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flexiFED 4 Elect

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Type of Medical Aid Plan: 
Medical Aid Year: 
Day to day Benefits: 

Unlimited network General Practitioner (GP) visits
On flexiFED 4, members can see their GP as often as they need by visiting any network GP.
On flexiFED 4GRID and flexiFED 4Elect members must nominate a network GP.
On flexiFED 1,2 and 3 members can s...

In Hospital Benefits
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...

Members on network hospital options can go to ANY hospital for emergencies.
Members who choose network hospital options are often concerned about what happens in case of
an emergency, when the nearest hospital is one that’s not on the network. These ...

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
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
R464 700 at Designated Service Provider. 40% co-payment on use of non-DSP
Oncology / Cancer: 
R464 700
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-R4 400 Other joint replacements-R4 400
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.
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.
Day-to-day benefits
GP consultations: 

Unlimited at nominated network GPs

Specialist consultations: 

Same benets as
exiFED 1, 2 and
3 as well as unlimited network GP
consultations always paid from the Risk
Benet and never from Savings.

Acute medicine: 

Chronic medicine benefit for allergic rhinitis medicine for concomitant asthma (up to the age of 18),
eczema (up to the age of 18) and acne (up to age 21) onfl exiFED 3 and flexiFED 4. Attention Deficit
Hyperactivity Disorder, Depression, Generalised...

Over-the-counter (OTC) 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.

Optometry benefits: 
Limit of R3 490 per person per year, up to an overall limit of R10 640 per family per year
Basic dentistry: 
Basic dental benefit
MRI and CT Scans (Out of Hospital): 
We cover specialised radiology like MRI/CT scans whether it’s performed in- or out-of-hospital. A co-payment applies for non-PMB MRI/CT scans
Radiology and Pathology: 
Unlimited at 100% of Fedhealth Rate
Chronic Conditions
Chronic Conditions: 

Acne, Allergic Rhinitis, Ankylosing Spondylitis, Anorexia Nervosa, Attention Deficit Hyperactivity Disorder (in children 6-18 years), Bulimia Nervosa, Depression, Dermatomyositis, Eczema,
Generalised Anxiety Disorder, Narcolepsy, Obsessive Compulsive...

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