What are the membership options available through Fedhealth?

Fedhealth offers a range of membership options to suit the needs of individuals and families, including FlexiFED 1, FlexiFED 2, Maxima EXEC, and several others.

Try our new AI Assistant

...

Home » Medical Aid »

Fedhealth FlexiFED 1 Medical Aid Plan

Overall, the Fedhealth FlexiFED 1 Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance to up to 3 Family Members. The Fedhealth FlexiFED 1 MedAdd Medical Aid Plan starts from R1,716 ZAR.

👤 Main Member Contribution	R1,716 – R2,201
👥 Adult Dependent Contribution	R1,341 – R1,725
🍼 Child Dependent Contribution	R625 – R806
📉 Annual Limit	Unlimited Hospital Cover
🏥 Hospital Cover	Unlimited
💶 Prescribed Minimum Benefits	☑️ Yes
➡️ Screening and Prevention	☑️ Yes
🔍 Medical Savings Account	☑️ Yes
🤰 Maternity Benefits	☑️ Yes
🔁 Gap Cover	None

Fedhealth FlexiFED 1 Plan – 8 Key Point Quick Overview

☑️ Fedhealth FlexiFED 1 Plan Overview
☑️ Fedhealth FlexiFED 1 Plan Contributions and Medical Savings
☑️ Fedhealth FlexiFED 1 Plan Benefits and Cover Comprehensive Breakdown
☑️ FlexiFED 1 Programs and Wellness Initiatives
☑️ Fedhealth FlexiFED 1 Plan Exclusions and Waiting Periods
☑️ Fedhealth FlexiFED 1 Plan vs. Similar Plans from other Medical Schemes
☑️ Our Verdict on the Fedhealth FlexiFED 1 Plan
☑️ Fedhealth FlexiFED 1 Plan Frequently Asked Questions

Fedhealth FlexiFED 1 Plan Overview

The Fedhealth FlexiFED 1 medical aid plan is one of 8, starting from R1,716 and includes access to Fedhealth Savings powered by MediVault for unexpected day-to-day medical expenditures, a beneficial Threshold Benefit that kicks in once your claims reach a certain threshold, and more. Gap Cover is not available on the Fedhealth FlexiFED 1 Plan. However, Fedhealth offers 24/7 medical emergency assistance. According to the Trust Index, Fedhealth has a trust rating of 4.5.

Fedhealth offers 8 medical aid plans

Fedhealth FlexiFED 1 Plan Contributions and Medical Savings

Contributions – Supercharged Hospital Plan

👤 Main Member	👥 +1 Dependent	👥 +1 Child Dependent
R2,513	R4,394	R5,303

Discover the 5 Best Hospital Plans under R200

Contributions – Supercharged Savings Plan

🔎 Member Option	1️⃣ FlexiFED 1	2️⃣ Annual Threshold	3️⃣ Day-to-Day Available
👤 Main Member Only	R2,513	R5,100	R3,744
👥 Main + Adult	R4,394	R8,100	R5,616
🍼 Main + Adult + Child	R5,303	R9,900	R6,852
➡️ Main + Adult + 2 Children	R6,265	R11,800	R8,724

Contributions – Supercharged Flexible Savings Plan

🔎 Member Option	1️⃣ FlexiFED 1	2️⃣ Annual Threshold	3️⃣ Available Day-to-Day	⬇️ Total repayment to Fedhealth
👤 Main Member Only	R2,201	R5,100	R6,540	Total + Fedhealth savings used ÷ 12
👥 Main + Adult	R3,926	R8,100	R11,664	Total + Fedhealth savings used ÷ 12
🍼 Main + Adult + Child	R4,732	R9,900	R16,188	Total + Fedhealth savings used ÷ 12
➡️ Main + Adult + 2 Children	R5,538	R11,800	R18,576*	Total + Fedhealth savings used ÷ 12

Fedhealth FlexiFED 1 Plan Benefits and Cover Comprehensive Breakdown

FlexiFED 1 Supercharged Hospital Plan and In-hospital benefits

All hospitalization-required treatments and procedures included in the flexiFED plans are covered under this benefit.
Unless otherwise specified, annual restrictions apply to an entire household.

Overall Annual Limit (OAL):

At network hospitals, there is no limit.
Co-payment of R7,800 for voluntary usage of a non-network hospital.
Co-payment of R2,200 for voluntary using a non-network day surgery facility.

