Maxima PLUS
About this plan
🥇 Best suited for families wanting comprehensive healthcare with savings and Above Threshold benefits.
Principal Member
From
R19,393
per month
Adult Dependant
From
R16,739
per month
Child Dependant
From
R5,992
per month
What's covered
Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health
Waiting periods
- General
- 3 months
- Pre-existing conditions
- 12 months
Maxima PLUS
Fedhealth Maxima PLUS Plan (🇿🇦 2026)
Overall, the Fedhealth Maxima PLUS Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and generous in-hospital . The Fedhealth Maxima PLUS Medical Aid Plan starts from R19,393 ZAR.| 🔎 Medical Aid Plan | 🥇 Fedhealth Maxima PLUS |
| 👤 Main Member Contribution | R19,393 |
| 👥 Adult Dependent Contribution | R16,739 |
| 🍼 Child Dependent Contribution | R5,992 |
| 📉 GP Visits | Unlimited network GP visits. once OHEB is depleted on maxima PLUS. |
| 💙 Hospital Cover | Unlimited Private Hospital Cover |
Fedhealth Maxima PLUS Plan - 9 Key Point Quick Overview
- ☑️ Fedhealth Maxima PLUS Plan Overview
- ☑️ Fedhealth Maxima PLUS Plan Contributions and Calculations
- ☑️ Fedhealth Maxima PLUS Plan Benefits and Cover Comprehensive Breakdown
- ☑️ Maxima PLUS Screening and Prevention Benefits
- ☑️ Maxima PLUS Programs and Wellness Initiatives
- ☑️ Fedhealth Maxima PLUS Plan Exclusions and Waiting Periods
- ☑️ Fedhealth Maxima PLUS Plan vs. Similar Plans from other Medical Schemes
- ☑️ Our Verdict on the Fedhealth Maxima PLUS Plan
- ☑️ Fedhealth Maxima PLUS Plan Frequently Asked Questions
Fedhealth Maxima PLUS Plan Overview
The Fedhealth Maxima PLUS medical aid plan is one of 8, starting from R19,393 and includes generous in-hospital cover, an out-of-hospital expenses benefit, day-to-day savings, a threshold benefit, dentistry, internal and external prostheses benefit, screening, chronic, and more. Gap Cover is not included on the Fedhealth Maxima PLUS 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
- ▶️ FlexiFED Savvy
- ▶️ MyFED
- ▶️ Maxima PLUS
- ▶️ Maxima EXEC
- ▶️ FlexiFED 4
- ▶️ FlexiFED 3
- ▶️ FlexiFED 2
- ▶️ FlexiFED 1
Fedhealth Maxima PLUS Plan Contributions and Calculations
Fedhealth Maxima PLUS Contributions
| 🔎 Membership | 📈 Risk | 💶 Savings | 💴 Total Contribution | 💵 Out-of-Hospital Expenses Benefit (OHEB) |
| 👤 Main Member | R18,749 | R644 monthly R7,728 annually | R19,393 | R10,630 |
| 👥 Adult Dependents | R16,183 | R556 monthly R6,672 annually | R16,739 | R7,680 |
| 🍼 Child Dependents | R5,793 | R199 monthly R2,388 annually | R5,992 | R2,370 |
Fedhealth Maxima PLUS Savings and Self Payment Gap
| 1️⃣ Membership | 🟪 Annual Savings | 🟨 Annual Threshold | 🟫 Self-Payment Gap (SPG) |
| 👤 Main | R7,728 | R23,400 | R5,042 |
| 👥 Adult Dependant | R6,672 | R18,250 | R3,898 |
| 🍼 Child Dependant | R2,388 | R6,390 | R1,632 |
💙 POLL: 5 Best Medical Aids under R500
Fedhealth Maxima PLUS Plan Benefits and Cover Comprehensive Breakdown
Maxima PLUS 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.
Maxima PLUS Co-Payments
Fedhealth Maxima PLUS plan members must note that the following co-payments may apply according to the procedure performed. These co-payments are for the member’s account.- ✅️ Joint Replacement Co-Payments:
- ️✅ Single hip and knee replacement (voluntary non-use of a CP): R36,330.
💙 You might like 5 Best Medical Aid Co-Payment Cover in South Africa
Maxima PLUS Prothesis Benefits
- ✅️ External Prostheses: Limited to R25,050 at cost per family yearly.
- ️✅ Internal Prostheses:
| 🟥 Aorta Stent Grafts | Limited to R67 530 per family yearly. |
| 🟧 Bi-ventricular pacemakers and implantable cardioverter defibrillators (ICDs), bone lengthening devices, carotid stents, embolic protection devices, other approved spinal implantable devices, and intervertebral discs, peripheral arterial stent-grafts, spinal plates, and screws, total ankle replacement | Covered under the combined benefit limit for all unlisted internal prostheses |
| 🟨 Cardiac pacemakers | Covered up to R67 530 per family yearly. |
| 🟩 Cardiac stents | Covered up to R57 840 per family yearly. |
| 🟦 Cardiac valves | Covered up to R51 340 per family yearly. |
| 🟪 Detachable platinum coils | Limited to R58 460 per family yearly. |
| 🟥 Elbow, hip, knee, and shoulder replacement | Limited to R51 340 per family yearly. |
| 🟧 Intraocular lenses (per lens) | Limited to R3 610 per family yearly. |
| 🟨 Combined benefit limit for all unlisted internal prosthesis | Limited to R41 650 per family yearly. |
Maxima PLUS Chronic Disease Benefits
- ✅ Limited to R17,220 per beneficiary and subject to the R31,960 limit per family annually. After that, CDL conditions have unlimited coverage.
