Hospital Rate of Payment:
We cover post-hospitalisation treatment for up to 30 days after discharge from hospital, such as
physiotherapy, x-rays and pathology. This means follow-up treatment for a full 30-day period is
covered, to preserve members’ day-to-day benefit. Pre-aut...
Casualty / Emergency Visits:
Whether the member is admitted to hospital or not, emergency treatment, like stitches, is always
covered. A co-payment of R600 applies for non-PMB visits. Authorisation must be obtained
Specialists:
Network GPs and Specialists Unlimited cover at cost
Non-network GPs, Specialists and all other healthcare professionals Up to 100% of FR
Radiology and pathology:
Unlimited at 100% of Fedhealth Rate
Dialysis:
R290 400 at Designated Service Provider. 40% co-payment on use of non-DSP
Joint Replacements:
Non-PMB single hip and knee replacements with CP-No co-payment
Non-PMB single hip and knee replacements – voluntary use of non-CP-R27 400
Involuntary use of non-CP* for single hip and knee replacements-R6 500
Other joint replacements-R6 500
Medical and Surgical Appliances:
In and out-of-hospital: paid from Savings/Wallet or self-funded. Doesn’t accumulate to Threshold. Paid from Threshold up to R12 100 per family per year. Sub-limit of R4 530 for foot orthotics
In Hospital Dentistry:
Unlimited at 100% of Fedhealth Rate
Take home Medicine:
7-days of paid for take home medication after discharge from hospital - provided the medication is dispensed by the hospital and reflects on the original hospital account.
Treatment for Mental Health:
The Mental Health Programme provides members with mental health or substance-abuse issues, as
well as their GP, with access to the best quality primary mental healthcare, available on flexiFED 4 only.
HIV / AIDS:
Through the Aid for Aids managed care programme, we take expert care of members with HIV/Aids.
The programme acts as a care-coordinator between Fedhealth, doctors, pathology labs, pharmacies
and patients.
