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.
If you really don’t want to leave any aspect of your healthcare to chance, maxima PLUS is the height of extensive medical aid cover. It offers generous in-hospital, chronic medicine, screening and additional benefits, a day-to-day savings portion, a Threshold benefit, as well as an Out-of-Hospital Expenses Benefit (OHEB) to pay for your day-to-day expenses once your savings have been depleted.
This refers to the procedures and treatments that take place in hospital for which you enjoy cover on this option.
• For your peace of mind, there’s no overall annual limit for hospitalisation.
• You benefit from unlimited maternity cover.
• 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.
• The oncology benefit on this option is unlimited.
• You also enjoy a specialised medication benefit of R347 900.
On this option, you enjoy cover for 65 chronic diseases subject to the comprehensive formulary. Under this benefit, you have R15 000 per beneficiary per year available – capped at R28 100 per family per year. Our preferred providers are MediRite, Clicks, Dis-Chem and Pharmacy Direct.
This benefit includes the tests and healthcare assessments that ensure that your health is 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.
• We cover one cholesterol screening (full lipogram) every five years for everyone over the age of 20.
• Over 50s: - All over 65s get one pneumococcal vaccination per lifetime - All members between 50 and 75 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.
• All members enjoy one wellness screening per year that includes BMI, blood pressure, finger prick cholesterol and glucose tests.
• All members enjoy one preventative screening by a contracted wellness network provider per year that includes waist-to-hip ratio, body fat %, flexibility, posture and fitness).
Fedhealth offers many extras to optimise your health even more, such as 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.
• Members with specific healthcare needs 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!
The funds you have available upfront for day-to-day medical expenses like GP visits or the dentist. Once your annual savings account is depleted, the Out-of-Hospital Expenses Benefit will cover many of your day-to-day expenses. Available for day-to-day expenses Annual Savings and OHEB Member R14 243 Adult Dependant R11 047 Child Dependant (up to a maximum of 3 children) R3 662
• On this 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.
• We will cover your follow-up treatment for 30 days once you get discharged from hospital, like physio, x-rays and pathology.
• You 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. Member R15 818 Adult Dependant R12 166 Child Dependant (up to a maximum of 3 children) R3 662