FedHealth Medical Aid Comparison - 2013 Plans

Fedhealth is a well-established medical aid registered in 1969, it covers close to 200,000 lives and has one of the highest Global Credit Ratings at AA-. They have a range of new generation schemes all covering hospital and related bills at 3 x NHRPL (National Health Reference Price List) rate (Private Rate).

 
Fedhealth
Plans:
Entryzone Maxima Core Maxima Basis
Maxima Standard Maxima Exec  
 
FEDHEALTH
ENTRYZONE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate or cost Fed Network  
  No overall annual limit  
  Network hospitals to be used  
  R4,500 co-payment on voluntary  
  non-network admissions  
  Co-payments are due for  
  certain procedures  
  (eg. R3,350 Anthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment & Ocology PMB  
  Hospital Care - R14,500  
  Internal Prosthesis - PMB  
     
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite Pharmacies  
       
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
Does not apply
 
     
     
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
                  Does not apply    
     
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 883  
  Spouse/Adult dependant R 660  
  Per Child R 297  
     
FEDHEALTH
MAXIMA CORE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate or cost Fed Network  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R1,800 Anthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  Oral Contraceptives  
  *Emergency Trauma at Out Patients  
       
  Psychiatric Treatment R 19,200  
  Hospice care R 14,500  
  Oncology (only at DSP) R190,000  
  Internal Prosthesis:    
  See detailed benefits    
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite Pharmacies  
       
       
               
  ANNUAL DAY TO DAY BENEFIT (including savings)  
  Does not apply   
     
     
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
                 Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Member R 1,258  
  Spouse/Adult dependant R 1, 066  
  Per Child R 440  
     
FEDHEALTH
MAXIMA BASIS
  IN HOSPITAL BENEFIT  
  100% Scheme Rate or cost FedHealth Provider  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R1,800 Anthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Oral contraceptives  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment R 19,200  
  Hospice care R 14,500   
  Oncology (only at DSP) R243,000  
  Internal Prosthesis:     
  See detailed benefits    
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite Pharmacies  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 2,600  
  Member +Spouse R 4,550  
  Member +Spouse +Child 1 R 4,815  
  Member +Spouse +Child 2 R 5,080  
  Member +Spouse +Child 3 R 5,345  
  Member +Child 1 R 2,865  
       
  Unlimied GP Network    
   benefit    
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 8,500  
  Spouse/Adult dependant R 6,500  
  Per Child (Max 3) R 2,200  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,668  
  Spouse/Adult dependant R 1,420  
  Per Child R 503  
     
.
FEDHEALTH
MAXIMA STANDARD
  IN HOSPITAL BENEFIT  
  100% Non Network  
  200% Network Partner  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R1,800 Arthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  Oral Contraceptives  
  *Emergency Trauma at Out Patients  
  Annual Sub-limits per person:  
  Psychiatric Treatment R 19,200  
  Hospice Care R 14,500  
  Oncology(Only at DSP) R 424,000  
  Internal Prosthesis:    
  See detailed benefits    
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Additional 14 Chronic Disease Conditions  
  Annual limit:  
  Single R 4,340  
  Per Family R 8,630  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 5,620  
  Member+ Spouse R 9,958  
  Member+ Spouse + Child 1 R 10,943  
  Member+ Spouse + Child 2 R 11,928  
  Member+ Spouse + Child 3 R 12,913  
  Member + Child 1 R 6,605  
       
  Unlimited Network GP benefit    
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 8,500  
  Spouse/Adult dependant R 6,500  
  Per Child (Max 3) R 2,200  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,055  
  Spouse/Adult dependant R 1,751  
  Per Child R 616  
     
     
 FEDHEALTH
MAXIMA EXEC
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R1,800 Arthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  Oral Contraceptives  
  *Emergency Trauma at Out Patients  
  Annual Sub-limits per person:  
  Psychiatric Treatment R 24,500
  Hospice Care R 14,500
  Oncology Unlimited
  Specialised Medication R132,500
  Benefit  
  Internal Prosthesis:  
  See detailed benefits  
   
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Additional 26 Chronic Disease Conditions  
  Annual limit:  
  Single R 5,450  
  Per Family R 10,200  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R 7,042  
  Member + Spouse R 12,712  
  Member + Spouse + Child 1 R 14,037  
  Member + Spouse + Child 2 R 15,362  
  Member + Spouse + Child 3 R 16,687  
  Member + Child 1 R 8,367  
       
  Unlimited Network GP benefit    
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 8,500  
  Spouse/Adult dependant R 6,500  
  Per Child (Max 3) R 2,200  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,558  
  Spouse/Adult dependant R 2,179  
  Per Child R 763  
     
     
 
 
     
     
     
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
               
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
     
       
       
     
     
     
       
       
       
       
     

For more detailed information on any of the above FedHealth plans, just click on the name of the relevant plan in the tables above. If you already know what you want, why not make use of our site to download the relevant Medical Aid Application form and then fax it back to us on 0866 200 320. Alternatively, if you would like us to confirm some of the finer details and/or pricing, just fill in our Medical Aid Quote Request form and we will get back to you promptly.

Finally, we invite you to contact us on +27 21 712-8866 at any point in your decision making process for further information on the FedHealth Medical Aids.