Fedhealth Maxima Plus: cancer, maternity and mental health (2024)

This page has information on: Costs, Maternity, Oncology, Mental Health for Fedhealth Maxima Plus

We also have information on: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Other/Extra Benefits, Wellness and Preventative and Prosthetics

Find all the open medical aid plans here.
Compare any two plans
side by side, instantly.

Monthly Costs:

Maxima Plus 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R14,883
  • R12,846
  • R4,598
  • Only pay for 3 children
Savings:
  • R7,128
  • R6,144
  • R2,196
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • R9,794
  • R7,067
  • R2,171
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R3,878
  • R2,989
  • R1,233
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Unlimited
  • Unlimited
  • Unlimited
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
.


You'll get the printable guide as well as a weekly newsletter 🙂

Cancer/ Oncology benefits for 2024:

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

Fedhealth: Maxima Plus
Assume scheme pays all these costs, unless otherwise stated
Overall coverage (in and out of hospital):
  • Unlimited, from Enhanced Protocol
♦️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
.
.
.

Maternity benefits for 2024:

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

Fedhealth: Maxima Plus
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
  • Doula benefit: R3,000
  • Private ward
Consultations:
  • Consults: 12 consults paid by scheme
  • Ante-natal classes: R1,160
  • Thereafter, From day to day benefit
Scans:
  • 2 x2D ultrasound scans
  • 1 amniocentesis test
  • Threshold does not pay for extra scans
Note:
♦️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
.
.
.

Mental Health benefits for 2024:

\

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

Fedhealth: Maxima Plus
Assume scheme pays all these costs, unless otherwise stated
In-hospital:
  • PMBs: 21 days admission
  • Alcoholism/Drug Addiction: 21 days admission
  • Otherwise, R45,100
Out-of-hospital:
  • PMBs: 10+ consults, paid by scheme
  • Network Psychiatrist: from day-to-day benefit. Once in Threshold, benefit is shared with Additional Medical Services at R19,400 per family, before and after Threshold, and paid at cost.
  • Non-Network Psychiatrist: as above, but paid at scheme rate
Trauma: .
Note:
  • PMBs: Prescribed Minimum Benefits. Here is a list of PMB conditions: Mental Illness.
  • 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
.

    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

Also see these: