Fedhealth FlexiFed 4 Elect: dentistry, optometry and wellness (2024)

Monthly Costs:

FlexiFed 4 Elect 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R3,805	R3,546	R1,167 Only pay for 3 children
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= R18,500 Main+1= R33,700 Main+2= R38,200 Main+3= R42,700
"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:	Under 27yrs, provided they are financially dependant, unmarried and don't earn more than the maximum social pension Only pay for 3 children
Note:	Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list. All treatments and procedures are subject to authorisation and protocols All benefits are listed as an indication only. Please verify with your broker and scheme
♦️View all the other benefits for this plan:♦️ Inhospital \| 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
.

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Dentistry benefits (2024):

Fedhealth: FlexiFed 4 Elect
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:	From day to day benefit Once your day-to-day claims have accumulated to the threshold: Unlimited
Specialised Dentistry:	From day-to-day benefit R8,270 per person and R24,700 per family before and after Threshold
In-Hospital Dentistry:	Maxilo-facial surgery: Unlimited, subject to approval Wisdom teeth: R5,440 co-payment Children under 7: Hospital bill paid by scheme, dentist paid from day to day benefit Osseo-integrated implants, orthognathic surgery: From day to day benefit . Does not accumulate or pay from Threshold.	PMBs are always covered by the scheme, and cannot have sublimits or co-payments imposed. These include fracture of face bones, orbit and/or jaw. You can see a full list of maxillo facial PMB benefits here.
Orthodontics:	See Specialised Dentistry, above
Note:	PMBs: Prescribed Minimum Benfits. To read more about PMBs click here DSPs: Designated Service Provders. Where stipulated, you must use specific 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
♦️View all the other benefits for this plan:♦️ Inhospital \| 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
.

Optometry benefits (2024):

Fedhealth: FlexiFed 4 Elect
Assume scheme pays all these costs, unless otherwise stated
Optometry:	R1,930 per person, every 24 months Thereafter, R3,740 per person and R11,400 per family, From day to day benefit
Note:	This section does not apply to opthamology 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.
♦️View all the other benefits for this plan:♦️ Inhospital \| 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
.

Wellness/Preventative benefits (2024):

Fedhealth: FlexiFed 4 Elect
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 all the other benefits for this plan:♦️ Inhospital \| 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
.

Other benefits for 2024:

FlexiFed 4 Elect
International Insurance:	.
Other:	.
♦️View all the other benefits for this plan:♦️ Inhospital \| 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
.

Important!

Unless specified, assume that all benefits are paid 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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Fedhealth FlexiFed 4 Elect: dentistry, optometry and wellness (2024)

Monthly Costs:

Dentistry benefits (2024):

Optometry benefits (2024):

Wellness/Preventative benefits (2024):

Other benefits for 2024:

All the medical aid jargon explained (2024)

How do I make a medical aid plan change (2024)?

Medical Aid waiting periods: what you need to know (2024)

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