Fedhealth Maxima Plus: prosthetic benefits (2024)

This page has information on: Costs and Prosthetics for Fedhealth Maxima Plus We also have information for: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Maternity, Cancer, Mental Health, Other/Extra Benefits and Wellness and Preventative 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 🙂 Prosthetics benefits (2024): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Fedhealth: Maxima Plus Overal Limit: Internal: R40,400 unless listed below External: R24,300 Prosthetics required for PMB conditions are always paid paid in full by scheme, with no co-payment, if you follow the protocols. More info here Sub-limits: Aorta Stent Grafts: R65,500 Cardiac pacemakers: R65,100 Cardiac stents: R56,100 Cardiac valves: R49,800 Detachable platinum coils: R56,700 Intraocular lenses: R3,500 per lens Elbow, hip, knee and shoulder replacement:: R49,800 Note: PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs 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 .

Always consult with your broker before making final decisions regarding your healthcare cover.

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