FedHealth Medical Aid Review 2023

Fedhealth medical aid varies from R945.00 to R13,122.00 per month for the main member and covers emergency hospitalisation, day-to-day benefits, […]

Fedhealth medical

Fedhealth medical aid varies from R945.00 to R13,122.00 per month for the main member and covers emergency hospitalisation, day-to-day benefits, and more. Children and other dependents can be added to the main member’s medical aid.

FedHealth is one of South Africa’s fastest growing open medical schemes. The Council for Medical Schemes approved its merger with Topmed on August 1, 2019, leaving FedHealth with some of Topmed’s members.

According to the feedback on Hello Peter, FedHealth was able to keep Topmed’s former members by providing adequate coverage and honoring their claims. FedHealth has a good reputation as a result of this successful merger, and the scheme is poised for even more growth in terms of membership subscriptions.

Fedhealth offers 7 medical aid plans for customers to choose from. We cover all the medical aid plans in detail below. 

Fedhealth Medical Aid Plans

Fedhealth medical aid consist of the following plans:

  • FlexiFED Savvy Plan, 
  • FlexiFED 1 Plan, 
  • FlexiFED 2 Plan, 
  • FlexiFED 3 Plan, 
  • FlexiFED 4 Plan, 
  • Maxima EXEC Plan, and
  • Maxima Plus Plan. 

1. FlexiFED Savvy Plan

The FlexiFED Savvy medical aid plan is designed for young people, with monthly premiums starting at R945.00. Adult dependents can be added to the policy for a monthly premium of R945.00 per dependent. Child dependents can be added to the policy for a monthly fee of R709.00.

Day to day benefit can also be added to the account of up to R6,000.00. Additional members can also have a day to day benefit of up to R600.00 per year. FlexiFED Savvy Plan only allows for private network hospital visits. 

With the FlexiFED Savvy Plan, members get the following benefits. 

  • Unlimited private hospitalisation. 
  • Unlimited cover with network specialists and GPs in hospital. 
  • Take home medication for 7 days supply. 
  • Chronic Medicine benefit. 
  • 30 day post hospitalisation benefit. 
  • Unlimited trauma treatment. 
  • Screening benefit. 
  • Specialised radiology. 
  • Can add a savings account with a maximum of R6000.00 to use per year.
  • Unlimited virtual GP consults. 
  • Virtual mental support. 
  • Stress and anxiety benefit. 

2. FlexiFED 1 Plan

The FlexiFED 1 medical aid is a cover that is intended for young individuals with premiums starting from R1,583.00 per month. A full cover for a network hospital is R2,031.00 per month. A day to day benefit can be added of up to R9,696.00 per annum. 

The main member can add a dependent adult for a monthly fee of R1,591.00. Child dependents can also be added to the plan for a monthly fee of R743.00. 

The FlexiFED 1 Plan comes with the following benefits:

  • Mental health benefit, 
  • Maternity and childhood benefit, 
  • Cancer cover, 
  • Screening benefit, 
  • Chronic benefit, 
  • In hospital benefit and more. 

3. FlexiFED 2 Plan

FlexiFED 2 Plan is a medical aid plan aimed at young professionals as it comes with great maternity and childhood benefits. Premiums on the FlexiFED 2 Plan starts from R2,196.00. The maximum premium is R2,934.0p per month for full cover at any private hospital. 

The main member can add adult dependents for a monthly fee of R2,611.00. Child dependents can be added for a monthly fee of R866.00.

FlexiFED 3 Plan come with the following benefits:

  • Flexible savings plan. 
  • Screening benefit. 
  • Chronic benefit. 
  • In hospital cover and more. 

4. FlexiFED 3 Plan

FlexiFED 3 Plan is designed for young and growing families. The main member of the cover pay between R2,508.00 to R3,347.00 per month. Members have an option to choose between cover to any hospital with Co payment, network hospitals or at all private hospitals. 

The day to day benefit on the FlexiFED 3 Plan can be up to R11,496.00 per year. Adult dependents can be added for a monthly fee of up to R3,066.00 and child dependents can be added on a plan for a monthly fee of R1,186.00.

FlexiFED 3 Plan come with the following benefits:

  • Flexible savings plan. 
  • Screening benefit. 
  • Chronic benefit. 
  • In hospital cover and more. 

5. FlexiFED 4 Plan

flexiFED 4 is an ideal option for a well matured family looking for comprehensive hospital cover at any hospital and get to also benefit from reliable Day-to-Day cover. In their Day-to-Day cover FedHealth has the MediVault and Wallet offer coupled with a threshold benefit once prescribed daily limits are reached. 

In-hospital cover

  • There are no hospitalisation annual overall limits and flexiFED 4 members have the peace of mind knowing they can even use a hospital of their choice. 
  • Using network GPs and specialists gets your bills covered at cost while non-network bills are covered 100% of the FedHealth rate.
  • Prevention, diagnosis and treatment of cancer, together with organ transplants and renal dialysis are covered up to R480 400 per family.
  • There is unlimited maternity benefits at network GPs and Specialists while delivery has a private ward cover

Chronic Disease Benefits

  • On Top of the 27 chronic diseases that are listed on the Chronic Disease List (CDL), flexiFED 4 also covers additional 16 chronic conditions including eczema and acne for children
  • Treatment can be obtained from either a Designated Service Provider or a provider of your choice
  • Cover is limited to R6 100 per beneficiary up to R12 200 per family however conditions listed in the CDL continue to receive unlimited cover

Day-to-Day Benefits

  • Your MediVault and wallet are used to cover daily medical expenses, then a threshold benefit utilised once a predetermined threshold level is reached.
  • There is a 20% co-payment for claims paid from the threshold benefit, however claims for network specialists are fully paid
  • There is post hospital treatments, Fedhealth Baby Programme, trauma treatments among other day-to-day benefits

6. Maxima EXEC Plan

The maxima EXEC plan has a good all-round coverage that includes in-hospital, chronic medicine, screening benefits, and a wide range of added benefits to give you ultimate peace of mind when it comes to medical cover. 

