Fedhealth Medical Scheme
Open scheme · ~135,000 principal members · 250,000+ beneficiaries · Administered by Medscheme · Planned amalgamation with Medshield (subject to CMS approval)
Fedhealth 2027 contributions: what changed, option by option →
Overview
Fedhealth Medical Scheme is a registered non-profit open medical scheme regulated by the Council for Medical Schemes under the Medical Schemes Act. Administered by Medscheme, Fedhealth is a mid-sized open scheme that distinguishes itself through plan modularity (the flexiFED range allows members to mix network and benefit levels) and through a strategic partnership with Sanlam, branded "Built Different", positioning the Scheme as a digital-first medical aid.
Planned amalgamation with Medshield (subject to CMS approval): Fedhealth and Medshield Medical Scheme have announced a planned amalgamation that, if approved by the CMS under the Medical Schemes Act, would combine the two schemes into a single entity. A merged Fedhealth/Medshield scheme would have approximately 270,000+ beneficiaries — placing it in the top four open schemes by membership in South Africa. The amalgamation is subject to formal CMS regulatory approval and is not expected to be effective before 2027. Fedhealth's 2026 plan range, contribution structure, and benefits are unaffected for the 2026 benefit year. Members and prospective members should monitor CMS and Fedhealth communications for updates on amalgamation progress and timeline.
Source: Fedhealth Member Report 2024; Daily Maverick, "Built Different: Fedhealth and Sanlam are redefining medical aid" (16 Oct 2025); CMS scheme register — Fedhealth/Medshield amalgamation announcement.
Membership Profile
Fedhealth reports over 135,000 principal members and more than 250,000 beneficiaries — placing the Scheme in the mid-tier of South Africa's 16 open medical schemes.
Membership requirements
Open to any South African resident; no employer, industry or professional restrictions. Standard Medical Schemes Act waiting periods apply.
Source: Fedhealth Member Report 2024; LinkedIn company profile.
Financial Health
Fedhealth reports a statutory solvency ratio of 36.9% and reserves of R3.3 billion — comfortably above the 25% statutory minimum and above the open-scheme peer average.
Source: Fedhealth Member Report 2024; Fedhealth 2026 brochure suite.
Plans & Options
Fedhealth's plan range is built around two product families: flexiFED (modern, savings-based, modular) and maxima (traditional, no-MSA), plus myFED (an income-banded entry plan).
| Plan family | Options | Day-to-day model | Notable feature |
|---|---|---|---|
| myFED | Single plan | Insured GP visits, network | Income-banded entry plan |
| flexiFED | flexiFED 1, 2, 3, 4 — each with Elect and non-Elect (any-provider) variants | MSA (or hospital-only on flexiFED 1) | Elect = Fedhealth Hospital Network (lower premium); non-Elect = any private hospital. R15,950 excess if Elect member uses non-network voluntarily. |
| maxima | Standard, Plus, Exec | Scheme-paid limits (no MSA) | Traditional comprehensive cover |
Source: Fedhealth flexiFED Rates and Benefits Guide 2026; medicalaid.com Fedhealth 2026 plan pages.
Key Benefits & Differentiators
Elect network model with voluntary use exception. The flexiFED Elect plans require members to use the Fedhealth Hospital Network for planned hospital admissions; voluntarily using a non-network hospital triggers a R15,950 excess (PMB and emergency admissions exempt). The non-Elect variants of the same plan tier carry a higher contribution but allow any-private-hospital admission without excess.
"Built Different" Sanlam partnership. Fedhealth's partnership with Sanlam combines medical scheme cover with Sanlam Reality and selected Sanlam financial-services rewards, positioned around a digital-first member experience.
maxima traditional plans. The maxima family is one of the few remaining traditional, no-MSA comprehensive plan ranges in the open-scheme market, with day-to-day claims paid against per-discipline scheme limits.
Chronic, oncology and mental health
All plans cover the 27 PMB Chronic Disease List conditions. Mid-tier flexiFED and maxima plans add additional chronic conditions. Oncology is managed via the ICON network. Mental health is covered to PMB minimum on all plans, with outpatient sessions on mid-tier and above.
Source: Fedhealth 2026 plan brochures; Daily Maverick, "Built Different".
Wellness & Loyalty
Fedhealth members get access to a wellness benefit on every plan covering annual screenings (BMI, cholesterol, glucose, blood pressure) and preventive immunisations. Through the Sanlam partnership, members can additionally enroll in Sanlam Reality, which adds rewards across health, retail and travel partners.
Source: Daily Maverick, "Built Different"; Fedhealth wellness benefit summary.
Claims & Service
Claims can be submitted via the Fedhealth app, the online portal, email or in person at Fedhealth offices. Administration runs through Medscheme, South Africa's largest medical scheme administrator by lives covered.
Service details
Dispute resolution follows the CMS process: internal dispute committee → CMS adjudication.
How the Scheme Is Set Up
Fedhealth's plan flexibility is designed around: members who want choice in network width independent of plan tier (flexiFED Elect vs non-Elect); families seeking a low-cost entry point with the option to upgrade as needs change (myFED → flexiFED 1 → 2/3/4); and members who prefer traditional comprehensive cover without an MSA (maxima Standard/Plus/Exec). The Sanlam partnership may appeal to existing Sanlam clients who want integrated rewards across health and financial services.
Members considering an Elect plan should plan for the R15,950 voluntary-non-network excess: this is a meaningful out-of-pocket exposure if a non-network hospital is preferred for a planned admission.
Prospective members — pending Medshield amalgamation: If the planned Fedhealth/Medshield amalgamation proceeds (subject to CMS approval), Fedhealth's plan range, brand, and administrative structure may change materially from 2027 onwards. For the 2026 benefit year, Fedhealth operates entirely as normal. Members who value long-term plan continuity should factor the pending structural change into their scheme selection. Under the Medical Schemes Act, members must be formally notified before any amalgamation takes effect and will have the opportunity to transfer schemes if they choose not to remain in the merged entity.
Source: Fedhealth flexiFED 2026 brochures; CMS scheme register — Fedhealth/Medshield amalgamation announcement.
Each plan in detail
One page per plan: contributions and what it covers, in Fedhealth’s own words, with the source for every line.
- flexiFED 1 (Hospital)
- flexiFED 1 (Savings)
- flexiFED 1 Elect (Hospital)
- flexiFED 1 Elect (Savings)
- flexiFED 2 (Hospital)
- flexiFED 2 (Savings)
- flexiFED 2Elect (Hospital)
- flexiFED 2Elect (Savings)
- flexiFED 2GRID (Hospital)
- flexiFED 2GRID (Savings)
- flexiFED 3 (Hospital)
- flexiFED 3 (Savings)
- flexiFED 3Elect (Hospital)
- flexiFED 3Elect (Savings)
- flexiFED 3GRID (Hospital)
- flexiFED 3GRID (Savings)
- flexiFED 4 (Hospital)
- flexiFED 4 (Savings)
- flexiFED 4Elect (Hospital)
- flexiFED 4Elect (Savings)
- flexiFED 4GRID (Hospital)
- flexiFED 4GRID (Savings)
- flexiFEDSavvy (Hospital)
- flexiFEDSavvy (Savings)
- maxima EXEC
- maxima PLUS
- myFED
- sureFED Essential
- sureFED Plus
Programmes you have to ask for
7 of these 12 programmes do not start on their own. You have to register, apply or get authorisation before the benefit applies — and until you do, you are paying for cover you are not receiving.
Read from Fedhealth Medical Scheme’s own documents. Each page quotes the wording and names the source. Compare programmes across every scheme →