Healthcare Professional Tariff in-hospital (HPT):

👨‍⚕️ Fedhealth Network GPs and Specialists	Unlimited cover. Accounts will be paid in full.
👩‍⚕️ Non-network GPs	Covered up to the Fedhealth Rate.
📈 Non-Network Specialists	Covered up to the Fedhealth Rate.
📉 PMBs treatment	You must use Fedhealth Network Doctors and specialists to receive complete coverage for PMB conditions. If you choose not to use network providers, the Scheme will only reimburse you for treatment up to the Fedhealth Rate for non-network GPs and specialists. If the healthcare practitioner charges extra, you will have a shortfall.
💶 Hospitalization Costs	The unlimited cover is according to the negotiated tariff.
🚑 Additional medical services	Paid from Fedhealth savings or must be self-funded. The benefit will accumulate at cost towards the Threshold level.

Hospitalisation Alternatives:

👩‍⚕️ Nursing services Private nurse practitioners Nursing agencies	Unlimited according to the negotiated tariff.
➡️ Sub-acute facilities Physical Rehabilitation facilities	Unlimited according to PMB level of care.
🩺 Appliances, external accessories, and orthotics	Paid from Fedhealth savings or must be self-funded. The benefit will accumulate at cost towards the Threshold level.
🩸 Blood, Blood Equivalents, and Blood Products	Unlimited cover.
☑️ Immune Deficiency relating to HIV	Unlimited cover.

Maternity:

Fedhealth Network GPs and Specialists: Unlimited and fully covered.
Non-network GPs and Specialists: Covered up to the Fedhealth Rate.
Other healthcare professionals: Covered up to the Fedhealth Rate.

You might like 5 Best Medical Aids for Babies in South Africa

Additional Benefits:

😊 Maxillo-Facial Surgery	Unlimited cover. Subject to approval.
📈 Oncology	Unlimited PMB care at a designated service provider under the Essential protocol. Non-DSP users must pay a 25% co-payment.
❤️ Organ Transplants	Unlimited according to PMB level of care.
📉 Pathology and Radiology (Basic)	Unlimited up to the Fedhealth Rate.
📊 Physiotherapy	Pre-authorization and treatment regimens apply. Subject to referral by a medical practitioner.
💙 Psychiatric Services Accommodation in a general ward Procedures ECT Materials Hospital Equipment Consultations and Visits Medicines Injectable Material	Unlimited according to PMB level of care.
➡️ Renal Dialysis Consultations Visits All services, materials, and medicine associated with the cost of renal dialysis	Unlimited PMB care at Designated Service Provider (DSP). A 40% co-payment will apply if a DSP is not used.
☑️ Specialized Radiology	Unlimited according to the Fedhealth rate. The first R3,650 for non-PMB MRI/CT scans is for the member’s account.
⚕️ Spinal Surgery	No benefit unless it is according to PMB level of care.
💖 Terminal Care Benefit	Limited to R34,500 per family per year.

FlexiFED 1 Co-Payments

Members of the Fedhealth FlexiFED 1 plan must note that the following co-payments may apply according to the procedure performed. These co-payments are for the member’s account.

Co-payments per event applicable on hospital or facility account:

💴 Adenoidectomy, bunion procedures, diagnostic cystoscopy, gastritis/ dyspepsia/ heartburn, nasal procedures, skin biopsy/ excision	R7,540 per event.
💵 All open hernia surgery	R7,540 per event.
💶 Arthroscopic procedures – knee, shoulder, ankle	R9,450 per event.
💷 Back & neck procedures	R7,540 per event.
💴 Colonoscopy, upper GI endoscopy	R7,540 per event.
💵 Hysterectomy (unless for cancer)	R4,460 per event.
💶 Inguinal hernia surgery	R7,540 per event.

Joint Replacement Co-Payments:

💴 Laparoscopic hernia repairs (bilateral inguinal, repeated inguinal hernias & Nissen/ Toupet hernia repairs only), laparoscopic procedures	R7,540 per event.
💵 Laparoscopic varicocelectomy	R7,540 per event.
💶 Surgical extraction of impacted wisdom teeth	R5,100 per event.
💷 Varicose vein procedures	R7,540 per event.

Tonsillectomy Co-Payments:

12 and over R7,540 per event.

FlexiFED 1 Prothesis Benefits

External Prostheses: Unlimited according to PMB level of care.

