Fedhealth Maxima Saver Option

The Fedhealth Maxima Saver option is ideal for 20-something professional that is serious about their health and willing to pay a little more for medical cover

An innovative hospital plan, this option provides unlimited cover at all private hospitals. This option also includes a nice day-to-day medical cover. You will enjoy unlimited FP visits at nominated FPs on the Fedhealth FP Network once your savings is depleted.

If you are looking for a hardworking hospital plan with added day-to-day medical cover, the Maxima Saver is for you.

This options covers the following:

  • Unlimited private hospital cover at all private hospitals
  • Post-hospitalisation treatment for up to 30 days after discharge from hospital
  • 7 days of take-home medication
  • Unlimited specialised radiology, like MRI and CT Scans (covered from Risk after the first R2 100)
  • Trauma treatment at a casualty ward whether you’re admitted to hospital or not (a R550 co-payment per visit for non-PMBs will apply if you are not admitted to hospital straight from casualty)
  • Unlimited specialist cover at cost with Fedhealth Network Specialists – while under the care of a network specialist in hospital, your treatment will always be covered in full. Use of non-Fedhealth contracted healthcare professionals is covered at up to 100% of the Fedhealth Rate

The Maxima EntryZone also provides you with the following unique benefits and value adds:

  • Chronic medicine cover for 25 Prescribed Minimum Benefit (PMB) chronic conditions from a pharmacy of your choice
  • Female contraceptives covered: oral, patches, contraceptive rings and certain injectables, as well as IUDs including Mirena® device
  • An innovative screening benefit (part of the new foundation benefit) that covers specific women’s, children’s and cardiac health, as well as wellness and preventative screenings
  • Free flu vaccinations for the whole family!
  • NEW! From January 2018 qualifying members benefit from a 12-week biokineticist led programme with access to a dietician and behavioural psychologist to help them lose the weight for good
  • NEW! From January 2018 all smokers can have their GoSmokeFree consultation paid from risk (once per beneficiary per year). Nicotine replacement therapy will be paid from savings on options with a savings benefit
Contributions
Principal Member Adult Dependant Child Dependant*
Monthly Contribution (Main Option) R2 259 R1 887 R657
Monthly Contribution (Grid Option) R2 003 R1 678 R584

* Contributions for the first 3 children only. Child rates up to the age of 27.

Day-to-Day Benefits
Principal Member Adult Dependant Child Dependant*
Benefits Available R4 068 R3 396 R1 188

Basic Dentistry

Even if your Savings run out, we’ll still take care of you. Your Savings account refunds your day-to-day expenses at cost, until it is finished. If you use a Fedhealth Network FP, your consultations will continue to be covered unlimited for the remainder of the year. You and your dependents must however nominate a network FP. A different can be nominated for every depended if required.

Chronic Diseases Benefits
Subject to formulary? Yes
Co-payment for Non-Formulary 40%
Number of Conditions Covered 25
Annual Limit to PMB Cover none
Medicine Medicine can be obtained from a service provider of choice. Fedhealth pays up to an agreed rate for dispensing fees on prescribed medicine. Member will pay difference if pharmacy charges more.

Please Note: You have to apply for your Chronic Disease Benefit to be activated, even if you’ve declared your condition on your application form.

Chronic Disease
CD-1 Addison’s Disease
CD-2 Asthma
CD-3 Biopolar Mood Disorder
CD-4 Bronchiectasis
CD-5 Cardiac Failure
CD-6 Cardiomyopathy
CD-7 COPD / Emphysema / Chronic Bronchitis
CD-8 Chronic Rental Disease
CD-9 Coronary Artery Disease
CD-10 Crohn’s Disease
CD-11 Diabetes Insipidus
CD-12 Diabetes Mellitus Type 1 & 2
CD-13 Dysrhythmias
CD-14 Epilepsy
CD-15 Glaucoma
CD-16 Haemophilia
CD-17 Hyperlipidaemia
CD-18 Hypertension
CD-19 Hypothyroidism
CD-20 Multiple Sclerosis
CD-21 Parkinson’s Disease
CD-22 Rheumatoid Arthritis
CD-23 Schizophrenia
CD-24 Systemic Lupus Erythematosus
CD-25 Ulcerative Colitis
In-Hospital Benefits

Please note that certain procedures performed in-hospital are subject to a co-payment ranging from R4 000 to R7 500.

Benefit Name Benefit Description
In-hospital Benefit Unlimited
Network Hospital Yes
Co-payment if a Network Hospital is NOT used: R11 000 (not applicable if admitted to a non-network hospital in an emergency)
Any Private Hospital Yes
Authorisation Required 48 hours before admission
48 hours after admission in case of emergency
Organ Transplants R264 500
In-Hospital Specialist Covered in full if network specialists are used
Shortfall if Network Specialist is Not Used Yes
Oncology R264 500 at designated service providers and subject to level 1 treatment protocols.
40% co-payment for non-use of DSP
Renal Dialysis R264 500
Specialised Medication No benefit
Foundation Benefit
Benefit Name Benefit Description
Women’s Health Breast cancer screening with mammography
Cervical cancer screening
Children’s Health Immunisation Programme (as per State EPI)
Cardiac Health Cholesterol screening (full lipogram)
General Health Flu vaccination
HIV test
Health Risk Assessment Wellness screening (BMI, blood pressure, finger prick cholesterol & glucose tests)
Preventative screening (waist-to-hip ratio, body fat %, flexibility, posture & fitness)
Doula Benefit R1 270 per delivery
Postnatal Midwifery Benefit 4x consultations with a midwife in- and out-of-hospital per pregnancy
Newborn Hearing Screening Up to the age of 8 weeks
Extended Care Benefits
  • Unlimited Network FP visits
  • Fedhealth Nurse Line
  • Trauma counselling
  • Emergency Transport/Response
  • Comprehensive managed care programmes (weight management, smoking cessation, Aid for AIDS (AfA), oncology disease management)
  • Active disease risk management (conservative back & neck rehabilitation programme, mental health programme)
  • Post-hospitalisation treatment
  • Take-home medicine
  • Specialised radiology (in- and out-of-hospital)
  • Trauma treatment at a casualty ward
  • Female contraception
  • In-hospital dentistry (children up to age of 7)
  • Dentistry (basic)
Download Option Guide