At a glance
- Plan type
- Hospital plan
- Hospitals
- Network hospitals
- Hospital and specialists
- 100% of Scheme tariff
- Day-to-day costs
- Your own
- Chronic conditions
- 28
- Cancer
- PMB level of care
- Children you pay for
- Up to 3
- Children on the plan to age
- 27
Fedhealth’s 2027 benefits are not in our records yet. Its 2027 contributions are below.
Monthly contributions
2027 rates take effect on 1 January 2027. 2027 contributions: Fedhealth flexiFED Hospital Plans Rates and Benefits Guide 2027, p6. Its 2027 benefits are not in our records yet. You pay for up to 3 children.
| Member | 2026 | 2027 | Change |
|---|---|---|---|
| Main member | R2 603 | R2 885 | +10.8% |
| Adult dependant | R2 041 | R2 261 | +10.8% |
| Child | R954 | R1 056 | +10.7% |
Benefits
We hold Fedhealth’s 2027 contributions; its 2027 benefit rules are not in our records yet. Each row shows the 2026 rule, marked.
Benefits in force for 2026.
In hospital
Hospitals
Network hospitals only (flexiFED 1 Hospital Network)
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19
Hospitals
2027 not in our records yet. 2026: Network hospitals only (flexiFED 1 Hospital Network)
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19 (2026)
Specialists in hospital
100% of Scheme tariff. A specialist who charges more leaves a shortfall.
Fedhealth maxima EXEC Individual Option brochure 2026, p14
Specialists in hospital
2027 not in our records yet. 2026: 100% of Scheme tariff. A specialist who charges more leaves a shortfall.
Fedhealth maxima EXEC Individual Option brochure 2026, p14 (2026)
Private ward
Not covered.
Fedhealth catalogue in hospital cover
Private ward
2027 not in our records yet. 2026: Not covered.
Fedhealth catalogue in hospital cover (2026)
Chronic and cancer
Chronic conditions
28 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
Chronic conditions
2027 not in our records yet. 2026: 28 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
(2026)
Cancer
Cover at the PMB level of care, through ICON.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p15
Cancer
2027 not in our records yet. 2026: Cover at the PMB level of care, through ICON.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p15 (2026)
Day to day
Maternity
Fedhealth Baby Programme, paid from the scheme’s risk benefits, not savings.
Fedhealth maxima EXEC Individual Option brochure 2026, pMaternity and childhood p10
Maternity
2027 not in our records yet. 2026: Fedhealth Baby Programme, paid from the scheme’s risk benefits, not savings.
Fedhealth maxima EXEC Individual Option brochure 2026, pMaternity and childhood p10 (2026)
Children on the plan
As dependants up to age 27.
Children on the plan
2027 not in our records yet. 2026: As dependants up to age 27.
(2026)
GP visits
Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
GP visits
2027 not in our records yet. 2026: Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7 (2026)
Specialist visits
Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Specialist visits
2027 not in our records yet. 2026: Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7 (2026)
Prescribed medicine (acute)
Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Prescribed medicine (acute)
2027 not in our records yet. 2026: Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8 (2026)
Basic dentistry
Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Basic dentistry
2027 not in our records yet. 2026: Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7 (2026)
Eyes (optometry)
Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Eyes (optometry)
2027 not in our records yet. 2026: Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8 (2026)
Basic X-rays
Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Basic X-rays
2027 not in our records yet. 2026: Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8 (2026)
Blood tests (pathology)
Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Blood tests (pathology)
2027 not in our records yet. 2026: Not covered.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8 (2026)
Full benefit list
Every benefit we hold for flexiFED 1 (Hospital), in Fedhealth’s own wording, from its 2026 documents. Fedhealth’s full 2027 list is not in our records yet.
