maxima EXEC

maxima EXEC

Mature families

From R 4 750

Are you more mature- maybe your kids have already left home? One of our most comprehensive medical plans, maxima EXEC gives you excellent all-round cover including in-hospital, chronic medicine, screening and a host of extra benefits. Plus, it also has a day-to-day savings portion, and a Threshold that kicks in once your claims have accumulated to a certain level.

 

Product Structure

This refers to the procedures and treatments that take place in hospital which you’re covered for, under 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 100% of the Fedhealth Rate.
• The oncology benefit on this option is R555 900.

On this option, you enjoy cover for 51 chronic diseases subject to the comprehensive formulary. Under this benefit, you have R7 100 per beneficiary per year available – capped at R13 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.
• 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.

• With us, you can upgrade to a higher option within 30 days of a life-changing event, like a pregnancy or the diagnosis of a dread disease.
• Members with specific healthcare needs can sign up for our comprehensive managed care programmes
• Have an emergency? Europ Assistance provides emergency transport and response.

This relates to the funds you have available upfront for day-to-day medical expenses like GP or dentist visits. On this plan the funds available are: Member R9 024, Adult Dependant R7 824, Child Dependant (up to a maximum of 3 children) R2 820

• We cover unlimited Fedhealth Network GP visits once your Savings is depleted.
• You enjoy unlimited specialised radiology from the core benefit bundle if you get pre-authorisation from us. The first R2 000 for non-PMB/CT scans will be for your account.
• We will cover your follow-up treatment for 30 days once you get discharged from hospital, like physio, x-rays and pathology. Threshold Benefit Once your claims have accumulated to the correct Threshold level, there are certain benefits that this option will continue to cover. Principal member R13 651 Adult R10 482 Child (up to a maximum of 3 children) R3 511