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 cover to up to 3 Family Members. The Fedhealth Maxima PLUS Medical Aid Plan starts from R16,937 ZAR.
π Medical Aid Plan | π₯ Fedhealth Maxima PLUS |
π€ Main Member Contribution | R16,937 |
π₯ Adult Dependent Contribution | R14,619 |
πΌ Child Dependent Contribution | R5,233 |
π GP Visits | Unlimited network GP visits. once OHEB is depleted on maxima PLUS. |
π Hospital Cover | Unlimited Private Hospital Cover |
The Fedhealth Maxima PLUS medical aid plan is one of 8, starting from R16,937 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.Β Gap Cover is not available 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.
FedhealthΒ offers 8 medical aid plans
π Download fedhealth-maxifed-rates-benefits-guide-2025 from Fedhealth.
π Membership | π Risk | πΆ Savings | π΄ Total Contribution | π· Annual Threshold | π΅ Out-of-Hospital Expenses Benefit (OHEB) |
π€ Main Member | R16,312 | R625 monthly R7,500 annually | R16,937 | R22,700 | R10,310 |
π₯ Adult Dependents | R14,080 | R539 monthly R6,468 annually | R14,619 | R17,700 | R7,440 |
πΌ Child Dependents | R5,040 | R193 monthly R2,316 annually | R5,233 | R6,200 | R2,290 |
1οΈβ£ Membership | 2οΈβ£ Risk | 3οΈβ£ Savings | 4οΈβ£ Total Contribution | 5οΈβ£ Annual Savings | 6οΈβ£ OHEB | 7οΈβ£ Total Day-to-Day Funds | 8οΈβ£ Annual Threshold | 9οΈβ£ Self-Payment Gap (SPG) |
π€ Main | R16,312 | R625 | R16,937 | R7,500 | R10,310 | R17,810 | R22,700 | R4,890 |
π₯ Main + Adult | R30,392 | R1,164 | R31,556 | R13,968 | R17,750 | R31,718 | R40,400 | R8,682 |
πΌ Main + Adult + Child | R35,432 | R1,357 | R36,789 | R16,284 | R20,040 | R36,324 | R46,600 | R10,276 |
β‘οΈ M + A + 2C | R40,472 | R1,550 | R42,022 | R18,600 | R22,330 | R40,930 | R52,800 | R11,870 |
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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 memberβs account.
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π₯ Aorta Stent Grafts | Limited to R65,500 per family yearly. |
π§ 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 |
π¨ Cardiac pacemakers | Covered up to R65,500 per family yearly. |
π© Cardiac stents | Covered up to R56,100 per family yearly. |
π¦ Cardiac valves | Covered up to R49,800 per family yearly. |
πͺ Detachable platinum coils | Limited to R56,700 per family yearly. |
π₯ Elbow, hip, knee, and shoulder replacement | Limited to R49,800 per family yearly. |
π§ Intraocular lenses (per lens) | Limited to R3,500 per family yearly. |
π¨ Combined benefit limit for all unlisted internal prosthesis | Limited to R40,400 per family yearly. |
and many more…
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π Tariff | Covered up to the Fedhealth rate. |
πΆ Co-payments in Threshold | None |
βοΈ 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 R19,400 per family each year. R4,860 sub-limit for foot orthotics per beneficiary. |
βοΈ Alternative Healthcare For example: Acupuncture Homoeopathy | Paid from savings, OHED, or Threshold benefit. Will not accumulate at a cost to the Threshold level. |
π Additional Medical Services For example: Audiology Dietetics Genetic Counselling Hearing Aid Acoustics | Paid from savings, OHED, or Threshold benefit. The threshold pays R19,400 per family each year before and after the Threshold. |
π¦· Advanced Dentistry For example: Inlays Crowns Bridges Mounted Study Models | Paid from savings, OHED, or Threshold benefit. Covers R8,270 per person, R24,700 per family per year before and beyond Threshold |
π Osseo-integrated Implants and Orthognathic Surgery | Paid from Savings and OHEB. Will not accumulate at the cost of the Threshold level. |
πBasic Dentistry | Paid from savings, OHED, or Threshold benefit. Unlimited cover once the threshold is reached. |
π©ββοΈ General Practitioners | – |
π¨ββοΈ 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. |
π Non-network GPs | Paid from savings, OHEB, and Threshold. There is unlimited accumulation to (and refund for) the threshold according to the Fedhealth rate. |
π€° 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 160 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 |
π Scans | Two 2D Scans |
β€οΈ Antenatal Classes | Limited up to R1,160. |
𧑠Antenatal and Postnatal Consultations | Twelve consults with a midwife, network GP or gynecologist |
π Amniocentesis | The test is included in the benefit. |
π Fedhealth Baby Programme | Pregnant Fedhealth members and beneficiaries receive free support, guidance, and a baby pack. |
π Doula Benefit | Fedhealth pays up to R3,600 per delivery for a doula. |
π Postnatal Midwifery Benefit | Four consultations with a midwife in and out-of-hospital. |
π Early Childhood Benefits | – |
π Pediatric Consultations | One consultation per beneficiary. For children up to 2 years. A network pediatrician must be used, and referral is not necessary. |
π Infant hearing Screening Benefit | Includes a screening test from birth up to 8 weeks. Covered up to the Fedhealth Rate. |
πΌ Childhood Illness Specialised Drug Benefit | Fedhealth covers specialized drugs for children up to 18. |
