maxima EXEC

maxima EXEC

Mature families

From R 5 992

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 R580 900.

On this option, you enjoy cover for 54 chronic diseases subject to the comprehensive formulary. Under this benefit, you have R7 400 per beneficiary per year available – capped at R13 600 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 maxima EXEC the funds available are: Member R9 288, Adult Dependant R8 064, Child Dependant (up to a maximum of 3 children) R2 952. On maxima EXEC GRID the funds available are: Member R8 280, Adult dependant R7 188, Child dependant R2 628

• 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 300 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 R14 265 Adult R10 954 Child (up to a maximum of 3 children) R3 669

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Disclaimer T's & C's
This website and the information contained within it is intended for information and consumption purposes only and does not by any means supersede the Rules of the Scheme. In the event of any discrepancy between this website and the Rules of the Scheme, the Rules of the Scheme will prevail. POPI act compliance information as well as the rules of the scheme are available here - Please click on the rules and annexures / POPI Compliance tab in order to access the documents. Alternatively a copy can be obtained by contacting the Fedhealth customer contact centre on 0860 002 153.