INSURANCEFUNDI | FEDHEALTH 2017

Fedhealth 2017 – Part One

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I’m not going to lie, I’m with Discovery Health.

I’ve been with them for years, I’ve never had any bad experiences with them, they’re an excellent medical aid scheme, the cost suits my pocket, and honestly, it’s a schlep to move.

But at the same time I’ve heard only good things about Fedhealth from people on the scheme, and they do offer a few interesting benefits which we’ll discuss below, but first…

Four ‘stating the obvious’ facts about medical aid:

Everyone needs one
We all hate paying for it (just like home insurance) until the day we need it
It’s not something you can put off till you’re old and sickly to join because of late joiner penalties and waiting periods,
Jumping from one medical aid to another is risky for two reasons. One, because of potential waiting periods, and two, uncertainty about what you’ll get for your money at the new company.

So basically, join an affordable medical aid, and stick with them unless you have a bad claims experience. Think about moving only if they become unaffordable or if you find out they’re no longer value for money. By that I mean the cost is going up but the benefits are shrinking.

This brings us to three groups of people

The person who can’t afford to make a mistake because they use their medical aid often. They need to know that if they end up in hospital, their bills are going to be paid.
The person who can’t afford to make a mistake because they hardly ever use their medical aid. They don’t want to waste money on benefits they seldom use.
The person who can’t afford to make a mistake because they might just use their medical aid often, but who also can’t afford to waste money on a medical aid they might never use.

It’s this third group of people who should consider Fedhealth.

This is what make Fedhealth unique:

Unlimited GP visits to network FP’s (Fedhealth Providers) with none of the cost coming from your savings on their comprehensive options.
“Hang on a moment!” I hear you say. “My medical aid does the same thing.”
But do they do that before – or after – you’ve exhausted all your own savings?
Fedhealth is saying, “Keep your savings, we’ll pay for it IF you use on our networked GP’s.”

I happen to think that’s kind of nice of them, don’t you?

Your children pay child rates even if they’re older than 21 as long as they’re financially dependent on you and younger than 27.
Two requirements in order for this to happen:

They must be single, and
They can’t be earning more than the maximum social pension which, for 2017 is R1, 520 a month.

So here’s an example using a family of four.

Let’s compare the Discovery Health Classic Saver to the Fedhealth Maxima Basis option. They’re in the same ballpark more or less in terms of cost.

In the first example let’s look at both children being younger than 21.

Discovery Health Classic Saver:

Main member – R2, 577 monthly
Adult dependant – R2, 029 monthly per person
Child dependant – R1, 031 monthly per person
Total cost – R6, 668 monthly

Fedhealth Maxima Basis:

Main member – R2, 501 monthly
Adult dependant – R2, 129 monthly per person
Child dependant – R754 monthly per person
Total cost – R6, 138 monthly

But here’s what happens when the two children turn 21.

Discovery Health Classic Saver:

Main member – R2,577 monthly
Adult dependant – R2,029 monthly per person
Total cost – R8,664 monthly

Fedhealth Maxima Basis:

Main member – R2,501 monthly
Adult dependant – R2,129 monthly per person
Child dependant – R754 monthly per person
Total cost – R6,138 monthly

What would you do with an extra two thousand Rand in your pocket – especially if your kids are both at varsity?

Upgrades to higher options any time of the year within 30 days of diagnosis of a dread disease or life changing event
Try your luck with this at your current medical aid scheme. So basically, only pay for it if you need it.

And then to top it all, there are these benefits

Post hospitalisation treatment for up to 30 days after discharge.
Let’s say you’ve just been discharged from hospital and need some physiotherapy. The next 30 days’ worth of physiotherapy is paid from risk and not your savings. In other words, Fedhealth pays for this.

7 days take home medication after discharge from hospital.
If the hospital you’re being discharged from dispenses the medicine then it gets added onto your hospital account. Nice.

MRI and CT scans are always paid from risk and never from savings.
It doesn’t matter whether the scan is done in or out of hospital. Some schemes will charge a co-payment to have these scans done.
This benefit doesn’t apply to the Fedhealth Blue Door Plus option and it does require pre-authorisation 48 hours beforehand.

Trauma treatment at a casualty ward is paid from risk.
Most schemes will only pay from risk if you get admitted to hospital. No admittance, no pay.

Monthly prescription for all forms of female contraception paid for on their comprehensive plans.
You name it – oral, patches, contraceptive rings (not sure whether they’re talking about wedding rings here?), certain injectables as well as IUD’s – are all covered.
Oral contraception is covered on their hospital plans – Maxima Core and Maxima EntryZone – as well as on their Blue Door Plus option.

So what is Fedhealth bringing to the table?

We’re going to run through each of the Fedhealth plans one by one. This article is just about you getting an idea of what’s on offer.

So first off you need to know that Fedhealth offers 12 plans in 2017
The 12 plans are broken down into 3 major plan groups
The lowest plan type is the Blue Door Plus option aimed at the lower income employee who has never been on a medical aid before
The next step up is the Maxima options which is broken down into 4 tiers
The first Maxima tier is the hospital plans consisting of two plans – the Maxima EntryZone and the Maxima Core
The second Maxima tier are the plans with savings consisting of four plans – the Maxima EntrySaver, the Maxima Saver, the Maxima Basis, and the Maxima Advanced option
The third Maxima tier is the comprehensive plans consisting of four plans – the Maxima StandardElect, the Maxima Standard, the Maxima Exec, and the Maxima Plus.
The ultimate step up is their Ultimax option.

We’re also including a handy Excel spreadsheet which will give you an idea of cost for your family.

You can download it here at Fedhealth 2017.

Once you open the sheet, simply enter the number of adult and child dependents in the two yellow blocks at the top left hand corner. You can then check the cost across all Fedhealth plan types. I’d suggest you download the spreadsheet and work out what’s affordable for you and your family.

Then in the coming weeks we’re going to go into much more detail on each of the Fedhealth plans. At that stage you’ll be able to make up your own mind as to which plan best suits you.