maxima PLUS


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maxima PLUS

Extensive medical cover that covers every aspect of your healthcare. Get generous in-hospital cover, chronic medicine, screening and additional benefits, day-to-day savings portion, a Threshold benefit, and an OHEB.

From
R 11 790 per month
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WHAT DOES IT COVER?

Looking for truly extensive medical aid cover that leaves nothing to chance? maxima PLUS gives you a superb range of benefits for every aspect of your health, from generous in-hospital and day-to-day cover plus screening benefits, chronic medication and more.

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

  • 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.

Get maximum chronic disease coverage, with cover for 70 chronic diseases subject to the comprehensive formulary. Under this benefit, you have R16 700 per beneficiary per year available – capped at R31 300 per family per year. Our preferred providers are Medirite, Clicks, Dis-Chem (and their courier pharmacies) and Pharmacy Direct

Get covered for all the tests and healthcare assessments to make sure your health stays on the right track:

  • 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.
    Prevention is the answer: Get one cholesterol screening (full lipogram) every five years for everyone over the age of 20.
  • If you’re over 65, you get one pneumococcal vaccination per lifetime.
  • If you’re between 50 and 75, you get one colorectal cancer screening (faecal occult blood test) per year.
  • Women over 65 and men over 70 are covered for one bone densitometry screening every two years.
  • Get one wellness screening per year that includes BMI, blood pressure, finger prick cholesterol and glucose tests.
  • Get one preventative screening per year by a contracted wellness network provider that includes 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.

We want to help you optimise your health even more, which is why we provide professional medical advice and a transport service when you need post-hospitalisation check-ups.

  • Call our 24-hour Emotional Wellbeing Programme support line to get you through life’s ups and downs.
  • If you have specific healthcare needs, you can sign up for our comprehensive managed care programmes.
  • Have an emergency? Europ Assistance provides emergency transport and response.
  • Our MediTaxi service transports you to follow-up medical treatments following a hospital stay (only certain regions).
  • Use our USSD call-back service, SOS Call Me, to access Emergency Medical Services, the Fedhealth Nurse Line or MediTaxi – free of charge to you!

These are the funds you have available upfront for day-to-day medical expenses like visiting the GP or going to the dentist. Once your annual savings account is depleted, this comprehensive cover includes an Out-of-Hospital Expenses Benefit to cover many of your day-to-day expenses.

Available for day-to-day expenses:

Annual Savings and OHEB Member: R16 922

Adult Dependant: R13 211

Child Dependant (up to a maximum of 3 children): R4 367

  • On this truly comprehensive option, you get unlimited Fedhealth Network GP visits – it’s always paid from Risk and never your Savings!
  • We cover unlimited specialised radiology like MRI and CT scans.
  • 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 get discharged from hospital, like physio, x-rays and pathology.
  • Benefit from trauma treatment at a casualty ward – unlimited at 100% of the Fedhealth Rate.

Threshold Benefit

Once your claims have accumulated to the correct Threshold level, there are certain benefits that this option will continue to cover. The threshold levels are Member R17 800 Adult Dependant R13 800 Child Dependant (up to a maximum of 3 children) R4 800.

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