Internal Prostheses:

1️⃣ Aorta Stent Grafts	Unlimited according to PMB level of care
2️⃣ Bone lengthening devices, carotid stents, embolic protection devices, and other approved spinal implantable devices and intervertebral discs, peripheral arterial stent-grafts, spinal plates, and screws	Unlimited according to PMB level of care
3️⃣ Cardiac pacemakers, cardiac stents, cardiac valves	Unlimited according to PMB level of care
4️⃣ Detachable platinum coils	Unlimited according to PMB level of care
5️⃣ Elbow, hip, knee, and shoulder replacement	Unlimited according to PMB level of care
6️⃣ Intraocular lenses (per lens)	Unlimited according to PMB level of care
7️⃣ Combined benefit limit for all unlisted internal prosthesis	Unlimited according to PMB level of care

POLL: 5 Best Medical Aids under R3000

FlexiFED 1 Chronic Disease Benefits

Chronic disease coverage is unlimited (CDL).
HIV/AIDS treatment for mother-to-child transmission, rape, and post-exposure prophylaxis is unlimited.

FlexiFED 1 Chronic Disease List (CDL)

☑️ Addison’s Disease
☑️ Asthma
☑️ Bipolar Mood Disorder
☑️ Bronchiectasis
☑️ Cardiac Failure
☑️ Cardiomyopathy
☑️ COPD/ Emphysema/ Chronic Bronchitis
☑️ Chronic Renal Disease
☑️ Coronary Artery Disease
☑️ Crohn’s Disease

and many more.

FlexiFED 1 Screening and Prevention Benefits

Women’s Health
Cervical Cancer Screening (Pap smear): One every three years for female beneficiaries between 21 and 65.

Men’s Health
Prostate Specific Antigen (PSA): One every year for male beneficiaries between 45 and 69.

Children’s Health
Immunisation Programme according to the State EPI: Various frequencies from birth to 12 years.

Beneficiary over 45
Breast cancer screening with mammography: One every two years for all beneficiaries 45>
Colorectal cancer screening via a fecal occult blood test: One every year for beneficiaries 50 to 75.
Pneumococcal vaccines: Once per lifetime for beneficiaries 65>

General
Flu Vaccine: Once every year for all beneficiaries.
HIV finger prick test: Once every year for all beneficiaries.

Health Risk Assessment
Wellness screening (BMI, blood pressure, finger prick cholesterol, and glucose tests): Once a year for all beneficiaries.
Preventative screening (Waist-to-hip ratio, body fat percentage, flexibility, posture, and fitness): Once a year for all beneficiaries.

FlexiFED 1 Day-to-Day Benefits

💶 Tariff	Covered up to the Fedhealth rate.
🩺 Appliances, External Accessories, and Orthotics: For example: Hearing Aids Wheelchairs, etc.	In and out of the hospital: Fedhealth Savings or self-funding. Accumulates at cost until it reaches the Threshold level
💙 Alternative Healthcare Acupuncture Homoeopathy Naturopathy Osteopathy Phytotherapy	Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level.
➡️ Additional Medical Services Audiology Dietetics Genetic Counselling Hearing Aid Acoustics Occupational Therapy Orthoptics Podiatry Private Nursing Psychologists Social Workers Speech Therapy	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
🦷 Advanced Dentistry Inlays Crowns Bridges Mounted Study Models Metal Base Partial Dentures Oral Surgery Orthodontic Treatment Periodontists Prosthodontists Dental Technicians	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
☑️ Osseo-integrated Implants and Orthognathic Surgery	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
📌 Basic Dentistry	Self-funded or paid from Fedhealth Savings. When you hit your Threshold level, the following advantages will be paid from your Threshold benefit and will be available to each beneficiary: Two annual visits X-rays Scaling and polishing Contract dentists must be used, and procedures, dental tariff codes, and protocols are confined to a list of approved procedures, dental tariff codes, and protocols.
📍 Fedhealth Network GPs	Paid from Fedhealth Savings, then unlimited visits to a selected network Physician after the Threshold is achieved. Each beneficiary may choose up to two network doctors. Each beneficiary is only allowed two mental health visits per year. Up to two out-of-area GP consultations per recipient per year are permitted.
👨‍⚕️ Non-network GPs	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
🍼 Maternity	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
🤓 Optometry	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
💊 Over-the-Counter Medication	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
📌 Pathology	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
📍 Physical Therapy	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
🧪 Prescribed Medication	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
📈 Basic Radiology	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
📉 Specialists (excl. Psychiatrists)	Network GP referral is required for consults, including PMB conditions. The benefit is paid from Risk benefits.
📊 Fedhealth Network Specialists	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
🔍 Non-network Specialists	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
🔎 Specialists – Psychiatrists	Network GP referral is required for consults, including PMB conditions. The benefit is paid from Risk benefits.
🧠 Fedhealth Network Psychiatrists	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.
💖 Non-network Psychiatrists	Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level.