In hospital
Cancer treatment
On flexiFED 1, oncology is covered unlimited at PMB level of care at the designated service provider, ICON, subject to Essential protocols. A 25% co-payment applies where a DSP is not used.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p15
Hospital stay and theatre
Accommodation, use of operating theatres and hospital equipment, medicine, pharmaceuticals and surgical items — Unlimited at any hospital.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19
Day procedures
R2 710 co-payment on voluntary use of non-network day surgery facilities. flexiFED 1GRID: 30% co-payment on voluntary use of non-network hospitals and non-network mental health facilities. flexiFED 1Elect: R15 950 excess on all hospital admissions except emergency admissions.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19
Surgery and anaesthetics
Specialists and GPs on the Fedhealth network are covered in full. Specialists and GPs not on the Fedhealth network are covered up to the Fedhealth Rate.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p18
Planned PMB procedures
To have treatment for PMB conditions covered in full, use Fedhealth Network GPs, Specialists, Hospitals and DSPs where applicable. Otherwise the Scheme refunds treatment up to the Fedhealth Rate and a co-payment applies if the provider charges more.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19
Organ and stem cell transplants
Organ tissue and haemopoietic stem cell (bone marrow) transplantation, immunosuppressive medication, post-transplantation biopsies — R321 570.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p20
Dialysis
Chronic renal dialysis — Haemodialysis and peritoneal dialysis, radiology and pathology, consultations, visits, all services, materials and medicine. R321 570 per family per year; DSP required, else 40% co-payment.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p20
Mental health admissions
Psychiatric hospitalisation: R27 220 per family. Up to 21 days of admission or up to 15 out-of-hospital consultations per beneficiary for major affective disorders.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p14
Birth (in hospital)
Not covered. Maternity confinement: Unlimited. Accommodation in a general ward, high care and intensive care unit, theatre fees, medicine, material and hospital apparatus. Private ward cover: No benefit. Delivery by Fedhealth Network GPs and specialists: Covered in full; non-network up to the Fedhealth Rate.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19
MRI, CT and PET scans
MRI and CT scans: in and out of hospital unlimited; first R3 050 for non-PMB scans for the member's account. Oncology PET and PET/CT scans: 2 per family per annum at DSP, R5 670 co-payment for non-DSP.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p20
Internal prostheses
Prostheses and devices (internal) — combined benefit limit for all unlisted internal prostheses up to R321 570.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p20
Medicine on discharge
We cover 7 days' supply of take-home (discharge) medication, to a maximum of R412 per beneficiary per admission.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19
Step-down and sub-acute care
Sub-acute facilities and physical rehabilitation facilities — covered subject to pre-authorisation, as an alternative to acute hospitalisation.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p19
Travel cover
Emergency Medical Benefit: Europ Assistance — cover of R5 million per person per journey (up to 45 days) for emergency medical treatment while travelling abroad.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p11
HIV/AIDS
HIV/AIDS covered as a Chronic Disease List (CDL) PMB condition — unlimited at PMB level of care on the HIV management programme; antiretroviral medication via DSP.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p13
Day to day
GP visits
Not covered. Pre Threshold: Consults with a nominated Network GP will be self-funded or paid from available D2D+ benefits and accumulate at cost to the Threshold level. Each beneficiary can nominate up to 2 Network GPs. In Threshold: Unlimited nominated Network GP benefit. Consults will be subject to a 20% co-payment in Threshold.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
GP visits
Not covered. Non-network GP: Pre Threshold self-funded or paid from available D2D+ benefits. In Threshold: Limit of 2 consults with an out-of-network or non-nominated GP per beneficiary paid from Threshold. Thereafter self-funded.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Specialist visits
Not covered. Network medical specialist consultations and visits (excluding psychiatrists): Self-funded or paid from available D2D+ benefits. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Specialist visits
Not covered. Non-network medical specialist consultations and visits (excluding psychiatrists): Self-funded or paid from available D2D+ at scheme rate. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Basic dentistry
Not covered. Basic dentistry: Self-funded or paid from available D2D+ benefits. Once Threshold level has been reached: 2 annual consultations per beneficiary incl. x-rays, scaling and polishing, fillings and extractions. Subject to contracted dentists and approved procedures.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Specialised dentistry
Not covered. Advanced dentistry (inlays, crowns, bridges, dentures, orthodontics, oral surgery, osseo-integrated implants): Self-funded. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Auxiliary services
Not covered. Additional medical services (audiology, dietetics, genetic counselling, hearing aid acoustics, occupational therapy, orthoptics, podiatry, private nursing, psychologists, social workers, speech therapy): Self-funded. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Alternative healthcare
Not covered. Alternative healthcare (acupuncture, homeopathy, naturopathy, osteopathy, phytotherapy incl. prescribed medication): Self-funded. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Eyes (optometry)
Not covered. Optical benefit — Spectacle lenses, frames and/or lens enhancements: Self-funded. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Medical appliances
Not covered. Appliances, external accessories and orthotics (hearing aids incl. repairs, wheelchairs, glucometers, CPAP, foot orthotics): Paid from day-to-day or self-funded, accumulates to Threshold. Stoma products, oxygen therapy, home ventilators, long leg callipers: Unlimited subject to authorisation. Moon boots: R2 060 per beneficiary from Risk.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p20
Casualty visits
Trauma treatment covered unlimited up to the Fedhealth Rate. Authorisation must be obtained within 48 hours and a co-payment of R880 per visit for non-PMBs applies.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Chronic medicine (Chronic Disease List)
Unlimited cover for the Prescribed Minimum Benefit conditions on the Chronic Disease List (CDL). Basic/restrictive formulary or a 30% co-payment for non-formulary medication. Scriptpharm Network Pharmacies, 30% co-payment for non-DSP.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p13
Chronic medicine (other conditions)
Additional condition covered beyond the CDL: Depression. Depression medication: R2 400 per beneficiary per annum subject to an approved list of medication.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p14
Psychologist and counselling visits
Two virtual mental health consultations per beneficiary at a nominated provider once threshold has been reached. Unlimited mental health consults in- or out-of-network pre-Threshold (self-funded).
