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Overall, the Fedhealth FlexiFED 3 Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and enhanced maternity plus childhood benefits to up to 3 Family Members. The Fedhealth FlexiFED 3 Medical Aid Plan Medical Aid Plan starts from R2,844 ZAR.
π€ Main Member Contribution | R2,844 – R3,796 |
π₯ Adult Dependent Contribution | R2,608 – R3,477 |
πΌ Child Dependent Contribution | R1,186 – R1,345 |
π Gap Cover | None |
π Annual Limit | Unlimited Hospital Cover |
π₯ Hospital Cover | Unlimited |
πΆ Prescribed Minimum Benefits | βοΈ Yes |
π©Ί Screening and Prevention | βοΈ Yes |
β‘οΈ Medical Savings Account | βοΈ Yes |
βοΈ Oncology Cover | R311,900 |
The Fedhealth FlexiFED 3 medical aid plan is one of 8, starting from R2,844 (elect), and includes chronic cover, screening benefits, enhanced maternity and childhood benefits, childhood illness specialized drug benefits, and a Threshold benefit once day-to-day claims reach the necessary level.Β Gap Cover is not available on the Fedhealth FlexiFED 3 Plan. However, Fedhealth offers 24/7 medical emergency assistance. According to the Trust Index, Fedhealth has a trust rating of 4.5.
FedhealthΒ offers 8 medical aid plans
π€ Main Member | π₯ +1 Dependent | πΌ +1 Child Dependent |
R3,796 | R3,477 | R1,345 |
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π Membership | πΆ FlexiFED 3 Contribution | π Annual Threshold Level |
π€ Main Member Only | R3,796 | R7,000 |
π₯ Main + Adult | R7,273 | R13,000 |
πΌ Main + Adult + Child | R8,618 | R14,800 |
π Main + Adult + 2 Children | R9,963 | R17,400 |
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π Member Option | π FlexiFED 3 | π Annual Threshold | βοΈ Day-to-Day Available |
π€ Main Member Only | R4,420 | R7,000 | R7,488 |
π₯ Main + Adult | R8,103 | R13,000 | R9,960 |
πΌ Main + Adult + Child | R9,710 | R14,800 | R13,104 |
βοΈ Main + Adult + 2 Children | R11,261 | R17,400 | R15,576 |
π Member Option | π FlexiFED 3 | π Annual Threshold | β‘οΈ Available Day-to-Day | β¬οΈ Total repayment to Fedhealth |
π€ Main Member Only | R3,796 | R7,000 | R11,220 | Total + Fedhealth savings used Γ· 12 |
π₯ Main + Adult | R7,273 | R13,000 | R21,492 | Total + Fedhealth savings used Γ· 12 |
πΌ Main + Adult + Child | R8,618 | R14,800 | R26,004 | Total + Fedhealth savings used Γ· 12 |
β‘οΈ Main + Adult + 2 Children | R9,963 | R17,400 | R29,988* | Total + Fedhealth savings used Γ· 12 |
π Overall Annual Limit (OAL) | Unlimited cover at the negotiated tariff. FlexiFED 3 covers admissions to any private hospital except for the following: Zuid-Afrikaans Hospital (Tshwane) Arwyp Medical Centre (Ekurhuleni) Busamed Modderfontein Private Hospital (Johannesburg) Hibiscus Hospital (Ugu) Mooimed Private Hospital (Dr. Kenneth Kaunda) St Helena Private Hospital (Lejweleputswa) Capital Hospital (Durban) Furthermore, emergency care is free, but elective procedures incur a co-payment of R7,800. |
π₯ Healthcare Professional Tariff in-hospital (HPT) | – |
β€οΈ Fedhealth Network GPs and Specialists | Unlimited cover. Accounts will be paid in full. |
𧑠Non-network GPs | Covered up to the Fedhealth Rate. |
