Hippo Partners - Fedhealth

Fedhealth

Fedhealth provides cover for approximately 143 500 lives and offers a choice of 15 plans. Members have the option of using a hospital of choice or a plan that uses a network of hospitals (the Elect or GRID options). The Elect hospital network is very restrictive whilst the GRID network includes a comprehensive list of hospitals.

On the flexiFED plans, hospitalization benefits are offered with very limited savings available for day to day claims. Additional funds are allocated for day to day benefits through MediVault (Wallet) which can be accessed only when needed and paid back over a rolling 12 month period, interest free.

Premiums for a single member range from R916 to R8354 and the Maxima Standard (now called flexiFED 4) is the most popular option.

All options offer some preventative care benefits.

Options:

Maxima Plus

Maxima Plus is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 200%. If the scheme’s Conservative Back and Neck Rehabilitation Programme is not completed, no cover is available for spinal surgery. Day to day claims are paid from savings, then from a risk benefit. Thereafter, a self payment gap applies and then claims are paid from the above threshold benefit.

Maxima Exec & Exec GRID

Maxima Exec is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, or if selecting the GRID option, through a hospital network, with in-hospital specialist bills paid at 200%. Co-payments are applied to a comprehensive list of in-hospital procedures. If the scheme’s Conservative Back and Neck Rehabilitation Programme is not completed, no cover is available for spinal surgery. Day to day claims are paid from savings, then from a risk benefit. Thereafter, a self payment gap applies and then claims are paid from the above threshold benefit.

flexiFED 4 & Elect & GRID

flexiFED 4 is suited for individuals requiring comprehensive medical cover. It offers unlimited hospital cover at a hospital of choice, or if selecting the GRID or Elect options, through a hospital network, with in-hospital specialist bills paid at 100%. Co-payments are applied to a comprehensive list of in-hospital procedures. If the scheme’s Conservative Back and Neck Rehabilitation Programme is not completed, no cover is available for spinal surgery.

This plan has very limited savings for day to day claims. Once savings have been exhausted, you have the option to buy additional funds which are allocated for day to day benefits through MediVault (Wallet). These funds are paid back over a rolling 12 month period, interest free. Once the MediVault has been exhausted, a self-payment gap and above threshold benefit applies. Unlimited cover for network GPs, network Specialists, Basic Dentistry, Pathology, Basic Radiology once threshold reached - 20% co-pay applies.

flexiFED 3 & Elect & GRID

flexiFED 3 is suited for individuals requiring general medical cover. It offers unlimited hospital cover at a hospital of choice, or if selecting the GRID or Elect options, through a hospital network, with in-hospital specialist bills paid at 100%. Co-payments are applied to a comprehensive list of in-hospital procedures. A short list of in-hospital exclusions apply.

This plan has very limited savings for day to day claims. Once savings have been exhausted, you have the option to buy additional funds which are allocated for day to day benefits through MediVault (Wallet). These funds are paid back over a rolling 12 month period, interest free. Over and above this, additional cover (certain dentistry and GP consultations only) is available once the Benefit Maximiser Threshold has been reached.  All day to day expenses accumulate to the Benefit Maximiser Threshold limit. Specialised radiology, optometry and preventative care benefits are also offered.

flexiFED 2 & Elect & GRID

flexiFED 2 is suited for individuals requiring general medical cover. It offers unlimited hospital cover at a hospital of choice, or if selecting the GRID or Elect options, through a hospital network, with in-hospital specialist bills paid at 100%. Co-payments are applied to a comprehensive list of in-hospital procedures. A short list of in-hospital exclusions apply.

This plan has very limited savings for day to day claims. Once savings have been exhausted, you have the option to buy additional funds which are allocated for day to day benefits through MediVault (Wallet). These funds are paid back over a rolling 12 month period, interest free. Over and above this, additional cover (certain dentistry and GP consultations only) is available once the Benefit Maximiser Threshold has been reached.  All day to day expenses accumulate to the Benefit Maximiser Threshold limit. Specialised radiology, optometry and preventative care benefits are also offered.

flexiFED 1 & Elect

flexiFED 1 is suited for individuals requiring general medical cover. It offers unlimited hospital cover through a hospital network, with in-hospital specialist bills paid at 100%. Co-payments are applied to a comprehensive list of in-hospital procedures. A short list of in-hospital exclusions apply.

This is predominantly a hospital plan, with very limited savings for day to day claims. You have the option to buy additional funds which are allocated for day to day benefits through MediVault (Wallet). These funds can be accessed only when needed and are paid back over a rolling 12 month period, interest free. Over and above this, additional cover (basic dentistry and GP consultations only) is available once the Benefit Maximiser Threshold has been reached.  All day to day expenses accumulate to the Benefit Maximiser Threshold limit. Specialised radiology and preventative care benefits are also offered. No benefits offered for maternity.

myFED

myFED is an entry level capitated network plan which is affordable and ideal for low earning individuals. A co-payment will apply for Elective Caesarean Sections and an extensive list of in-hospital exclusions applies. All treatments are subject to provider network protocols. 



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