FedHealth Medical Aid Comparison - 2018 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 Saver Maxima Exec
 
FEDHEALTH
ENTRYZONE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall annual limit  
  Network hospitals to be used  
  R6,100 co-payment on voluntary  
  non-network admissions  
  Co-payments are due for  
  certain procedures  
  (eg. R7,500 Anthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment & Ocology PMB  
  Hospice Care - R29,500  
  Internal Prosthesis - PMB  
     
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite,Clicks, Dischem &  
          Pharmacy Direct    
               
               
  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 1,424  
  Spouse/Adult dependant R 1,088  
  Per Child R 482  
     
FEDHEALTH
MAXIMA CORE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R6,900 Anthroscopy )  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  Oral Contraceptives  
  *Emergency Trauma at Out Patients  
       
  Psychiatric Treatment R 23,900  
  Hospice care R 29,500  
  Oncology (only at DSP) R 264,500  
  Internal Prosthesis:    
  See detailed benefits    
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite,Clicks, Dischem &  
           Pharmacy Direct    
       
               
  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 2,082  
  Spouse/Adult dependant R 1,806  
  Per Child R 732  
     
FEDHEALTH
MAXIMA BASIS
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R6,900 Anthroscopy )  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Oral contraceptives  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment R 23,900  
  Hospice care R 29,500   
  Oncology (only at DSP) R264,500  
  Internal Prosthesis:     
  See detailed benefits    
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite,Clicks, Dischem &  
     Pharmacy Direct       
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 4,896  
  Member +Spouse R 9,168  
  Member +Spouse +Child 1 R 10,656  
  Member +Spouse +Child 2 R 12,144  
  Member +Spouse +Child 3 R 13,632  
  Member +Child 1 R 6,384  
  Member +Child 2 R 7,872  
  Member +Child 3 R 9,360  
       
  Unlimied GP Network    
   benefit    
       
  ANNUAL THRESHOLD BENEFIT  
             Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,722  
  Spouse/Adult dependant R 2,374  
  Per Child R 826  
     
.
FEDHEALTH
MAXIMA STANDARD
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R2,100 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 23,900  
  Hospice Care R 29,500  
  Oncology(Only at DSP) R 423,200  
  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 5,410  
  Per Family R10,800  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 7,152  
  Member+ Spouse R 13,392  
  Member+ Spouse + Child 1 R 15,552  
  Member+ Spouse + Child 2 R 17,712  
  Member+ Spouse + Child 3 R 19,872  
  Member + Child 1 R 9,312  
  Member + Child 2 R 11,472  
  Member + Child 3 R 13,632   
       
  Unlimited Network GP benefit    
       
  ANNUAL THRESHOLD BENEFIT  
  Member R 12,320  
  Mem+Spouse/Adtdependant R 9,460  
  Per Child (Max 3) R 3,168  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,310  
  Spouse/Adult dependant R 2,890  
  Per Child R 998  
     
     
 FEDHEALTH
MAXIMA SAVER
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R6,900 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 29,500
  Oncology (only at DSP) R264,500
     
     
  Internal Prosthesis: PMB
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite , Dischem, Clicks &  
  Pharmacy Direct  
       
       
       
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R 4,068  
  Member + Spouse R 7,464  
  Member + Spouse + Child 1 R 8,652  
  Member + Spouse + Child 2 R 9,840  
  Member + Spouse + Child 3 R 11,028  
  Member + Child 1 R 5,256  
  Member + Child 2 R 6,444  
  Member + Child 3 R 7,632  
       
   Unlimited Network GP benefit    
       
  ANNUAL THRESHOLD BENEFIT  
              Does not Apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,259  
  Spouse/Adult dependant R 1,887  
  Per Child R 657  
     
     
 FEDHEALTH
MAXIMA EXEC
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R2,100 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 30,500
  Hospice Care R 29,500
  Oncology R529,000
  Specialised Medication R165,000
  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 6,800  
  Per Family R 12,500  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R 9,672  
  Member + Spouse R 17,508  
  Member + Spouse + Child 1 R 19,460  
  Member + Spouse + Child 2 R 21,412  
  Member + Spouse + Child 3 R 23,364  
  Member + Child 1 R 11,624  
  Member + Child 2 R 13,576  
  Member + Child 3 R 15,528  
       
   Unlimited Network GP benefit    
       
  ANNUAL THRESHOLD BENEFIT  
  Member R 12,300  
  Mem+Spouse/Adtdependant R 9,460  
  Per Child (Max 3) R 3,168  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 4,805  
  Spouse/Adult dependant R 4,103  
  Per Child R 1,463  
     
     

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.