maxima PLUS
maxima PLUS
From
- Complete peace of mind, Comprehensive cover, Mature Members
Maxima PLUS brings you comprehensive medical aid that leaves nothing to change when it comes to mature members’ health.
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Unlimited private hospital cover
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Generous Savings for day-to-day expenses
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Out-of-Hospital Expenses Benefit (OHEB)
Need more detail?
Want to check out other plans?
maxima PLUS
maxima PLUS
From
- Complete peace of mind, Comprehensive cover, Mature Members
maxima PLUS brings you comprehensive medical aid that leaves nothing to change when it comes to mature members’ health.
-
Unlimited private hospital cover
-
Generous Savings for day-to-day expenses
-
Out-of-Hospital Expenses Benefit (OHEB)
Need more detail?
Want to check out other plans?
Need a medical aid quote?
Tell us about you and your healthcare needs, and we’ll suggest a medical aid plan that closely matches your needs and budget
Type of Plan
maxima PLUS is a comprehensive option, offering in-hospital cover, a Medical Savings Account, Threshold benefit and Out-of-Hospital-Expenses Benefit (OHEB).
Choose how you pay for your day-to-day benefits and which hospitals you want available to you
Hospital Plan
Keep your contributions as low as possible by
choosing a Fedhealth Hospital Plan.
You're covered for any emergencies and hospital
stays, but visits to the dentist
or over-the-counter medicine will be paid from
your pocket.
Get in-hospital cover, but pay for day-to-day expenses like medication at the pharmacy yourself.
This keeps your contributions as low as possible.
Savings Plan
More Info
Pick a Savings Plan to enjoy the benefits of
a traditional medical savings account. This
is solid hospital cover with an additional
amount added to your premium to cover
your day-to-day expenses, such as a
specialist visit or blood tests.
We give you an annual pool of funds for day-to-day expenses upfront. It’s already added to your monthly contribution.
Since Fedhealth pays more from Risk, your day-to-day benefits tend to go further with us!
Flexible Savings Plan
More Info
A Fedhealth innovation! A Flexible Savings
Plan is for you if you want mostly a hospital
plan, but like the idea of having a day-to-day
back-up plan. Make transfers from your
MediVault to your Wallet to pay for antibiotics at
the pharmacy or a physio visit. You only pay for
what you use – interest-free over 12 months.
Unique to Fedhealth! This is a day-to-day back-up plan in case you need it.
You only pay for the day-to-day savings you use – interest-free over 12 months.
How does Flexible Savings work?
Let’s say you only get sick once in the year, or hurt.
You’d only want to pay for the medical savings you need to cover this one event, right?
Here’s how it would work:
Instead of paying R2 000 p/m for traditional savings, you only spend the R50p/m to pay back what you’ve used.
Hospital Discount Structures
What hospitals you would like access to on your plan?
Choose between the 120 world-class hospitals in our network or any private hospital with a co-payment on planned hospital procedures.
What hospitals you would like access to on your plan?
Choose between the 120 world-class hospitals in our network or any private hospital with a co-payment on planned hospital procedures.
Hospital Plan
Keep your contributions as low as possible by
choosing a Fedhealth Hospital Plan.
You're covered for any emergencies and hospital
stays, but visits to the dentist
or over-the-counter medicine will be paid from
your pocket.
Savings Plan
More Info
Pick a Savings Plan to enjoy the benefits of
a traditional medical savings account. This
is solid hospital cover with an additional
amount added to your premium to cover
your day-to-day expenses, such as a
specialist visit or blood tests.
Flexible Savings Plan
More Info
A Fedhealth innovation! A Flexible Savings
Plan is for you if you want mostly a hospital
plan, but like the idea of having a day-to-day
back-up plan. Make transfers from your
MediVault to your Wallet to pay for antibiotics at
the pharmacy or a physio visit. You only pay for
what you use – interest-free over 12 months.
Benefits we cover
In Hospital Cover
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Here are the procedures and treatments that take place in-hospital which you’re covered for under this option.
