Here are the procedures and treatments that take place in hospital which you’re covered for, under this option:

• There’s no overall annual limit for hospitalisation, so you can relax knowing you’re fully 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 100% of the Fedhealth Rate.  
• Get a generous oncology benefit of R624 000.

Get covered for 56 chronic diseases subject to the comprehensive formulary. Under this benefit, you have R7 890 per beneficiary per year available – capped at R14 500 per family per year. Our preferred providers are Medirite, Clicks, Dis-Chem (and their courier pharmacies) and Pharmacy Direct

Get access to all the tests and healthcare assessments you need to ensure that your health is on the right track.

• Get checked: we cover one Pap smear (cervical cancer screening) every three years for women aged 21 to 65.
• We also cover one Prostate Specific Antigen (PSA) per year for men aged 45 to 69.
• Your health is your wealth: all members enjoy one wellness screening per year measuring your BMI and blood pressure, plus finger prick cholesterol and glucose tests.
• Keep fit! All members benefit from one preventative screening by a contracted wellness network provider per year, which 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.

• With us, you can also upgrade to a higher option within 30 days of a life-changing event, like a pregnancy or the diagnosis of a dread disease.
• Have a specific healthcare need? Sign up for one of our comprehensive managed care programmes.

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 to you are: Member R11 556, Adult Dependent R10 032, Child Dependent (up to a maximum of 3 children) R3 564 

• We cover unlimited Fedhealth Network GP visits once your medical savings are depleted.
• You get 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.
• We’ll 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. These are the Threshold levels: Principal member R15 400 Adult R11 900 Child (up to a maximum of 3 children) R4 000.