Maxima PLUS CDL List
- ☑️ Addison’s Disease
- ☑️ Asthma
- ☑️ Bipolar Mood Disorder
- ☑️ Bronchiectasis
- ☑️ Cardiac Failure
- ☑️ Cardiomyopathy
- ☑️ COPD/ Emphysema/ Chronic Bronchitis
- ☑️ Chronic Renal Disease
- ☑️ Coronary Artery Disease
- ☑️ Crohn’s Disease
- ☑️ Diabetes Insipidus
- ☑️ Diabetes Mellitus type 1
- ☑️ Diabetes Mellitus type 2
- ☑️ Dysrhythmias
- ☑️ Glaucoma
💙 READ also: Best Medical Aid Schemes that cover a stroke
Maxima PLUS 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.
- HPV Vaccine: Limited to two doses per lifetime for female beneficiaries between 9 to 16.
- Optical Screening: One per lifetime for kids between 5 to 8.
- ✅ Cardiac Health
- Cholesterol screening (full lipogram): Once every five years for all beneficiaries aged 20>
- ✅ Beneficiary over 45
- Breast cancer screening with mammography: One every two years for all beneficiaries 40>
- 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.
💙 You might like 5 Best Hospital Plans Under R3000 in South Africa
Maxima PLUS Day-to-Day Benefits
| 🔎 Tariff | Covered up to the Fedhealth rate. |
| 💶 Co-payments in Threshold | None |
| ☑️ Appliances, External Accessories, and Orthotics: For example: Hearing Aids Wheelchairs, etc. | In and out of the hospital: Paid from savings, OHED, or Threshold benefit. Threshold pays R20 000 per family each year. R4,860 sub-limit for foot orthotics per beneficiary. |
| ⚕️ Alternative Healthcare For example: Acupuncture Homoeopathy | Paid from savings, OHED, or Threshold benefit. Will not accumulate at a cost to the Threshold level. |
| 💙 Additional Medical Services For example: Audiology Dietetics Genetic Counselling Hearing Aid Acoustics | Paid from savings, OHED, or Threshold benefit. The threshold pays R20,000 per family each year before and after the Threshold. |
| 🦷 Advanced Dentistry For example: Inlays Crowns Bridges Mounted Study Models | Paid from savings, OHED, or Threshold benefit. Covers R8,530 per person, R25,470 per family per year before and beyond Threshold |
| 📌 Osseo-integrated Implants and Orthognathic Surgery | Paid from Savings and OHEB. Will not accumulate at the cost of the Threshold level. |
| 📍Basic Dentistry | Paid from savings, OHED, or Threshold benefit. Unlimited cover once the threshold is reached. |
| 👩⚕️ General Practitioners | - |
| 👨⚕️ Fedhealth Network GPs | Paid from OHEB, then unlimited from Risk. Once OHEB has been depleted, there is unlimited coverage for GPs if the member uses a network provider. |
| 📈 Non-network GPs | Paid from savings, OHEB, and Threshold. There is unlimited accumulation to (and refund for) the threshold according to the Fedhealth rate. |
| 🤰 Maternity | The following benefits are paid from Risk: 12 ante/ postnatal consultations with midwife, Network GP or Gynae; Antenatal classes to the value of R1 200 conducted by Private Nurses; 2 x 2D scans; 1 x amniocentesis. Thereafter, paid from Savings, OHEB and Threshold. Limited to 2 x 2D antenatal scans per pregnancy before and after Threshold |
| 📉 Scans | Two 2D Scans |
| ❤️ Antenatal Classes | Limited up to R1,200. |
| 🧡 Antenatal and Postnatal Consultations | Twelve consults with a midwife, network GP or gynecologist |
| 💛 Amniocentesis | The test is included in the benefit. |
| 💚 Fedhealth Baby Programme | Pregnant Fedhealth members and beneficiaries receive free support, guidance, and a baby pack. |
| 💙 Doula Benefit | Fedhealth pays up to R3,600 per delivery for a doula. |
| 💜 Postnatal Midwifery Benefit | Four consultations with a midwife in and out-of-hospital. |
| 😊 Early Childhood Benefits | - |
| 🙂 Pediatric Consultations | One consultation per beneficiary. For children up to 2 years. A network pediatrician must be used, and referral is not necessary. |
| 👂 Infant hearing Screening Benefit | Includes a screening test from birth up to 8 weeks. Covered up to the Fedhealth Rate. |
| 🍼 Childhood Illness Specialised Drug Benefit | Fedhealth covers specialized drugs for children up to 18. |
| 🩺 Appliances and devices | Fedhealth covers breast pumps and nebulizers from medical savings if there is a NAPPI code. Benefit accumulates to the Threshold on the appliances, external accessories, and orthotics limit. |
| 🤓 Optometry | Fedhealth covers breast pumps and nebulizers from medical savings if there is a NAPPI code. Benefit accumulates to the Threshold on the appliances, external accessories, and orthotics limit. |
| ☑️ Over-the-Counter Medication | Covered from available savings. Will not accumulate at a cost to the Threshold level. |
