• Benefits, cancer benefits, Fedhealth Plan, maternity benefits, mental health benefits, Scheme Plans

Fedhealth FlexiFed 3 Elect:
cancer, maternity and mental health (2025)

Contents:

This page has information on: Costs, Maternity, Oncology, Mental Health for Fedhealth FlexiFed 3 Elect

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 3 Elect (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R3,705
  • R3,398
  • R1,314
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)		 14,472
"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

Cancer/ Oncology benefits (2025):

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

Fedhealth: FlexiFed 3 Elect
Assume scheme pays all these costs, unless otherwise stated
Overall cancer coverage (in and out of hospital):
  • R311,900 per family
  • You have the option of moving to a higher plan within 30 days of cancer diagnosis
  • Note: Most cancers are PMBs, and treatment is paid in full by scheme. More info here
  • Most schemes require use of specific providers (DSPs) for oncology treatment.
 Gap Cover:
Can cover the penalty in full
(Plans coming soon)

Maternity benefits (2025):

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

Fedhealth: FlexiFed 3 Elect
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
  • Scheme rate
  • Private ward
  • Doula benefit: R3,600
  • Usually covered for 2 nights for natural birth, and 3 nights for C-sections.
  • All newborns receive immediate full medical aid cover at birth, even if parents are on a waiting period.
 Gap Cover:
Can cover most shortfalls
(Plans coming soon)
Consultations:
  • Antenatal and postnatal: 12 consults, paid by scheme
  • Antenatal classes: R1,160
Scans:
  • 2 x 2D ultrasound scans
Note:

Mental Health benefits (2025):

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

Fedhealth: FlexiFed 3 Elect
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
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)
  • Main= R7,900
  • Main+1= R13,700
  • Main+2= R15,600
  • Main+3= R18,400
"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:
FYI:
  • Mental Health PMB conditions are covered for in and out of hospital treatment, even on "hospital" plans. For a full list see here.
  • Example of PMB condition: Acute stress disorder accompanied by recent significant trauma, including physical or sexual abuse. Treatment includes hospital admission for psychotherapy / counselling up to 3 days, or up to 12 outpatient psychotherapy / counselling contacts. Scheme will pay this in full, if you use a DSP.
In-hospital:
  • PMBs: 21 days admission
  • Alcoholism/Drug Addiction: 21 days admission
  • Otherwise, R28,000, all in
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Out-of-hospital:
  • PMBs: 10+ consults, paid by scheme
  • Chronic medication for some non-PMB conditions: R3,200 per family
  • Otherwise, from day-to-day benefit
Other:
  • Traumatic event claims: 6 counselling sessions per person per year, for the year in which the trauma event occurred and the year after

    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.

More Information