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There’s no overall annual limit for private hospitalisation, so enjoy the peace of mind of knowing that you’re covered no matter what.
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Network GPs and specialists are covered unlimited at cost.
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Non-network GPs are covered up to 100% of the Fedhealth Rate, non-network specialists are covered up to 200% of the Fedhealth Rate and other non-network healthcare providers are covered up to 300% of the Fedhealth Rate.
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You have an unlimited Oncology benefit. We use ICON as a Preferred Provider, and an Enhanced protocol.
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We offer R390 400 for specialised medication (biologicals) for oncology and non-oncology related conditions.
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Here are the procedures and treatments that take place in-hospital which you’re covered for under this option.
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There’s no overall annual limit for private hospitalisation, so enjoy the peace of mind of knowing that you’re covered no matter what.
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Network GPs and specialists are covered unlimited at cost.
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Non-network GPs are covered up to 100% of the Fedhealth Rate, non-network specialists are covered up to 200% of the Fedhealth Rate and other non-network healthcare providers are covered up to 300% of the Fedhealth Rate.
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You have an unlimited Oncology benefit. We use ICON as a Preferred Provider, and an Enhanced protocol.
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We offer R390 400 for specialised medication (biologicals) for oncology and non-oncology related conditions.
*Covers all admissions at any private hospital except the following hospitals: Zuid-Afrikaans Hospital (City of Tshwane), Arwyp Medical Centre (Ekurhuleni), Busamed Modderfontein Private Hospital (City of Johannesburg), Hibiscus Hospital (Ugu), Mooimed Private Hospital (Dr Kenneth Kaunda), Capital Hospital (Durban), which will not be covered in full for 2024. Emergency treatment at these 6 hospitals, however, will be covered in full without a co-payment but elective procedures will attract a R8 400 co-payment
*Covers all admissions at any private hospital except the following hospitals: Zuid-Afrikaans Hospital (City of Tshwane), Arwyp Medical Centre (Ekurhuleni), Busamed Modderfontein Private Hospital (City of Johannesburg), Hibiscus Hospital (Ugu), Mooimed Private Hospital (Dr Kenneth Kaunda), Capital Hospital (Durban), which will not be covered in full for 2025. Emergency treatment at these 6 hospitals, however, will be covered in full without a co-payment but elective procedures will attract a R8 840 co-payment
Chronic Benefits
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Enjoy cover for 70 chronic conditions with limits of R16 700 per beneficiary, with an overall limit of R31 300 per family per year.
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Once you’ve reached the annual limits after claiming medicine for the 27 CDL conditions and the 43 additional conditions, you will have unlimited cover for diseases on the CDL only.
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Enjoy cover for 70 chronic conditions with limits of R16 700 per beneficiary, with an overall limit of R31 300 per family per year.
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Once you’ve reached the annual limits after claiming medicine for the 27 CDL conditions and the 43 additional conditions, you will have unlimited cover for diseases on the CDL only.
*Comprehensive formulary applies.
Screening Benefits
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Prevention is better than cure! Make sure you and your loved ones can get all the tests and healthcare assessments you need to keep your health on track.
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We cover one Pap smear (cervical cancer screening) every three years for women aged 21 to 65.
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We cover 1 HPV PCR test every 5 years for women aged 21 – 65.
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We cover one Prostate Specific Antigen (PSA) test per year for men aged 45 to 69.
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Check your levels: We cover one cholesterol screening (full lipogram) every five years for everyone over the age of 20.
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Over 40’s health matters: We cover a breast cancer screening (mammogram) for everyone over 40 every 2 years.
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Protect those bones! Get a bone densitometry test every two years – for women over the age of 65 and men over the age of 70
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We cover a colorectal cancer screening for all members from 50 to 75 every year.
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HPV vaccine for all female beneficiaries aged 9 – 16 years. This benefit covers 2 doses per lifetime.
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Protect your family in winter: Everyone gets a free flu vaccination once a year.
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Get a pneumococcal vaccination if you’re 65 or older – 1 per lifetime.
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We cover one HIV finger prick test for all members once a year.