π Non-Network Specialists | Covered up to the Fedhealth Rate. |
π Other healthcare professionals | Covered up to the Fedhealth Rate. |
βοΈ 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. |
π΄ Hospitalization Costs | Unlimited cover at the negotiated tariff. A private ward will be covered for maternity admissions if available at the negotiated tariff. |
β³οΈ Additional medical services | Paid from Fedhealth savings or must be self-funded. The benefit will accumulate at cost towards the Threshold level. |
π Hospitalisation Alternatives | – |
π©ββοΈ Nursing services Private nurse practitioners Nursing agencies | Unlimited according to the negotiated tariff. |
π Sub-acute facilities Physical Rehabilitation facilities | Unlimited according to PMB level of care. |
π©Ί Appliances, external accessories, and orthotics | Paid from Fedhealth savings or must be self-funded. The benefit will accumulate at cost towards the Threshold level. |
π©Έ Blood, Blood Equivalents, and Blood Products | Unlimited cover. |
β¬οΈ Immune Deficiency relating to HIV | Unlimited cover. |
π€° Maternity | – |
π¨ββοΈ Fedhealth Network GPs and Specialists | Unlimited and fully covered. |
π Non-network GPs and Specialists | Covered up to the Fedhealth Rate. |
π Other healthcare professionals | Covered up to the Fedhealth Rate. |
π¦· Dentistry | – |
π Maxillo-Facial Surgery | Unlimited cover. Subject to approval. |
βͺοΈ Surgical extraction of impacted wisdom teeth | A co-payment of R5,100 is required. |
βοΈ In-hospital dentistry benefits for child beneficiaries <7 | Fedhealth covers the hospital and anesthetist costs from the in-hospital benefit. The Fedhealth savings cover the dentist account, or the member must fund it. |
π Oncology | Limited to R311,900 at a designated service provider under the Essential protocol. Non-DSP users must pay a 25% co-payment. |
β€οΈ Organ Transplants | Limited to R311,900. |
π§ͺ Pathology and Radiology (Basic) | Unlimited up to the Fedhealth Rate. |
π Physiotherapy | Pre-authorization and treatment regimens apply. Subject to referral by a medical practitioner. |
π§ Psychiatric Services Accommodation in a general ward Procedures ECT Materials, and more. | Limited to R28,000 per year. |
π©Ή Renal Dialysis Consultations Visits All services, materials, and medicine associated with the cost of renal dialysis | Limited to R311,900 up to the Fedhealth Rate at Designated Service Provider (DSP). A 40% co-payment will apply if a DSP is not used. |
πΆπ» Childhood illness specialized drug benefit | Childhood sickness specialized drug benefit for children under 18. |
π Specialized Radiology | Unlimited according to the Fedhealth rate. The first R3,650 for non-PMB MRI/CT scans is for the memberβs account. |
π Spinal Surgery | No advantage without Conservative Back & Neck Rehabilitation Programme. The hospital co-payment is R8,920. |
π€ Terminal Care Benefit | Limited to R34,500 per family per year. |
Members of the Fedhealth FlexiFED 3 plan must note that the following co-payments may apply according to the procedure performed. These co-payments are for the memberβs account.