FlexiFED 1 Programs and Wellness Initiatives

Fedhealth offers all FlexiFED 1 Member access to additional programs, benefits, and initiatives as indicated below.

🔍 HIV Management	Fedhealth provides the AfA program to help HIV-positive members manage their illnesses. Besides paying essential drug and pathology claims, the benefits of being on the program include therapeutic and emotional assistance with strict secrecy.
📉 Aligned	Fedhealth has teamed with Aligned to provide additional care to members suffering from critical illnesses such as advanced cancer. The benefit includes an initial consultation with a clinician trained in palliative care to examine their needs holistically. Counseling for the individual and their family is provided, as is establishing an advanced healthcare plan or living will. Three follow-up doctor visits and two follow-up social worker consultations are also provided yearly to ensure the member is supported throughout their treatment path.
💙 Corporate Wellness Days	Corporate wellness days allow for the creation of awareness, education, prevention, screening, and targeted interventions that encourage good lifestyle changes. These days are well-received because having these services at work is convenient for Fedhealth members. In addition to the therapeutic benefits that wellness days can bring, they allow Fedhealth to market the Scheme to clients and potential clients.
🍬 Diabetes Care	Fedhealth customers with diabetes can access a comprehensive program tailored to their specific needs and other chronic diseases. This involves ongoing access to a treating physician, authorized chronic medication, and blood and laboratory tests.
❤️ Emergency Transport/Response	In an emergency, Fedhealth will provide emergency transportation to all members through the partner Europ Assistance.
⚕️ Fedhealth Conservative Back and Neck Rehabilitation Program	Fedhealth has a well-established intervention for members experiencing back and neck pain. It is based on the notion of active muscle reconditioning and is supported by clinical research that indicates that exercise decreases discomfort and can restore function in many cases. The program offers qualifying participants customized treatment and takes a thorough and holistic approach to persistent back and neck pain. Following an initial assessment, recipients may get treatment up to twice a week for six weeks and a home-based long-term care protocol.
✅ GoSmokeFree Smoke Cessation Program	Fedhealth encourages smokers to join up for GoSmokeFree at 200 pharmacies nationwide, including Dis-Chem, Clicks, and independent pharmacies. Smokers receive an annual GoSmokeFree benefit from risk benefits. Pre-quit assessment, support, and a smoking cessation strategy are included.
☑️ Health Risk Assessments	This benefit identifies members at risk of lifestyle diseases. It helps them prevent or manage them with practical advice and Scheme advantages. Participating pharmacies and BASA biokinetics offer Health Risk Assessments.
🏠 Hospital at Home	Fedhealth and Quro Medical’s technology-enabled Hospital at Home service offers in-patient care to patients’ homes, including real-time patient monitoring. Available in the Eastern Cape, Western Cape, Gauteng, and Bloemfontein, with further expansion planned. Fedhealth members can receive active treatment at home for a predetermined period without sacrificing care with this service.
🚑 MediTaxi	Fedhealth users with hospital authorizations in Cape Town, Johannesburg, Pretoria, and Durban can use MediTaxi. If they cannot drive after a medical procedure, members can use the 24/7 MediTaxi service to get to follow-up appointments. Limited to two annual return trips per member/beneficiary.
⏰ 24-Hour Nurse line	The Fedhealth toll-free 24-hour service is staffed by nurses who can advise on medical crises, symptoms, medication side effects, stress management, and teen support.
🅰️ Paed-IQ	Parents of children under 14 can call Paed-IQ 24/7 for advice. This service assists parents with healthcare-related childcare difficulties.
🅱️ Sisters-on-Site	Fedhealth and SOS Corporate Wellness (Sisters-on-Site) provide nursing Sisters-on-Site to members’ workplaces.
📲 SOS Call Me	Fedhealth members and their dependents receive free USSD callbacks. The service offers three options, including the following: Emergency Medical Services (EMS) Nurse Line MediTaxi
😊 Weight Management Program	Fedhealth members with high BMI and waist circumference can participate in the Weight Management Plan. Members reduce weight and enjoy healthier, more fulfilling lives through a 12-week biokinetics-led intervention plan with a nutritionist and psychologist. After the program, continuous assistance and advice are offered.

Fedhealth FlexiFED 1 Plan Exclusions and Waiting Periods

FlexiFED 1 Exclusions

Fedhealth FlexiFED 1’s exclusions include, but are not limited to, the following:

Art Therapy
Aromatherapy
Herbalists
Reflexology
Therapeutic massage therapy
Appliances, external accessories, and orthotics
Blood, Blood Equivalents, and Blood Products
Dentistry
Infertility
Maternity
Medicine and Injectables, including,

FlexiFED 1 Waiting Periods

Fedhealth FlexiFED 1 typically has the following waiting periods:

General Waiting periods: This is often three months, depending on your chosen medical aid plan. During this period, you must pay your regular monthly payments. However, you are not eligible for benefits except for some PMB-related claims.
A secondary waiting period: This is typically around 12 months and pertains to therapy for any pre-existing conditions you had when you joined the program.

Medical Aid Comparisons : FlexiFED 1 Plan vs. Similar Plans from other Medical Schemes

🔎 Medical Aid	🥇 Fedhealth FlexiFED 1	🥈 Bestmed Beat 2	🥉 Discovery Health Essential Delta Saver
🌎 International Cover	None	R500,000 – R3 million	R5 million
👤 Main Member Contribution	R2,201 (Network Hospitals)	R2,545	R2,673
👥 Adult Dependent Contribution	R1,725	R1,976	R2,017
🍼 Child Dependent Contribution	R806	R1,071	R1,072
🏥 Hospital Cover	Unlimited	Subject to scheme rules	Unlimited
➡️ Oncology Cover	Unlimited at cost at PMB level of care at DSP	100% of the scheme tariff	R250,000

Our Verdict on the Fedhealth FlexiFED 1 Plan

The FlexiFED 1 plan from Fedhealth is a comprehensive medical aid plan that offers a range of benefits and features designed to meet the healthcare needs of its members. One of the advantages of the FlexiFED 1 plan is that it offers comprehensive coverage for a wide range of healthcare needs, including in-hospital care, day-to-day medical expenses, and preventative care. In addition, members of the plan also have access to a range of additional benefits, such as coverage for chronic conditions, mental health, and rehabilitation services. Another advantage of the plan is that it offers a range of wellness and preventative care benefits, including coverage for diabetes care programs, conservative back and neck rehabilitation, health assessments, and lifestyle management programs.

However, one potential drawback of the FlexiFED 1 plan is that it may be more expensive than other medical aid plans, particularly for individuals or families with limited healthcare needs. Members may also be subject to certain exclusions and waiting periods, depending on their specific healthcare needs and the terms and conditions of the plan. Overall, the FlexiFED 1 plan from Fedhealth is a comprehensive medical aid plan that offers a range of benefits and features designed to meet the healthcare needs of its members.

While it may not be suitable for everyone, particularly those with limited healthcare needs, it offers a range of advantages that may be attractive to individuals and families who require comprehensive healthcare coverage.

You might also consider the following options FedHealth has to offer:

Fedhealth FlexiFED 1 Plan Frequently Asked Questions

What is FlexiFED 1?

FlexiFED 1 is a medical aid plan offered by Fedhealth that provides affordable healthcare coverage for individuals and families.

What benefits does FlexiFED 1 offer?

FlexiFED 1 offers a range of benefits, including hospital cover, chronic medication cover, day-to-day medical expenses, and access to a network of healthcare providers.

What is the claims process for FlexiFED 1?

The claims process for FlexiFED 1 is straightforward. Submit your claim through the Fedhealth website or mobile app, and your claim will be processed within a few business days.

What is the network of healthcare providers available through FlexiFED 1?

FlexiFED 1 offers access to various healthcare providers, including hospitals, doctors, dentists, and other healthcare professionals. You can search for providers in your area using the Fedhealth website or mobile app.

How do I join enroll in FlexiFED 1?

To enroll in FlexiFED 1, visit the Fedhealth website and follow the steps to sign up for a membership. You must provide basic personal and health information to complete the enrollment process.

What makes Fedhealth and FlexiFED 1 unique?

Fedhealth and FlexiFED 1 are unique in that they provide affordable healthcare solutions that are tailored to the needs of individuals and families. In addition, they are known for their comprehensive cover, network of healthcare providers, and easy claims process.

Can I enroll in FlexiFED 1 if I am self-employed?

Yes, FlexiFED 1 is an excellent option for self-employed individuals seeking affordable healthcare coverage.

Does FlexiFED 1 cover pre-existing medical conditions?

Yes, FlexiFED 1 covers pre-existing medical conditions. However, waiting periods may exist before you can claim treatment related to your condition. Contact Fedhealth for more information.

What if I need emergency medical care while traveling outside of South Africa?

Fedhealth might offer international travel coverage. However, none is indicated under the FlexiFED 1 option.

Adriaan Schoeman

Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.