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Family takes care of family

Our philosophy

Our Fedhealth family has been growing from strength to strength since 1936, and includes our members, business partners and service provider networks.

Thanks to our proud heritage and thorough understanding of healthcare, we continue to look after South African families with quality, value for money medical aid. Our consistently high Global Credit Rating of AA- (retained for nine years in a row) and reserves well over the required 25%, ensure that our family is financially sound and rated as one of the top medical aid schemes in South Africa.

Sustainability is at the heart of everything we do, and we are always developing initiatives that benefit our members, partners and providers – our extended family – alike. Run by members for members, and with complete transparency, our member-elected Board of Trustees operates with one objective only, namely to put the interests of our members first.

Today, our extensive option range and unique benefits, where we pay more from Risk than other schemes to ensure that members’ day-to-day benefits go further, prove that we’re in it with families for the long run.

For us, it’s more than service, it’s support. Always. Welcome to the Fedhealth family.

360 Care: Let the healing begin (with your FP)

As part of our ongoing drive to optimise healthcare, we adopted the 360 Care approach in 2015, which focuses on the coordination of member care. This sees one dedicated family practitioner or FP, chosen by the member, becoming the coordinator of the member’s care.

To avoid fragmented care that is dangerous, costly and time consuming, the FP and member work together closely so that all healthcare needs are met. 360 Care is a member-centric initiative, with the goal to improve health outcomes, enhance customer experience and reduce healthcare spending.

Should a member be referred to specialists, 360 Care ensures that only appropriate providers are consulted, to deliver the right care at the right time.

As part of this service, doctors assess patients’ healthcare needs, check that they’re taking medications as prescribed; monitor the care provided by other doctors; and make arrangements to ensure a smooth transition when patients move from hospital to home.

Electronic health records also allow for the easy exchange of information with other healthcare providers treating the member.

We believe 360 Care adds significant value to Fedhealth members’ experience!

Joining Fedhealth is about more than receiving quality healthcare, great benefits and sound support. It’s about belonging to a family. Always.

Cover for every stage of your family’s life

We offer an extensive product range featuring two hospital plans, three saver options and four comprehensive options. So whether it’s basic hospital cover through plans like Maxima EntryZone, or high-end options offering generous amounts of day-to-day cover like Maxima Plus for members who don’t want to leave anything to chance, we provide cover for every individual. We even cater for the needs of previously uncovered employees with our low cost, entry-level medical aid product called Blue Door Plus.

There’s nothing we wouldn’t do for our family

We protect Fedhealth family members’ pockets with a range of value-added benefits.

Unique to Fedhealth

  • Unlimited FP visits to Network FPs paid from Risk and never from Savings on all comprehensive options, unlimited FP visits to Network FPs paid from Risk once savings is depleted on Maxima Basis and unlimited FP visits to nominated Network FPs paid fromRisk once Savings is depleted on Maxima Saver and Maxima EntrySaver
  • Child rates for financially dependent children up to 27 years of age
  • Upgrades to higher options any time of the year on diagnosis of a dread disease or life-changing event.

We pay more from Risk than other schemes

  • Post-hospitalisation treatment for up to 30 days after discharge from hospital (physiotherapy, x-rays, pathology, etc)
  • 7 days of take-home medication
  • Specialised radiology like MRI and CT scans – whether admitted to hospital or not
  • Trauma treatment at a casualty ward – whether admitted to hospital or not
  • Monthly prescriptions for female contraception, including oral, patches, certain injectables, contraceptive rings as well as IUDs that include Mirena®, on all comprehensive options as well as the saver options.Oral contraception only, covered on our two hospital plans, Maxima Core and Maxima EntryZone.

From our family, with love to you

  • The Fedhealth Baby Programme
  • 24-Hour Fedhealth Nurse Line
  • Free trauma counselling for practical and emotional support
  • Emergency transport/response through Europ Assistance
  • Comprehensive managed care programmes:

– Aid for AIDS (AfA) for those living with HIV/AIDS

– AsthmaCare ensures that asthma patients still lead a normal life

– DiabeticCare assists diabetics in managing their blood sugar

– CardioCare to prevent heart attacks in Coronary Heart Disease sufferers; and

– Oncology Disease Management that supports cancer sufferers with comprehensive care including cover for chemotherapy, radiotherapy, approved medication, related consultations, pathology and general radiology.

The support you deserve

Administration by Medscheme, a level 3 BBBEE Company and South Africa’s largest managed care services provider and third largest medical scheme administrator, offers:

  • An average claim turn-around time of 5 days
  • An efficient and highly-rated ISO 9001:2008 certified Customer Contact Centre offers 88% one call query resolution, with an average 8-second waiting time on calls
  • Real-time electronic communication.

 

Family always keeps in touch

Constant engagement and communication with members by way of:

  • The Fedhealth Member Mobile App available free to both Apple and Android users  – the App is a unique customer experience, enabling members to enjoy direct access to their medical aid
  • The Fedhealth website – the definitive online portal for everything Fedhealth-related. Fun, functional and informative, the site brings the Fedhealth member experience to life online. It has a section devoted to Living Fedhealthy, where visitors to the site get to experience just what Fedhealth has to offer. Once in the Member Section of the site, members are able to update personal information, obtain hospital pre-authorisation, conduct benefit enquiries, locate Network FPs and Specialists, as well as successfully track their claim submissions and payments due to them. All brochure-ware, option selection forms and related Fedhealth documentation is also available as easy-to-access PDF downloads or e-books.
  • The glossy bi-monthly Fedhealthy Magazine – packed with articles and features to enrich a healthy lifestyle. For Apple and Android users, the magazine is also available in eye-popping e-format in the free Fedhealthy Magazine Mobile App.

 

Something for our corporate family members

For corporate organisations joining the Scheme we offer various initiatives to meet company-specific demands:

  • Group implementation and training ensures a smooth transition from previous schemes to Fedhealth
  • A dedicated Account Executive (AE) for each organisation with 25 or more staff members – regular visits take place and the AE is always available to solve queries online
  • A dedicated credit control person per organisation
  • Tailor-made solutions with option mapping to cater directly to the organisation’s staff
  • Update – an electronic newsletter aimed directly at HR/Finance departments delivers scheme-related news to employers

Our Network family

When it comes to giving our members quality healthcare they can trust, we partner with healthcare professionals with the same passion for healthcare. After all, only the best will do for our family!

Over 1 770 pharmacies nationwide currently belong to the Fedhealth Pharmacy Network (including all major retailers like Dis-Chem, Medi-Rite and Clicks Pharmacy and over 1 000 independent pharmacies). This means that 90% of our principal members have access to a network pharmacy within a 10km radius of where they reside.

We have over 4 950 Family Practitioners currently contracted to the Fedhealth FP Network. As such 97% of our principal members have access to a Network Doctor within a 10km radius of where they live. And more than 81% of claiming beneficiaries on all comprehensive and saver options are already using Network Doctors. On most options, members have access to unlimited FP visits.

We have over 3 950 specialists from all disciplines contracted to the Fedhealth Specialist Network. Using a Fedhealth Network Specialist means no co-payments and truly unlimited benefits at cost for members in-hospital and price certainty out-of-hospital.

We’ve also established partnerships with hospitals across the country. Our Hospital Network ensures that Blue Door Plus, Maxima EntryZone and Maxima EntrySaver members have access to unlimited hospitalisation – provided they make use of network facilities. This partnership provides immense financial peace of mind for members and allows the Scheme to provide comprehensive benefits at affordable rates.