Co-payments per event applicable on hospital or facility account:
π₯ All open hernia surgery | R5,100 per event. |
π§ Arthroscopic procedures – knee, shoulder, ankle, wrist, hip | R9,450 per event. |
π¨ Back & neck procedures | R5,000 per event. |
π© Colonoscopy, upper GI endoscopy | R5,100 per event. |
π¦ Hysterectomy (unless for cancer) | R4,460 per event. |
πͺ Inguinal hernia surgery | R5,100 per event. |
Joint Replacement Co-Payments
π₯ Laparoscopic hernia repairs (bilateral inguinal, repeated inguinal hernias & Nissen/ Toupet hernia repairs only), laparoscopic procedures | R7,540 per event. |
π§ Single hip and knee replacement (voluntary non-use of a CP) | R31,400. |
π¨ Other joint replacements (voluntarily non-use of CP) for single hip and knee replacements | R7,450 per event. |
π© Laparoscopic varicocelectomy | R7,540 per event. |
π¦ Spinal Surgery | R8,920 per event. |
πͺ Surgical extraction of impacted wisdom teeth | R5,100 per event. |
π₯ Varicose vein procedures | R5,100 per event. |
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Internal Prostheses:
π °οΈ Aorta Stent Grafts | Limited to R65,500. |
π ±οΈ 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 | Covered under the combined benefit limit for all unlisted internal prostheses |
π Cardiac pacemakers, cardiac stents, cardiac valves | Unlimited at cost per the PMB level of care. |
π Detachable platinum coils | Limited to R56,700. |
π©Έ Elbow, hip, knee, and shoulder replacement | Covered under the combined benefit limit for all unlisted internal prostheses |
β€οΈ Intraocular lenses (per lens) | Limited to R3,500. |
π₯ Combined benefit limit for all unlisted internal prosthesis | R27,900 |
and many more.
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π Tariff | Covered up to the Fedhealth rate. |
π©Ί 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 |
π§ͺ Alternative Healthcare For example: Acupuncture Homoeopathy | Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level. |
π
°οΈ Additional Medical Services For example: Audiology Dietetics Genetic Counselling | Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level. |
π
±οΈ Advanced Dentistry For example: Inlays Crowns Bridges | Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level. |
β‘οΈ 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. |
π¦· Basic Dentistry | Self-funded or paid from Fedhealth Savings. Fillings, extractions, and root canals are covered. 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. |
π©ββοΈ 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. |
π¨ββοΈ Non-network GPs | Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level. |
π€° Maternity | Covered from available savings or must be funded by the member. Will accumulate at the cost to the Threshold level. |
π Scans | Two 2D Scans |
π Antenatal Classes | Limited up to R1,160. |
π Antenatal and Postnatal Consultations | Twelve consults with a midwife, network GP or gynecologist |
βοΈ Amniocentesis | The test is included in the benefit. |
Fedhealth Baby Programme | Pregnant Fedhealth members and beneficiaries receive free support, guidance, and a baby pack. |
πΌ Doula Benefit | Fedhealth pays up to R3,000 per delivery for a doula. |
πΆπ» Postnatal Midwifery Benefit | Four consultations with a midwife in and out-of-hospital. |
π Pediatric Consultations | One consultation per beneficiary. For children up to 2 years. A network pediatrician must be used, and referral is not necessary. |
𦻠Infant hearing Screening Benefit | Includes a screening test from birth up to 8 weeks. Covered up to the Fedhealth Rate. |
π Childhood Illness Specialised Drug Benefit | Fedhealth covers specialized drugs for children up to 18. |
π€ Optometry | Limited to R1,930 per year per beneficiary. Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
π© Over-the-Counter Medication | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
βοΈ Pathology | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
π Physical Therapy | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
π Prescribed Medication | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
β οΈ Basic Radiology | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
𧑠Specialists (excl. Psychiatrists) | Network GP referral is required for consults Including PMB conditions. The benefit is paid from Risk benefits. |
π Fedhealth Network Specialists | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
π₯ Non-network Specialists | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
π§ Specialists β Psychiatrists | Network GP referral is required for consults Including PMB conditions. The benefit is paid from Risk benefits. |
π¨ Fedhealth Network Psychiatrists | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
π© Non-network Psychiatrists | Covered from available savings or must be funded by the member. Will accumulate at a cost to the Threshold level. |
Fedhealth offers all FlexiFED 3 Members access to additional programs, benefits, and initiatives as indicated below.
