for the whole family and 1 FREE Network GP visit!

Maxima EntryZone

You’re young, healthy and single; you can handle your medical bills…  you need Maxima EntryZone. This smart-thinking hospital plan provides solid and affordable cover and includes innovative value-adds, like FREE annual flu vaccines for the whole family and 1 FREE GP visit per beneficiary per year!

Maxima Exec:

You’re at the top of your game so you want every aspect of healthcare taken care of…Maxima Exec is a superior comprehensive option designed for the smart executive who relies completely on their medical aid to take proper care of themselves and their family. It covers an extensive 51 chronic conditions. And with the substantial amount of savings (for a single member per year) for daily healthcare spending, it

Maxima Plus:

You’re older and can afford the best protection. Your family has not only grown, you have changing needs as well, because having young adults in the family means having expect even more from your medical aid… So from ,Maxima Plus is the premium comprehensive option for you. At R11 062 (for a single member per year) it also boasts the highest amount of daily healthcare spending ability – to make sure every aspect of your day-to-day care is met and paid for.

Maxima saver: 

You’re a 20 something professional, who’s ready to take responsibility for your health by being prepared to pay a little more… Maxima Saver is for you. This innovative option provides unlimited cover at ALL private hospitals, together with Savings per year for Day-to-Day spending. Once savings is depleted, it still provides 2 FREE Network GP visits.

Maxima Standard net:

Less of a premium for most of the same Maxima Standard cover…  on Maxima StandardNet you get unlimited private hospital cover at our network hospitals.  The only difference on this sub-option is that the use of network hospitals is specified

Maxima Standard 

You’re at a life-stage where you’re responsible not just for yourself, but for your family too – health is something you take seriously, so you want your medical expenses well taken care of. From only R2450pm, Maxima Standard is a truly comprehensive option perfect for a young and healthy family. With a generous amount of day-to-day cover and improved hospital and screening benefits, as well as more cover for chronic conditions..