Note: We are updating 2024 benefits as they are released. Some plans show old benefits until schemes release new plans.

Fedhealth myFed E: in-and-out of hospital benefits (2024)


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Monthly Costs:

myFed E 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R3,448
  • R2,842
  • R1,347
  • Only pay for 3 children
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
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
Income band:
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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In-hospital Procedures for 2024:

Fedhealth: myFed E
Assume scheme pays all these costs, unless otherwise stated
non-Network Specialists:
  • 100% scheme rate
  • R2,500 per person
network Specialists:
  • Covered in full
non-Network GPs:
  • 100% scheme rate
  • R2,500 per person, combined with non-network specialists
network GPs:
  • Covered in full
Hospital Choice:
  • Network Hospitals
Day Hospitals:
  • Many procedures will be paid from in-hospital benefit if done in a day clinic, day ward or an outpatient section of a hospital.
  • Must use facilities on the Fedhealth Day Surgery Network
Penalty for using other hospital:
  • non-network Hospitals: R14,700 co-payment
  • non network Day Hospital: R2,500 co-payment
Other Co-payments:
  • Elective C-section: R14,700 co-payment
Specialised Radiology:
  • MRI and CT Scan: R15,030 per person and R30,300 per family
Supplementary Services: (Physio, etc)
  • 100% scheme rate
Transplants:
  • PMBs only
  • Corneal graft: No benefit
Dialysis:
  • PMBs only
Exclusions: .
Alternatives to hospitals:
  • PMBs only
Casualty:
  • Emergency treatment, like stitches: R660 co-payment, unless PMB
Other: .
Note:
  • 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 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
.
.
.

Out-of-hospital Procedures for 2024:

Fedhealth: myFed E
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
PMBs out of hospital:
  • All medical aids must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
  • This can include consults with specialists, blood or other tests, radiology and medicine
  • The benefit is paid by the scheme, and not out of your savings account
  • If you have no day-to-day funds, you still have cover for PMBs
  • Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
  • See our Guide to PMBs for more information.
General info: .
GP consultations:
  • Contracted GP: Unlimited
  • Not contracted: 2 consults per person
Childcare:
Specialists consultations:
  • Contracted: 2 consults and up to R2,000 per family per year
  • Not contracted: No benefit
Pathology:
  • Unlimited, subject to protocols
General radiology:
  • Unlimited, subject to protocols
Specialised radiology:
  • PMBs only
Supplementary Services: (Physio, etc)
  • PMBs only
General Appliances:
  • No benefit
1.1. Hearing Aids:
  • No benefit
1.2. Wheelchairs:
  • No benefit
Note:
  • PMBs: Prescribed Minimum Benefits. 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
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

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Medication Benefit for 2024:

Fedhealth: myFed E
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Chronic: .
Acute (presrcibed) medication:
  • Unlimited if dispensed by contracted GP, from formulary
Over-the-counter:
  • No benefit
Birth Control:
  • Oral and injectables: Paid by scheme
On Discharge:
  • 7 days
Biological:
  • PMBs only
Note:
  • Schemes have very strict rules about where you can get your medicine to get full benefit. We do not list the requirements here, so confirm with your scheme before you collect your medicine.
  • Formulary: A pre-defined list of approved medicines. Each plan has a different list, and might not pay for non-listed medicine. Confirm with your scheme whether your required medicine is covered by them.
  • 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
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.


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