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All members enjoy one wellness screening per year including BMI, blood pressure, finger prick cholesterol and glucose tests.
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Find your fitness: all members enjoy one preventative screening by a contracted wellness network provider per year including waist-to-hip ratio, body fat %, flexibility, posture and fitness.
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Prevention is better than cure! Make sure you and your loved ones can get all the tests and healthcare assessments you need to keep your health on track.
-
We cover one Pap smear (cervical cancer screening) every three years for women aged 21 to 65.
-
We cover 1 HPV PCR test every 5 years for women aged 21 – 65.
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We cover one Prostate Specific Antigen (PSA) test per year for men aged 45 to 69.
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Check your levels: We cover one cholesterol screening (full lipogram) every five years for everyone over the age of 20.
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Over 40’s health matters: We cover a breast cancer screening (mammogram) for everyone over 40 every 2 years.
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Protect those bones! Get a bone densitometry test every two years – for women over the age of 65 and men over the age of 70
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We cover a colorectal cancer screening for all members from 50 to 75 every year.
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HPV vaccine for all female beneficiaries aged 9 – 16 years. This benefit covers 2 doses per lifetime.
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Protect your family in winter: Everyone gets a free flu vaccination once a year.
-
Get a pneumococcal vaccination if you’re 65 or older – 1 per lifetime.
-
We cover one HIV finger prick test for all members once a year.
-
All members enjoy one wellness screening per year including BMI, blood pressure, finger prick cholesterol and glucose tests.
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Find your fitness: all members enjoy one preventative screening by a contracted wellness network provider per year including waist-to-hip ratio, body fat %, flexibility, posture and fitness.
Additional Benefits
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Enjoy even more peace of mind with extra benefits like professional medical advice and a transport service when you need a check-up after being in hospital.
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Got a health-related question? Phone our 24-hour toll-free Nurse Line and get expert medical and health advice from qualified nurses.
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We’ll get you to your check-up! Our MediTaxi service transports you to follow-up medical treatments following a hospital stay (only in certain regions). Call 0860 333 432 and press 5 for the point-to-point service.
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Want to manage your weight better but not sure how? Qualifying members can join our 12-week Weight Management Programme led by biokineticists and dieticians, so you can make healthy and sustainable lifestyle changes.
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Quit smoking for good! We cover the GoSmokeFree Smoking Cessation Programme so you can kick the smoking habit once and for all.
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Need a little support through life’s ups and downs? The October Health app, available through the Fedhealth Member App, provides mental health support to Fedhealth members.
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Enjoy even more peace of mind with extra benefits like professional medical advice and a transport service when you need a check-up after being in hospital.
-
Got a health-related question? Phone our 24-hour toll-free Nurse Line and get expert medical and health advice from qualified nurses.
-
We’ll get you to your check-up! Our MediTaxi service transports you to follow-up medical treatments following a hospital stay (only in certain regions). Call 0860 333 432 and press 5 for the point-to-point service.
-
Want to manage your weight better but not sure how? Qualifying members can join our 12-week Weight Management Programme led by biokineticists and dieticians, so you can make healthy and sustainable lifestyle changes.
-
Quit smoking for good! We cover the GoSmokeFree Smoking Cessation Programme so you can kick the smoking habit once and for all.
-
Need a little support through life’s ups and downs? The October Health app, available through the Fedhealth Member App, provides mental health support to Fedhealth members.
Your day-to-day benefits
Fedhealth’s maxifed medical aid plans help your money go further by covering you for a range of day-to-day benefits from Risk, and not your savings. This means members can save a significant amount since they can use their savings for other expenses instead.
Fedhealth’s maxima medical aid plans help your money go further by covering you for a range of day-to-day benefits from Risk, and not your savings. This means members can save a significant amount since they can use their savings for other expenses instead.
Benefits Unique To Fedhealth
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We cover take-home medicine for seven days to a maximum of R400 per beneficiary per hospital event at 100% of the Medicine Price List.
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Get cover for follow-up treatment for 30 days once you’re discharged from hospital, like physio, x-rays and pathology.
