Fedhealth Medical Scheme
The Fedhealth Medical Scheme is one of the oldest medical aids in South Africa; it was established as Reef Medical Scheme in 1936. It has almost 80 000 members and an annual turnover of over R2 billion, which makes it one of the biggest open medical schemes in the country.
Financially stable medical health service provider
For the past six years this financially stable medical health service provider has maintained an AA- Global Credit Rating for its claim paying ability and it has a solvency rate of 37%, which is well above the required 25%.
There are 4 700 doctors that belong to the Fedhealth Network and so they assert that 96% of their members have access to these doctors in a 10km radius of their homes. Furthermore they claim that 89% of members have access to a pharmacy that falls under the network, also within this same distance from where they live.
The Fedhealth Medical Scheme offers a range of health care cover from hospital plans to comprehensive full schemes and they fall under the Ultima, Maxima and Blue Door health plans.
This product range generally caters for older members who require more assistance from their medical scheme. They will usually be in a better financial position and can afford to pay the higher rates. With the Ultimax the main member pays R5 933, the Ultima 300 has the main member paying R4 117 and the Ultima 200 rate for the main member is R1 895.
This range is the most popular as it provides a variety of cover from basic to full comprehensive. The six different options are Maxima Plus (main member: R4 341), Maxima Exec (main member: R2 558), Maxima Standard (main member: R2 055), Maxima Basic (main member: R1 668), Maxima Core (main member: R1 258), Maxima EntryZone (main member: R883).
This plan caters for lower income members who have not enjoyed previous medical assistance. It’s not appropriate for those who have high benefit needs of for those who are already on a medical scheme.
There is a tier that begins with a salary bracket of less than R4 749 a month, where the principal member pays R463 and it extends up to members with a salary of more than R11 100 a month, where the principal member pays R1 418.
The monthly contributions will generally dictate which medical plan you choose but equally important are the healthcare benefits that you’ll receive. With the Fedhealth Medical Scheme, most of the benefits can be enjoyed across their entire range of schemes and this includes unlimited hospital cover and medical cover for more than 56 chronic conditions.
Other benefits include:
- Dependent children up to the age of 27 can stay on the child rate
- Members can upgrade to a higher plan irrespective of the annual deadline
- Covers extreme sports
- Any medicine that needs to be taken home when you leave the hospital is covered
- Emergency medical transport anywhere in the country
- Post-hospitalisation treatment covered for 30 days after hospital discharge
- A 24-hour Fedhealth nurseline
- Specialised radiology is not paid for with your savings
- Comprehensive HIV/Aids and other disease management programmes