In-hospital benefits

  • There’s no overall annual limit for hospitalisation, so you can relax knowing you’re fully covered, no matter what happens.
  • Get unlimited maternity cover, should you need it.
  • Network GPs and specialists are covered unlimited at cost.
  • Non-network GPs are covered up to 100% of the Fedhealth Rate.
  • Non-network specialists are covered up to 200% of the Fedhealth Rate.
  • Other healthcare professionals are covered up to 100% of the Fedhealth Rate.  
  • Get a generous oncology benefit of R624 000.

Chronic benefits

In this plan, there are 56 chronic diseases covered  and are subject to the comprehensive formulary. Subscribers  Under get R7 890 per beneficiary each year, the benefits capped at R14 500 per family per year.

 The plan’s preferred providers include MediRite, Clicks, Dis-Chem and Pharmacy Direct.

Day-to-Day medical benefits

For your daily medical expenses like GP or dentist visits,  maxima EXEC provides funds as follows: Member R11 556, Adult Dependent R10 320, Child Dependent (up to a maximum of 3 children) R3 564.

7. Maxima PLUS Plan

For an extensive medical cover that will comprehensively cover all aspects of your health needs, FedHealth has the maxima PLUS plan to offer. Apart from the day-to-day savings portion and the threshold benefits, maxima PLUS cover, this plan has an OHEB (Out-of-Hospital Expenses Benefit) to cover daily medical benefits.


In-hospital Benefits

  • There’s no overall annual limit for hospitalisation, so you can get peace of mind knowing you’re covered no matter what happens.
  • Get unlimited maternity cover should you need it.
  • Network GPs and specialists are covered unlimited at cost.
  • Non-network GPs are covered up to 100% of the Fedhealth Rate.
  • Non-network specialists are covered up to 200% of the Fedhealth Rate.
  • Other healthcare professionals are covered up to 300% of the Fedhealth Rate.
  • Get an unlimited oncology benefit.
  • You’ll also enjoy a specialised medication benefit of R390 400.

Chronic Benefits

Maxima PLUS covers 70 chronic illnesses and each beneficiary has a limit of R16 700 per year while the whole family is limited to R31 300 per year.

Day-to-Day benefits

In this option, members enjoy the comprehensive cover on their daily medical benefits. The plan has set up two pools to cover Day-to-Day medical benefits; the savings account and the OHEB when the savings account has been depleted.

Once claims reach the predetermined threshold level, the scheme continues to cover some of members’ day-to-day benefits up to the following limits; Member R16 922 Adult Dependant R13 211 Child Dependant (up to a maximum of 3 children) R4 367.

  • Fedhealth Network GP visits have unlimited cover and are paid from the scheme risk
  • There is unlimited specialised radiology cover for the likes of MRI and CT scans
  • Seven days’ medicine after discharge from hospital is covered at 100% of the Medicine Price List
  • trauma treatment at a casualty ward has unlimited cover at 100% of the Fedhealth Rate

Competitive advantages of FedHealth medical scheme

  • The scheme provides a variety of plans that accommodate everyone and upgrading your plan can take you 30 days without hassle
  • MyFed plan is salary bended giving you the opportunity to get a plan you can afford based on your income
  • The flexiFED plans are designed in such a way that you can get a customised cover that will cover what you need the most at that particular time
  • Claims are in the click of your fingertips using the Fedhealth Family Room and usually you should not even worry about making a claim since a healthcare professional can do that on your behalf, the scheme has a good reputation of honoring claims
  • From flexiFED 4 going up the tier, there is a threshold benefit allowing you to continue receiving cover on some day-to-day medical benefits even after your day-to-day limits are depleted
  • All FedHealth plans have incredible additional benefits you can rely on
  • Maxima PLUS has Out-of-Hospital Expenses Benefit to cover many of your day-to-day expenses
  • Some day-to-day benefits in the maxima PLUS are covered from the scheme risk, easing pressure on your savings

Competitive disadvantages of FedHealth medical scheme

  • Even though the maxima PLUS plan has the Out-of-Hospital Expenses Benefit to cover some day-to-day expenses, the scheme does not really make more room for day-to-day benefits because the savings in the maxima PLUS are less than in the maxima EXEC.
  • The scheme does not have Spinal surgery cover, even the maxima PLUS which is meant to be the most comprehensive only steps in when Conservative Back & Neck Rehabilitation Programme has been completed

Conclusion

Getting a medical aid plan is an essential decision you must do for yourself and loved ones. You surely need a reputable healthcare scheme like FedHealth to get started since the scheme has stood the test of time, showing its strength in growth  and has moreover received lots of positive reviews in its efficiency when it comes to honouring claims. FedHealth also stands out among its competitors such as Bestmed on diversity in their  plan options which allows almost every breadwinner to afford a medical plan. 

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