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Receive trauma treatment at a casualty ward – whether you’re admitted to the hospital or not.
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Enjoy unlimited specialised radiology paid by the Scheme if you get pre-authorisation from us. The first R2 810 for non-PMB MRI/CT scans will be for your account.
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Family planning: We cover oral female contraception, patches, contraceptive rings, certain injectables and IUDs including the Mirena (prescribed by a GP or gynae, and not prescribed for acne).
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We cover take-home medicine for seven days to a maximum of R400 per beneficiary per hospital event at 100% of the Medicine Price List.
-
Get cover for follow-up treatment for 30 days once you’re discharged from hospital, like physio, x-rays and pathology.
-
Receive trauma treatment at a casualty ward – whether you’re admitted to the hospital or not.
-
Enjoy unlimited specialised radiology paid by the Scheme if you get pre-authorisation from us. The first R2 960 for non-PMB MRI/CT scans will be for your account
-
Family planning: We cover oral female contraception, patches, contraceptive rings, certain injectables and IUDs including the Mirena (prescribed by a GP or gynae, and not prescribed for acne).
Threshold Benefits
Claim your day-to-day expenses up to the threshold amount*, then we will cover the rest!
Claim your medical expenses up to the threshold amount*, then we will cover the rest! You can then enjoy:
- Once your claims have accumulated to a pre-determined Threshold level, any further claims will be paid from the Threshold Benefit, with a 10% co-payment for your account on all claims paid from the Threshold benefit (except claims for network specialists). Certain day-to-day expenses are limited.
*These are the threshold levels: Member R20 800 Adult Dependant R16 200 Child Dependant (up to a maximum of 3 children) R5 600.
Threshold Benefits
The Threshold Benefit pays for members’ day-to-day expenses once claims have accumulated up to the required level
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Once your claims have accumulated to a pre-determined Threshold level, any further claims will be paid from the Threshold Benefit. Certain day-to-day expenses are limited.
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Once your claims have accumulated to a pre-determined Threshold level, any further claims will be paid from the Threshold Benefit, with a 10% co-payment for your account on all claims paid from the Threshold benefit (except claims for network specialists). Certain day-to-day expenses are limited.
*These are the Threshold levels: Principal member R20 800 Adult R16 200 Child (up to a maximum of 3 children) R5 600.
*These are the Threshold levels: Principal member R22 700 Adult R17 700 Child (up to a maximum of 3 children) R6 200.
For our pregnant members:
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Get access to our Fedhealth Baby Programme for great discounts, gifts and parenting advice.
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Our postnatal midwifery benefit includes four consultations with a midwife in- and out-of-hospital.
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Want to use a doula? We cover doulas up to R3 600 per delivery.
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We cover one test with an audiologist per newborn up to the Fedhealth Rate (including consultation).
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Worried sick about your child? Use the Paed-IQ advice line for all your paediatric questions.
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Get access to our Fedhealth Baby Programme for great discounts, gifts and parenting advice.
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Our postnatal midwifery benefit includes four consultations with a midwife in- and out-of-hospital.
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Want to use a doula? We cover doulas up to R3 600 per delivery.
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We cover one test with an audiologist per newborn up to the Fedhealth Rate (including consultation).
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Worried sick about your child? Use the Paed-IQ advice line for all your paediatric questions.
Preventative Benefits
- Female contraception including oral patches, contraceptive rings, certain injectables and IUDs that include Mirena*
*These need to be prescribed by a GP or gynae and can not be prescribed for acne.
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Frequently asked questions
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Dependants
Adult Dependants
Child Dependants (Under 25)
Total Contributions
R0 Risk cover (main member)
R0 Dependant/s contribution
R0 Day-to-day portion
R0 p/m
Annual Savings: R0 p/y
Annual OHEB: R0 p/y
Total annual day-to-day benefit: R0 p/y
*Calculations are not final and does not include any late joiner penalties or pro rate amounts
Having trouble choosing ?
Want to check out other plans?
Need a medical aid quote?
Tell us about you and your healthcare needs, and we’ll suggest a medical aid plan that closely matches your needs and budget
