We let you be YOU.
Who are we?
Fedhealth has been growing from strength to strength since 1936, and today, we’re proud of the legacy we’ve built with the help of our members, business partners and service provider networks.
Thanks to our heritage and thorough understanding of healthcare, we continue to look after South Africans with quality, value for money medical aid. Our consistently high Global Credit Rating of AA- (retained for 12 years in a row) and reserves well over the required 25%, ensure that our scheme 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 alike. A great example of this is our innovative new flexiFED range, designed to put more control, flexibility and choice within our members’ reach.
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.
Trust Fedhealth to take care of your healthcare needs, whilst giving you the freedom to have more of a say in how your medical aid is structured.
Our philosophy of 360 Care
Our 360 Care philosophy is one in which we wholeheartedly believe. In encourages our members to see the same general practitioner (GP) every time, who then becomes the coordinator of your care. In this way, the doctor builds a valuable relationship with you, and gets to know your health history. So when you need a specialist, your GP can refer you to the appropriate specialist type, avoiding fragmented care, costly duplications of tests and treatments, and even the prescription of conflicting medication.
Coordinated care protects our members and gives you better quality of care, and it also helps ensure the financial sustainability of the Scheme. A referral from your general practitioner is necessary on all options where the specialist consultation is paid from a risk benefit, for example the Out-of-Hospital Expenses Benefit (OHEB) and the Threshold Benefit.
Members on certain options have to nominate a Fedhealth Network general practitioner to enjoy UNLIMITED GP visits paid from Risk.
GP nomination and referral management through the nominated GP helps Fedhealth to ensure that all members get quality care and better value for money.
Join Fedhealth for medical aid that puts control, flexibility and choice in your hands like never before! Medical aid for all of you, and only you.
Flexible cover for every stage of your life
We offer an option for every life stage and healthcare need. For members who are looking for choice, flexibility and control, and who also want to know that their healthcare requirements as single people, young couples or growing families are met, our flexiFED range is ideal. And, thanks to our innovative MediVault and Wallet facility, members on flexiFED can save on their monthly contribution whilst still having access to funds for day-to-day medical expenses.
We also offer comprehensive options that provide generous amounts of day-to-day cover like maxima PLUS for members who don’t want to leave anything to chance, or who might have more serious healthcare needs.
We even cater for the needs of previously uncovered employees with our low cost, entry-level medical aid product called myFED.
Unique to Fedhealth
- Unlimited Network doctor’s visits – Members can see their GP as often as they need on most options, by either visiting any network GP or a nominated network GP (depending on the option)
- 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, like a pregnancy
We pay more from Risk than other schemes
- Post-hospitalisation treatment for up to 30 days after discharge from hospital (e.g. physiotherapy, x-rays, pathology)
- 7 days of take-home medication
- Specialised radiology like MRI and CT scans – whether admitted to hospital or not. Co-payment may apply depending on the option
- Trauma treatment at a casualty ward – whether admitted to hospital or not. Co-payment may apply depending on the option
- Monthly prescriptions for female contraception, including oral, patches, certain injectables, contraceptive rings as well as IUDs that include Mirena®, on most options.
- In-hospital dentistry for children under 7 – The hospital and anaesthetist costs are covered from the core benefit bundle, while the dentist is paid for by the member. Not applicable to flexiFED 1
More support when you need it
- The Fedhealth Family Room, our online member portal
- The Fedhealth Baby Programme
- 24-Hour Fedhealth Nurse Line
- Emergency transport/response through Europ Assistance
- Comprehensive managed care programmes:
- Aid for AIDS (AfA) for those living with HIV/AIDS
- Oncology Disease Management supports cancer sufferers with comprehensive care including cover for chemotherapy, radiotherapy, approved medication, related consultations, pathology and general radiology.
- Mental Health Programme provides qualifying members who have mental health or substance abuse issues with access to the best quality primary mental healthcare.
- Emotional Wellbeing Programme gives members free telephonic support and advice through those stressful curveballs life throws at us, and can put them in touch with a psychologist at a reduced rate if required.
- Conservative Back and Neck Rehabilitation Programme helps qualifying members address their back and neck issues to avoid spinal surgery. Over six weeks, members benefit from a multidisciplinary approach including a GP, physio and biokineticist to assess and treat their condition.
- Smoking Cessation Programme – All members on all options can sign up for the GoSmokeFree service at 200 pharmacies countrywide to help them kick the habit for good. This programme will be paid from Risk.
- Weight Management Programme is a 12-week programme designed for qualifying Fedhealth members with a high BMI and waist circumference. Led by a biokineticist, members have access to a dietician and behavioural psychologist with the goal to lose the excess weight and lead healthier, more rewarding lives.
- MediTaxi – A free transport service to take members with hospital authorisations to follow-up medical appointments.
- SOS Call Me – Our user-friendly call-back service for members and dependants.
We’ve got your back
Administration by Medscheme, a level 2 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 90% one-call query resolution, with an average 8-second waiting time on calls
- Real-time electronic communication.
Engage with us
Constant engagement and communication with members by way of:
- The Fedchat Mobile App – FREE Instant Messenger channel for Apple, Android, Blackberry and Windows Phone users
- The Fedhealth website. Visit fedhealth.co.za to access our interesting Living Fedhealthy blog brimming with must-reads, as well as all our product brochures, option selection forms and related documents.
- The Fedhealth Family Room (accessed via fedhealth.co.za) allows you to: obtain hospital pre-authorisation; apply for chronic medication; submit claims; locate network pharmacies, GPs and Specialists using the locator tool; update personal information; conduct benefit enquiries; track claim submissions and claims due to you; join communities based on your interests; earn rewards; and read all the latest Scheme news.
- The Fedhealth microsite – a user-friendly tool that allows existing and potential members to do a needs analysis to determine which flexiFED option is best suited to them.
Caring for corporates
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 controller 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 Provider Network
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 members!
We’ve negotiated dispensing fees with Clicks, MediRite, Dis-Chem and Pharmacy Direct, as well as plenty of smaller pharmacies. This provides price certainty for our members, regardless of where they live in South Africa.
We have over 5 873 General Practitioners currently contracted to the Fedhealth GP 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 GP visits.
We have over 4 736 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 excellent hospitals across the country. This partnership provides immense financial peace of mind for members, and allows the Scheme to provide sound benefits at affordable rates.