FedHealth Medical Aid Comparison - 2016 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  
  No overall annual limit  
  Network hospitals to be used  
  R5,270 co-payment on voluntary  
  non-network admissions  
  Co-payments are due for  
  certain procedures  
  (eg. R5,000 Anthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment & Ocology PMB  
  Hospice Care - R27,900  
  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)
 
 
GP and Specialist benefit subject
 
       to PMB and pre-authorisation  
       only at contracted providers  
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
                  Does not apply    
     
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,179  
  Spouse/Adult dependant R 881  
  Per Child R 396  
     
FEDHEALTH
MAXIMA CORE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R6,500 Anthroscopy hip & wrist)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  Oral Contraceptives  
  *Emergency Trauma at Out Patients  
       
  Psychiatric Treatment R 22,600  
  Hospice care R 27,900  
  Oncology (only at DSP) R250,000  
  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)  
  GP and Specialist benefit subject  
  to PMB and pre-authorisation  
  only at contracted providers  
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
                 Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Member R 1,695  
  Spouse/Adult dependant R 1,436  
  Per Child R 593  
     
FEDHEALTH
MAXIMA BASIS
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R6,500 Anthroscopy hip & wrist)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Oral contraceptives  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment R 22,600  
  Hospice care R 27,900   
  Oncology (only at DSP) R250,000  
  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 4,008  
  Member +Spouse R 7,416  
  Member +Spouse +Child 1 R 8,628  
  Member +Spouse +Child 2 R 9,840  
  Member +Spouse +Child 3 R 11,052  
  Member +Child 1 R 5,220  
       
  Unlimied GP Network    
   benefit    
       
  ANNUAL THRESHOLD BENEFIT  
             Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,223  
  Spouse/Adult dependant R 1,893  
  Per Child R 670  
     
.
FEDHEALTH
MAXIMA STANDARD
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R2,000 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 22,600  
  Hospice Care R 27,900  
  Oncology(Only at DSP) R 400,000  
  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 5,120  
  Per Family R10,200  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 6,754  
  Member+ Spouse R 11,974  
  Member+ Spouse + Child 1 R 13,166  
  Member+ Spouse + Child 2 R 14,358  
  Member+ Spouse + Child 3 R 15,550  
  Member + Child 1 R 7,946  
       
  Unlimited Network GP benefit    
       
  ANNUAL THRESHOLD BENEFIT  
  Member R 10,000  
  Mem+Spouse/Adtdependant R7,680  
  Per Child (Max 3) R 2,580  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,693  
  Spouse/Adult dependant R 2,294  
  Per Child R 806  
     
     
 FEDHEALTH
MAXIMA EXEC
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R2,000 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 28,900
  Hospice Care R 27,900
  Oncology R500,000
  Specialised Medication R156,000
  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 6,430  
  Per Family R 11,900  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R 8,570  
  Member + Spouse R 15,470  
  Member + Spouse + Child 1 R 17,118  
  Member + Spouse + Child 2 R 18,766  
  Member + Spouse + Child 3 R 20,414  
  Member + Child 1 R 10,218  
       
  Unlimited Network GP benefit    
       
       
  ANNUAL THRESHOLD BENEFIT  
  Member R 10,000  
  Mem+Spouse/Adtdependant R 7,680  
  Per Child (Max 3) R 2,580  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,639  
  Spouse/Adult dependant R 3,100  
  Per Child R 1,086  
     
     
 
 
     
     
     
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
               
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
     
       
       
     
     
     
       
       
       
       
     

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.