• Benefits, dentistry, Fedhealth Plan, optometry, Scheme Plans, wellness

Fedhealth FlexiFed 1 Main:
dentistry, optometry and wellness (2025)

Contents:

This page has information on: Costs, Dentistry, Optometry, Wellness and Preventative and Other benefits for Fedhealth FlexiFed 1 Main

Terminology:

  • PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
  • DSPs: Designated Service Providers. Where stipulated, you must use specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product.
  • All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Monthly Costs (2026)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Fedhealth:FlexiFed 1 Main (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R2,630
  • R2,061
  • R963
Savings (per year):
  • This plan offers a flexible savings option, which you only pay for if you use it. This cost is not included above.
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)		 5,508
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Some day-to-day claims, like GP consults, are covered by Fedhealth once you've paid the Self Payment Gap
Children Rates:
  • Up to 27yrs if student, otherwise up to 21yrs
  • Only pay for 3 children
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Dentistry benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Fedhealth: FlexiFed 1 Main
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings (per year):
  • This plan offers a flexible savings option, which you only pay for if you use it. This cost is not included above.
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)		 5,508
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Some day-to-day claims, like GP consults, are covered by Fedhealth once you've paid the Self Payment Gap
Other Day-to-Day Funds:
Standard Dentistry:
  • From day to day benefit
  • Once your day-to-day claims have accumulated to the Threshold, Fedhealth will pay for 2 consults per person, including x-rays and scaling and polishing
Specialised Dentistry:
  • From day-to-day benefit
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
In-Hospital Dentistry:
  • Maxilo-facial surgery: Unlimited, subject to approval
  • Wisdom teeth: R5,730 co-payment
  • Children under 7: No benefit
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Orthodontics:
  • From day-to-day benefit

Optometry benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Fedhealth: FlexiFed 1 Main
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings (per year):
  • This plan offers a flexible savings option, which you only pay for if you use it. This cost is not included above.
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)		 5,508
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Some day-to-day claims, like GP consults, are covered by Fedhealth once you've paid the Self Payment Gap
Other Day-to-Day Funds:
Optometry:
  • From day-to-day benefit
  • Refractive Surgery: No benefit
Note:
  • This section does not apply to ophthalmology benefits, which fall under "in-hospital" benefits. Some of those are PMBs, and are paid for in full by your scheme. You can read more about PMBs here.

Wellness/Preventative benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Fedhealth: FlexiFed 1 Main
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • Covered
Pneumonia vaccines:
  • Covered, 65yrs+
Biometric Screening:
  • Covered
Child Immunisation:
  • Covered, up to 12yrs
Pap Smear:
  • Covered, 21yrs-65yrs, every 3 years
Mammogram:
  • Covered, 40yrs+ every 2 years
PAS Test:
  • Covered, 45yrs-69yrs
HIV Test:
  • Covered
Other:
  • Lipogram: Every 5 yrs
  • Faecal occult blood test: Covered, 50yrs-75yrs, every year
View other benefits for this plan:
In-hospital | Out-of-hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

You can also:
Compare any two plans, side by side | View all the Fedhealth plans, with costs and brief summary.

Find all other open medical aid plans here.

Other benefits for 2025:

FlexiFed 1 Main
International Insurance:
Other:
    Important!
  • Unless specified, assume that all benefits are paid at 100% scheme rate.
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • "Unlimited" benefits are still subject to authorisation, protocols and sublimits.
  • Assume that all benefits need to be pre-authorised.
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