Fedhealth Maxima Plus:
dentistry, optometry and wellness (2025)

This page has information on: Costs, Dentistry, Optometry, Wellness and Preventative and Other benefits for Fedhealth Maxima Plus

• View all the Fedhealth plans, with costs and brief summary.
• View all open medical aid plans.
• Compare any two plans side by side, instantly.

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)

Dentistry benefits (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
Main Member: Adult: Child: Savings: R7,728 R6,672 R2,388 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account R10,630 R7,680 R2,370 Self Payment Gap: (What you need to pay out of pocket before you can access the "Above Threshold" benefit) R5,042 R3,898 R1,632 "Above Threshold" benefit (ATB): Additional cover the scheme makes available to you, once you've paid the self payment gap. Unlimited Unlimited Unlimited Other Day-to-Day Funds:
Standard Dentistry:	From day-to-day benefit Unlimited once Threshold is reached.
Specialised Dentistry:	From day-to-day benefit , including Threshold. R8,270 per person and R24,700 per family before and after Threshold Osseo-integrated implants, orthognathic surgery: From day-to-day benefit . Does not accumulate or pay from Threshold	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
In-Hospital Dentistry:	Maxilo-facial surgery: Unlimited, subject approval Children under 7: hospital and anaesthetist paid by scheme. Dentist account paid out-of-pocket	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Orthodontics:	From day-to-day benefit . Does not accumulate to or pay from Threshold.

Optometry benefits (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
Main Member: Adult: Child: Savings: R7,728 R6,672 R2,388 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account R10,630 R7,680 R2,370 Self Payment Gap: (What you need to pay out of pocket before you can access the "Above Threshold" benefit) R5,042 R3,898 R1,632 "Above Threshold" benefit (ATB): Additional cover the scheme makes available to you, once you've paid the self payment gap. Unlimited Unlimited Unlimited Other Day-to-Day Funds:
Optometry:	From day-to-day benefit or Threshold R3,740 per person and R11,400 per family, before and after Threshold
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 (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
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 2024:

Maxima Plus
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.