π· 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. |
π 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 support the member throughout their treatment. |
π 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. |
π¬ 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. |
π Emergency Transport/Response | In an emergency, Fedhealth will provide emergency transportation to all members through the partner Europ Assistance. |
βοΈ 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 twice a week for six weeks and a home-based long-term care protocol. |
β οΈ 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. |
β‘οΈ 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. |
π Hospital at Home | Fedhealth and Quro Medicalβs technology-enabled Hospital at Home service offers in-patient care to patientsβ 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. |
β οΈ 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. |
β° 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. |
π Paed-IQ | Parents of children under 14 can call Paed-IQ 24/7 for advice. This service assists parents with healthcare-related childcare difficulties. |
π Sisters-on-Site | Fedhealth and SOS Corporate Wellness (Sisters-on-Site) provide nursing Sisters-on-Site to membersβ workplaces. |
π 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 |
π 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 3βs exclusions include, but are not limited to, the following:
Fedhealth FlexiFED 3 typically has the following waiting periods:
π Medical Aid Plan | π₯ Fedhealth FlexiFED 3 | π₯ Momentum Custom Plan | π₯ Discovery Health Classic Core |
π€ Main Member Contribution | R3,796 | R2,580 | R3,322 |
π₯ Adult Dependent Contribution | R3,477 | R3,176 | R2,621 |
πΌ Child Dependent Contribution | R1,345 | R2,449 β R6,573 | R1,329 |
π₯ Hospital Cover | Unlimited | Unlimited | Unlimited |
π Annual Limit | βοΈ Yes | None | βοΈ Yes |
π¦ Gap Cover | None | βοΈ Yes | βοΈ Yes |
Fedhealth FlexiFED 3 is an advanced medical aid plan that offers its members a range of comprehensive benefits. This plan provides extended maternity and early childhood cover, including pediatric consults, infant hearing screening, and eight additional chronic disease list (CDL) conditions. FlexiFED 3 also provides higher limits for psychiatric care, which can benefit those with mental health conditions. However, one of the drawbacks of FlexiFED 3 is that members may face out-of-pocket expenses when their medical savings are depleted, which can add to the overall cost of healthcare. The plan also restricts members from using a limited network of hospitals for treatment, which could be inconvenient for those who prefer to use a specific hospital or live in an area without a network hospital.
Compared to FlexiFED 1 and 2, FlexiFED 3 offers more advanced benefits, including extended maternity and early childhood cover and higher psychiatric limits. However, these benefits come at a higher cost, as the premium for FlexiFED 3 is significantly higher than that of FlexiFED 1 and 2.Β FlexiFED 1 provides unlimited coverage on oncology and no restrictions on hospital providers. At the same time, FlexiFED 3 offers limited oncology benefits and some restrictions on hospital choice and co-payments for elective treatments.
You might also consider the following options FedHealth has to offer:
FlexiFED 3 is a medical aid plan offered by Fedhealth, which provides members with a range of benefits to meet their healthcare needs. In addition, it offers flexibility in terms of cover and contributions, allowing members to choose a plan that suits their budget and lifestyle.
FlexiFED 3 offers a range of benefits, including hospital cover, chronic medication, day-to-day benefits, network providers, prescribed minimum benefits, a medical savings account, and more. However, gap cover is currently not offered by Fedhealth.
The contributions for FlexiFED 3 depend on the level of cover selected by the member and other factors such as age, location, and family size.
Yes, there are waiting periods for some benefits under FlexiFED 3, such as pre-existing conditions and certain treatments. However, these waiting periods can be reduced or waived if the member has previously been on a medical aid scheme.
The medical savings account is a portion of the memberβs monthly contribution for day-to-day medical expenses, such as GP consultations, medication, and dental and optical benefits. Furthermore, any unused funds in the medical savings account at the end of the year are carried over to the following year.
Yes, emergency medical services are covered under FlexiFED 3, including emergency transportation, treatment, and hospitalization.
To sign up for FlexiFED 3, visit the Fedhealth website or contact their customer service team. You will need to provide some personal and medical information and choose the level of coverage and contributions that best suits your needs.
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