These are the procedures and treatments that take place in hospital, that you’ll be covered for on this option:

• There’s no overall annual limit for hospitalisation, so get peace of mind knowing that you’re covered no matter what.
• You benefit from unlimited maternity cover with network GPs and specialists.
• Network GPs and specialists are covered unlimited at cost.
• Non-network GPs, specialists and other healthcare providers are covered up to 100% of the Fedhealth Rate.
• There’s an oncology benefit of R499 100 available, should you need it.
• You also get a childhood illness specialised drug benefit for children up to 18.

Get covered for 27 chronic diseases as listed on the Chronic Disease List (CDL), PLUS an additional 18 at either a Designated Service Provider or a provider of choice

This medical aid plan option is limited to R6 300 per beneficiary up to R12 600 – once you’ve reached the annual limits after claiming medicine for the 27 CDL conditions and the 18 additional conditions, then you have unlimited cover for diseases on the CDL only. Intermediate formulary and the Medicine Price List (MPL) apply.

flexiFED 4: Preferred Provider - Clicks, Dis-Chem, Medirite (and their courier pharmacies), and Pharmacy Direct

flexiFED 4 GRID: Preferred Provider - Clicks, Dis-Chem, Medirite (and their courier pharmacies), and Pharmacy Direct

flexiFED 4 Elect: Designated Service Provider - Clicks Direct Medicines, Dis-Chem Direct, Medirite Courier Pharmacy and Pharmacy Direct

Make sure your growing family has all the tests and healthcare assessments they need, to ensure that their health is in the best possible shape.

• We cover one Pap smear (cervical cancer screening) every three years for women aged 21 to 65.
• We cover one Prostate Specific Antigen (PSA) per year for men aged 45 to 69.
• Keep them protected as they grow: Children’s immunisations are covered from birth to 12 years (as per the State EPI).
• Check your levels: we cover one cholesterol screening (full lipogram) every five years for everyone over the age of 20.
• Get your family covered each winter: everyone can have a free flu vaccination once a year.
• We cover one HIV finger prick test for all members once a year.
• All members enjoy one wellness screening per year including BMI, blood pressure, finger prick cholesterol and glucose tests.
• Find your fitness: all members enjoy one preventative screening by a contracted wellness network provider per year including waist-to-hip ratio, body fat %, flexibility, posture and fitness.
• NEW: From 2022 we now cover the HPV vaccine for all female beneficiaries aged 9 - 14 years. This benefit is 2 doses per lifetime. 

Bonus benefits:

Boost your family’s health even more, by enjoying extras on top of your hospital plan like professional medical advice and a transport service when you need a check-up after being in hospital.

• Life can change in an instant: upgrade to a higher option within 30 days of a life-changing event, like a pregnancy or being diagnosed with a dread disease.
• Got a health-related question? Phone our 24-hour toll-free Nurse Line and get expert medical and health advice from qualified nurses.
• Our MediTaxi service transports you to follow-up medical treatments following a hospital stay (only certain regions).
• Get help when you need it most: call our USSD call-back service, SOS Call Me, to access Emergency Medical Services, the Fedhealth Nurse Line or MediTaxi – free of charge.
• Want to manage your weight better but not sure how? Qualifying members can join our 12-week Weight Management Programme led by biokineticists and dieticians, so you can make healthy and sustainable lifestyle changes.
• Quit smoking for good! We provide free to the GoSmokeFree Smoking Cessation Programme to help you end this very unhealthy habit.

• Get access to our Fedhealth Baby Programme for great discounts, gifts and parenting advice.
• Our postnatal midwifery benefit includes four consultations with a midwife in- and out-of-hospital.
• Want to use a doula? We cover one up to R3 000 per delivery.
• We cover one test with an audiologist per infant up to the Fedhealth Rate (including consultation).
• Worried sick? Get access to the Paed-IQ advice line for all your paediatric questions.
• We cover take-home medicine for seven days per hospital event at 100% of the Medicine Price List.
• Get cover for follow-up treatment for 30 days once you’re discharged from hospital, like physio, x-rays and pathology.
• Receive trauma treatment at a casualty ward – whether you’re admitted to the hospital or not. A R660 co-payment will apply per visit for non-PMBs (if you’re not admitted to hospital straight from casualty).
• Enjoy unlimited specialised radiology paid by the scheme if you get pre-authorisation from us. The first R2 480 for non-PMB MRI/CT scans will be for your account.
• Family planning: We cover oral female contraception, patches, contraceptive rings, certain injectables and IUDs including the Mirena (prescribed by a GP or gynae, and not prescribed for acne).

Threshold Benefit

Once your claims have accumulated to a pre-determined Threshold level, any further claims will be paid from the Threshold Benefit, with a 20% co-payment for your account on all claims paid from the threshold benefit (except claims for network specialists). Certain day-to-day expenses are limited.

• See the doctor whenever you need to: you’ll enjoy unlimited GP visits from R1 on this option!