| ✅ Pathology | Paid from savings, OHEB, and Threshold. Unlimited cover once the Threshold is reached. |
| 📌 Physical Therapy | Paid from savings, OHEB, and Threshold. Threshold unlimited |
| 📍 Prescribed Medication | Paid from savings, OHEB, and Threshold. Before and after Threshold, R11,400 per beneficiary and R22,690 per household annually. |
| 🧪 Basic Radiology | Paid from Risk if pre-approval is obtained. |
| ➡️ Specialists (excl. Psychiatrists) | - |
| 1️⃣ Fedhealth Network Specialists | Savings, OHEB, and accumulation at a cost to Threshold are used to pay for this. Once the Threshold is met, the cover is unlimited. |
| 2️⃣ Non-network Specialists | Savings, OHEB, and Thresholds are used to pay medical expenses. Accumulation to and refund from the Threshold only at the Fedhealth Rate |
| 3️⃣ Specialists – Psychiatrists | Network GP referral is required for consults, including PMB conditions. The benefit is paid from Risk benefits. |
| 4️⃣ Fedhealth Network Psychiatrists | Paid from Savings, OHEB, and Threshold at cost. Subject to an R20,000 limit per family per year for Extra Medical Services both before and beyond the Threshold. |
| 5️⃣ Non-network Psychiatrists | Paid from Savings, OHEB, and Threshold accumulation and refund at the Fedhealth Rate. Subject to a limit of R20,000 per family per year for Extra Medical Services both before and beyond the Threshold. |
Maxima PLUS Programs and Wellness Initiatives
Fedhealth offers all Maxima PLUS Members 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 support the member throughout their treatment. |
| 💙 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 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. Members can use the 24/7 MediTaxi service for follow-up appointments if they cannot drive after a medical procedure. 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 Maxima PLUS Plan Exclusions and Waiting Periods
Maxima PLUS Exclusions
Fedhealth Maxima PLUS’ 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,
- And more....
Maxima PLUS Waiting Periods
Fedhealth Maxima PLUS could have 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 : Fedhealth Maxima PLUS Plan vs. Similar Plans from other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 Fedhealth Maxima PLUS (2026) | 🥈 Bestmed Pace 4 (2026) | 🥉 Momentum Summit Plan |
| 👤 Main Member Contribution | R19,393 | R12,572 | R |
| 👥 Adult Dependent Contribution | R16,739 | R12,572 | R |
| 🍼 Child Dependent Contribution | R5,992 | R2,945 | R |
| 📉 Annual Limit | Unlimited Hospital Cover | Several limits and sub-limits | Unlimited |
| 💙 Day to Day Benefits | ✅ YES | ✅ Yes | ✅ |
Our Verdict on the Fedhealth Maxima PLUS Plan
💙 The Fedhealth Maxima PLUS plan is a comprehensive medical aid plan offered by Fedhealth, a South African medical scheme. It is designed to provide members extensive cover for various medical expenses, including hospitalization, chronic medication, and day-to-day healthcare needs. Some of the key features of the Fedhealth Maxima PLUS plan include unlimited private hospital cover, access to a network of medical specialists, and generous benefits for chronic conditions. 💙 Members of the plan also have access to a range of wellness benefits, such as health assessments, screenings, and disease management programs. One of the main advantages of the Fedhealth Maxima PLUS plan is its comprehensive coverage. With unlimited hospital coverage and generous benefits for chronic conditions, members can have peace of mind knowing that they will be covered for most of their medical needs. 💙 The plan also offers a range of wellness benefits that can help members maintain their health and prevent future health problems. However, one of the drawbacks of the Fedhealth Maxima PLUS plan is its high cost. As a comprehensive medical aid plan, it is more expensive than other plans offered by Fedhealth or other medical schemes in South Africa. 💙 Additionally, some of the plan’s benefits, such as the wellness benefits, might not be fully utilized by all members. Furthermore, as with any medical aid plan, it is vital for individuals to carefully consider their healthcare needs and budget before choosing a plan.
You might also consider the following options FedHealth has to offer:
- Fedhealth FlexiFED 1
- Fedhealth FlexiFED 2
- Fedhealth FlexiFED 3
- Fedhealth FlexiFED 4
- Fedhealth Maxima EXEC
- Fedhealth MyFED
- Fedhealth FlexiFED Savvy
