Child dependants stay at “child rate” until age 27
You only pay the child dependant rate for your children up to the age of 27. On our Maxima Standard option, that could mean a saving of over R6 000 a year! The child rate applies if your child is either a full time student, living at home or in res, is unmarried and not earning more than the maximum social pension.

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Grown up “child dependant” can transfer to their own membership without underwriting
Where your child dependant no longer qualifies as a dependant of your medical aid, Fedhealth will transfer them to their own membership without a break in cover. No underwriting would apply in this instance.

You can upgrade to a higher cover option at any time
Fedhealth allows members to upgrade any time during the year if you or any of your dependants are diagnosed with a chronic condition and you want to move to an option with a higher benefit limit for the treatment of your condition.

You get unlimited oral contraception with no impact to your savings
From 1 January 2006, Fedhealth introduced this new benefit on all its options except Maxima Core. Prescriptions for oral contraceptives taken for the purpose of contraception only will be paid from the In-Hospital Benefit and not from day-to-day benefits (OHEB and Savings). Oral contraceptives for skin conditions will continue to be paid from Savings without accumulation to the Safety Net.

We cover all professional and extreme sports
At Fedhealth, we lead the way when it comes to covering our members who enjoy partaking in professional and extreme sports.

Claims incurred as a result of any injury sustained while participating in an extreme sport such as rock climbing, scuba diving and hunting will be covered within the benefits and rules of the scheme - provided the treatment is received in South Africa. Professional sports such as rugby and soccer are also covered within the benefits and rules of the scheme.

You get 30-days of cover from your hospital benefit after you leave hospital
Certain treatment arising from a hospital event, for example physiotherapy, X-rays and blood tests are covered for 30 days from date of discharge from hospital from the In-Hospital Benefit and not from the day-to-day benefits (OHEB and savings). The Authorisation Centre must be contacted 48 hours before treatment is received.

MRI and CT scans do not impact your savings
MRI and CT scans are covered from the In-Hospital Benefit regardless whether the procedure is performed as an in-patient or out-patient and will not be paid from your OHEB or Savings.

Fedhealth will pay for your take home medication when you leave hospital
Fedhealth covers 7 days’ worth of TTO’s (take home medication) from the In-Hospital Benefit. The medication must both be dispensed by the hospital and reflect on the original hospital account.

If you are given a prescription for the TTO’s and you take this prescription to a pharmacy, the claim will be paid from your day-to-day benefits (OHEB and Savings) and not from the In-Hospital Benefit.

We pay for dentistry in-hospital for children under the age of 8
The hospital and anaesthetist costs are covered from the In-Hospital Benefit. The dentist’s account is covered from day-to-day benefits (OHEB and Savings) and will accumulate to Safety Net.

The Authorisation Centre must be contacted at least 48 hours before the procedure. Authorisation will be granted provided that no dental authorisation was granted for the same child within at least six months of the required admission date.

We pay for emergency treatment in a casualty ward
Treatment received in a casualty ward for trauma, as well as any other treatment in a casualty ward immediately followed by a hospital admission, is covered from the In-Hospital Benefit.

Trauma is defined as a physical injury to the body by an external force which requires immediate attention, for example, stitches. The Authorisation Centre must be notified within 24 hours or the next working day.

General radiology will also be paid from the In-Hospital Benefit if it is part of the treatment in the casualty ward.
 

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