Fedhealth Hospital Plans

Fedhealth offers 2 Hospital plans under its Maxima series

These plans are:

  • Maxima Entryzone (network hospitals only)
  • Maxima Core

The hospital benefit will cover all the services offered in hospital including the anaesthetist and the surgeon provided that you are admitted to hospital and Fedhealth has confirmed your admission and treatment plan prior to your admittance. Outpatients and trauma units are generally not considered a hospital event unless you are admitted but Fedhealth offers you unlimited trauma treatment at a casualty ward whether you are admitted to hospital or not . Fedhealth also offers post –hospitalisation treatment for up to 30 days after you are discharged from hospital as well as 7 days of take-home medication

Important FedHealth Hospital Plan Information

Please note that surgeons and anaesthetists charge separately and have the choice of charging anywhere between the Fedhealth Scheme rate and Private rates which can be as much as 4 times higher than the scheme rate. You will personally be liable for any difference in these related accounts unless you have purchased a gap cover product or you use a specialist who has entered into a partnership arrangement with Fedhealth

You have cover for 25 Prescribed Minimum Benefit chronic conditions through MEDI –Rite pharmacies only and subject to a fairly restrictive formulary. You also have cover for cancer, HIV and AIDS as well as a certain amount of International cover.

Both the Fedhealth plans offer unlimited hospital benefits but with the Entryzone plan you need to use the Fedhealth hospital network otherwise you will be liable for a co-payment of R4500 per admission. Maxima Core covers claims at 200% of the Fedhealth scheme rate and Entryzone covers claims at 100% of the scheme rate Your hospital bill would be paid in full because of tariff agreements that Fedhealth has with the Hospital groups but as previously stated you could have a shortfall with regard to the surgeons and anaesthetists unless you have gap cover or use a Fedhealth Specialist partner.

FedHealth Hospital Plan Upgrades or Downgrades

Fedhealth normally only allows you to upgrade or downgrade your plan from 01 January of the following year but if you are diagnosed with a dread disease or in the case of a life changing event you may upgrade your plan immediately.

For more detail on the benefits of the FedHealth Hospital Plan please contact us or go to Hospital Plan comparisons page contained within this site.