π©Ί 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. |
π€ Optometry | Paid from savings, OHEB, and Threshold. Before and after Threshold, the benefit is limited to R3,740 per beneficiary, R11,400 per family per year. |
βοΈ Over-the-Counter Medication | Covered from available savings. Will not accumulate at a cost to the Threshold level. |
β Pathology | Paid from savings, OHEB, and Threshold. Unlimited cover once the Threshold is reached. |
π Physical Therapy | Paid from savings, OHEB, and Threshold. Not Threshold-accumulating. |
π Prescribed Medication | Paid from savings, OHEB, and Threshold. Before and after Threshold, R11,060 per beneficiary and R22,010 per household annually. |
π§ͺ Basic Radiology | Paid from Risk if pre-approval is obtained. |
β‘οΈ Specialists (excl. Psychiatrists) | – |
1οΈβ£ 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. |
2οΈβ£ 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 |
3οΈβ£ Specialists β Psychiatrists | Network GP referral is required for consults, including PMB conditions. The benefit is paid from Risk benefits. |
4οΈβ£ Fedhealth Network Psychiatrists | Paid from Savings, OHEB, and Threshold at cost. Subject to an R19,400 limit per family per year for Extra Medical Services both before and beyond the Threshold. |
5οΈβ£ Non-network Psychiatrists | Paid from Savings, OHEB, and Threshold accumulation and refund at the Fedhealth Rate. Subject to a limit of R19,400 per family per year for Extra Medical Services both before and beyond the Threshold. |
Fedhealth offers all Maxima PLUS Members access to additional programs, benefits, and initiatives as indicated below.
βοΈ 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. |
βͺοΈ 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. |
π¬ 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. |
π 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. |
πͺ 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©βπ§βπ§ Sisters-on-Site | Fedhealth and SOS Corporate Wellness (Sisters-on-Site) provide nursing Sisters-on-Site to membersβ workplaces. |
β€οΈ 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. |
π Try our free Menstrual Cycle Calculator
Fedhealth Maxima PLUSβ exclusions include, but are not limited to, the following:
Fedhealth Maxima PLUS typically has the following waiting periods:
π Medical Aid Plan | π₯ Fedhealth Maxima PLUS (2025) | π₯ Bestmed Pace 4 (2025) | π₯ Momentum Summit Plan |
π€ Main Member Contribution | R16,312 | R11,662 | R |
π₯ Adult Dependent Contribution | R14,619 | R11,662 | R |
πΌ Child Dependent Contribution | R5,233 | R2,732 | R |
π Annual Limit | Unlimited Hospital Cover | Several limits and sub-limits | Unlimited |
π Day to Day Benefits | β | β | β |
π 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.
π 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.
π 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.
π Additionally, some of the planβs 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:
Β
Fedhealth Maxima PLUS offers unlimited private hospital cover, access to a network of medical specialists, and generous benefits for chronic conditions. In addition, members can also access various wellness benefits, such as health assessments, screenings, and disease management programs.
The cost of Fedhealth Maxima PLUS is R16 937 for the member, R14 619 for and adult dependent and R5 233 for a child dependent.
Fedhealth Maxima PLUS offers generous benefits for chronic medication. Members can receive up to three monthsβ supply of chronic medication at a time, and some chronic conditions are covered in full.
Yes, Fedhealth Maxima PLUS offers a range of wellness benefits, including health assessments, screenings, and disease management programs. Members can also receive discounts on gym memberships and other wellness activities.
Fedhealth Maxima PLUS offers unlimited private hospital cover, which means members can receive treatment at any private hospital in South Africa without any limits on the cost of treatment.
Yes, members of Fedhealth Maxima PLUS have access to a network of medical specialists, and they can choose their specialists from within or outside the network. However, benefits may be reduced if the chosen specialist charges more than the Fedhealth rate.
Yes, Fedhealth Maxima PLUS offers disease management programs for various conditions, such as diabetes, hypertension, and asthma. These programs provide members with personalized support and education to help manage their condition.
Members of Fedhealth Maxima PLUS can claim for healthcare expenses by submitting their claims online, by email, or by post. Claims will be assessed and paid according to the terms of the plan.
Fedhealth Maxima PLUS may be more expensive than other medical aid plans, and all members may not fully utilize some of its benefits. Therefore, it is essential to carefully consider your healthcare needs and budget before choosing a plan.
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.
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