FedHealth South Africa

Fedhealth is a well-established medical aid registered in 1969, it covers close to 150,000 lives and has one of the highest Global Credit Ratings, currently at AA-.

All set benefits are pro-rated depending on when in the year one joins the scheme.

In 2019 Fedhealth has restructured their day to day benefits by introducing a minimum savings on all plans as well as introducing a benefit called your personal MediVault Wallet. Members can access these funds when required by contacting Fedhealth through the Fedhealth family room (web) or contact centre on 0860 002 153. One can access these funds in full upfront, or in part as needed and then pay it back interest free over the next 12 months. MediVault is not pro-rated and the amounts are based on your selected bundle and family size.

This medical aid has a unique benefit in that it allows members to upgrade their option in the event of a change of health status e.g. the onset of a serious chronic condition.

FedHealth FlexiFed 3 (old Maxima Core)

Has unlimited hospital cover paid out at 100% of Fedhealth rate to non-Fedhealth specialist partners and cost for Fedhealth specialist partners. There is also cover for Chronic Medication and Emergency Evacuation Cover i.e. Ambulance and Helicopter. Has a very limited savings and one can access the use of the Personal MediVault wallet benefit.

FedHealth FlexiFed 3 (old Maxima Basis)

Has unlimited hospital cover paid out at 100% of Fedhealth rate to non-Fedhealth specialist partners and cost for Fedhealth specialist partners. There is also cover for Chronic Medication and Emergency Evacuation Cover i.e. Ambulance and Helicopter. This plan has a Maximiser (Threshold) benefit for day-to-day claims kicks in at a specified Rand amount. There is a gap between the savings limit plus the Medvault limit before the Maximiser benefit kicks in, called the self-payment gap, during which expenses must be paid by the member but the bills must still be submitted to the medical aid. Once all your accumulated day-to-day expenses (irrespective of who pays them) reach the Maximiser Excess, it will pay for certain day-to-day expenses until the end of the year, subject to sub-limits. In addition this option also offers a limited fund (MediVault Wallet) for further day-to-day expenses e.g. doctor’s consultations, medicines, etc. The gap between the accumulated day-to-day benefit and the Maximiser Excess would be for the member’s account (self-payment gap) but the bills must still be submitted to the medical aid for them to be accumulated so that the Maximiser benefit can be activated. Once in self payment Gap members can use Fedhealth GP Partners.

FedHealth FlexiFed 4 (old Maxima Standard)

Has unlimited hospital cover paid out at 100% of Fedhealth rate to non-Fedhealth specialist partners and cost for Fedhealth specialist partners. There is also cover for Chronic Medication and Emergency Evacuation Cover i.e. Ambulance and Helicopter. A Maximiser (Threshold) benefit for day-to-day claims that kicks in at a specified Rand amount. There is a gap between the savings limit and the Maximiser benefit kicking in, called the self-payment gap, during which expenses must be paid by the member but the bills must still be submitted to the medical aid. Once all your accumulated day-to-day expenses (irrespective of who pays them) reach the Maximiser Excess, it will pay all day-to-day expenses until the end of the year, subject to sub-limits. In addition this option includes a fund (Personal MediVault Wallet) as well as a limited savings account for day-to-day expenses e.g. doctor’s consultations, medicines, etc. Claims submitted to the medical aid would first be paid out of savings until that is exhausted and then from your MediVault wallet upon activating it. Any portion of the unused funds would be carried forward to the following year. The gap between the accumulated day-to-day benefit and the Maximiser Excess would be for the member’s account (self- payment gap) but the bills must still be submitted to the medical aid for them to be accumulated, so that the Maximiser benefit can be activated. Once in self payment Gap members can use Fedhealth GP Partners.

Quick facts:

Click here to view a comparative summary of the Fedhealth medical aid plans