This refers to the procedures and treatments that take place in hospital for which you enjoy cover on this option.

• For your peace of mind, there’s no overall annual limit for hospitalisation.
• You benefit from unlimited maternity cover with network GPs and specialists.
• Network GPs and specialists are covered unlimited at cost.
• Non-network GPs, specialists and other healthcare providers are covered up to 100% of the Fedhealth Rate.
• You have an oncology benefit of R444 700 available.
• You also enjoy a childhood illness specialised drug benefit for children up to 18.

Get covered for 26 chronic diseases as listed on the Chronic Disease List (CDL), PLUS an additional 16.

This medical aid plan option is limited to R5 680 per beneficiary up to R11 350 – once you’ve reached the annual limits after claiming medicine for the 26 CDL conditions and the 16 additional conditions, then you have unlimited cover for diseases on the CDL only. Intermediate formulary and the Medicine Price List (MPL) apply.

This benefit includes the tests and healthcare assessments that ensure that your health is on the right track.

• We cover one Pap smear (cervical cancer screening) every three years for women aged 21 to 65.
• We cover one Prostate Specific Antigen (PSA) per year for men aged 45 to 69.
• Children’s immunisations are covered from birth to 12 years (as per the State EPI).
• We cover one cholesterol screening (full lipogram) every five years for everyone over the age of 20.
• Everyone in the family enjoys a free flu vaccination once a year!
• We cover one HIV finger prick test for all members once a year.
• All members enjoy one wellness screening per year that includes BMI, blood pressure, finger prick cholesterol and glucose tests.
• All members enjoy one preventative screening by a contracted wellness network provider per year that includes waist-to-hip ratio, body fat %, flexibility, posture and fitness.

We want to optimise your health even more, which is why we offer extras to this hospital plan such as professional medical advice and a transport service when you need post-hospitalisation check-ups.

• With us, you can upgrade to a higher option within 30 days of a life-changing event, like a pregnancy or the diagnosis of a dread disease.
• Phone our 24-hour toll-free Nurse Line for expert medical and health advice from qualified nurses.
• Our MediTaxi service transports you to follow-up medical treatments following a hospital stay (only certain regions).
• Use our USSD call-back service, SOS Call Me, to access Emergency Medical Services, the Fedhealth Nurse Line or MediTaxi – free of charge to you!
• Call our 24-hour Emotional Wellbeing Programme support line to get you through life’s ups and downs.
• Qualifying members can join our 12-week Weight Management Programme led by biokineticists and dieticians to make healthy lifestyle changes.
• We cover the GoSmokeFree Smoking Cessation Programme to help members quit the smoking habit for good!

You pay back your MediVault over 12 months, interest-free.

• All pregnant members and dependants can join the Fedhealth Baby Programme.
• We cover four consultations with a midwife in- and out-of-hospital under our postnatal midwifery benefit.
• We cover a doula up to R1 300 per delivery.
• We cover one test with an audiologist per infant up to the Fedhealth Rate.
• You have access to the Paed-IQ advice line for all your paediatric questions.
• We cover take-home medicine for seven days per hospital event at 100% of the Medicine Price List.
• We will cover your follow-up treatment for 30 days once you get discharged from hospital, like physio, x-rays and pathology.
• You benefit from trauma treatment at a casualty ward – whether you’re admitted to the hospital or not. A R570 co-payment will apply per visit for non-PMBs (if you’re not admitted to hospital straight from casualty).
• You enjoy unlimited specialised radiology from the core benefit bundle if you get pre-authorisation from us. The first R2 200 for non-PMB MRI/CT scans will be for your account.
• Female contraception: We cover oral, patches, contraceptive rings, certain injectables and IUDs that include Mirena (prescribed by a GP or gynae, and not prescribed for acne).

Threshold Benefit

Once your claims have accumulated to a pre-determined Threshold level, any further claims will be paid from the Threshold Benefit, with a 20% co-payment for your account on all claims paid from the threshold benefit except claims for network specialists.

• You’ll enjoy unlimited GP visits from R1 on this option!