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p11
Contraceptives
Certain oral and injectable female contraceptives covered from Risk.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p6
Care after a hospital stay
30-day post-hospitalisation benefit: follow-up treatment paid from Risk for up to 30 days after discharge (physiotherapy, occupational therapy, speech therapy, ultrasounds, general radiology and pathology).
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p11
Prescribed medicine (acute)
Not covered. Acute medicine — Self-funded or paid from available D2D+ benefits. (claims paid from D2D+ will not accumulate)
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Hearing aids
Not covered. Hearing aids including repairs — Paid from day-to-day or self-funded. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p20
Maternity care (out of hospital)
Maternity benefits: antenatal/postnatal consultations with a midwife, network GP or gynaecologist; 2D antenatal scans; antenatal classes; doula benefit; postnatal midwifery; Baby Programme from the 12th week of pregnancy.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p17
Over-the-counter medicine
Not covered. On flexiFED 1, day-to-day expenses are either self-funded, or they can be paid from Fedhealth Savings if the member makes use of their available back-up day-to-day savings, and from available D2D+ benefits.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p7
Blood tests (pathology)
Not covered. Pathology and medical technology — Self-funded or paid from available D2D+ benefits. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Physiotherapy and other therapists
Not covered. Physical therapy (chiropractics, biokinetics and physiotherapy) — Self-funded. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Basic X-rays
Not covered. General radiology — Self-funded or paid from available D2D+ benefits. Accumulates at cost to Threshold level.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
MRI, CT and PET scans
Specialised radiology — Unlimited at Fedhealth Rate. First R3 050 for non-PMB MRI/CT scans for the member's account.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p8
Procedures in the doctor’s rooms
Selected procedures in day wards, day clinics and doctor's rooms on the Fedhealth Day Surgery Network. Members must use facilities on the Fedhealth Day Surgery Network to avoid a R2 710 co-payment.
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p18
Screening and prevention
Screening and prevention
Screening & wellness benefit: age- and gender-specific screenings aimed to promote early detection and healthier living (flu vaccine, HIV finger prick, cancer screenings, etc.).
Fedhealth flexiFED 1 Hospital Plan Individual Option brochure 2026, p11
Conditions
The Chronic Disease List conditions are Prescribed Minimum Benefits on every medical aid. How each one works on a medical aid:
- Addison's Disease
- Asthma
- Bipolar Disorder
- Bronchiectasis
- Dysrhythmia
- Heart Failure
- Cardiomyopathy
- COPD
- Chronic Kidney Disease
- Coronary Artery Disease
- Crohn's Disease
- Type 1 Diabetes
- Type 2 Diabetes
- Epilepsy
- Glaucoma
- Haemophilia
- HIV (Human Immunodeficiency Virus)
- High Cholesterol
- Hypertension
- Hypothyroidism
- Multiple Sclerosis
- Parkinson's Disease
- Rheumatoid Arthritis
- Schizophrenia
- Systemic Lupus Erythematosus (SLE)
- Ulcerative Colitis
Fedhealth also names these on flexiFED 1 (Hospital)’s 2026 chronic list:
Questions about flexiFED 1 (Hospital)
Answered from Fedhealth’s documents.
Who is flexiFED 1 (Hospital) for?
In Fedhealth’s own words (Fedhealth flexiFED Hospital Plans Rates and Benefits Guide 2027, p5): “You generally spend very little on day-to-day medical expenses and/or prefer to self-fund these Keep your monthly medical scheme contributions low Our hospital plans come with essential, built-in day-to-day benefits, e.g. screening and wellness benefits You are covered for hospital bills”
How much does flexiFED 1 (Hospital) cost in 2027?
From 1 January 2027: R2 885 a month for the main member, R2 261 for an adult dependant and R1 056 for a child. You pay for up to 3 children.
How much is flexiFED 1 (Hospital) going up for 2027?
For the main member, from R2 603 to R2 885 a month, +10.8%.
Does flexiFED 1 (Hospital) pay for GP visits and day-to-day costs?
No. flexiFED 1 (Hospital) is a hospital plan, so day-to-day costs are your own.
How many chronic conditions does flexiFED 1 (Hospital) cover?
28: the 27 on the Chronic Disease List and others the scheme adds.
Is cancer treatment covered?
Yes, at the PMB level of care, through ICON.
Until what age can children stay on as dependants?
Up to age 27.
Will I have a shortfall if my specialist charges more?
flexiFED 1 (Hospital) pays specialists in hospital at 100% of the Scheme tariff. If a specialist charges more than that, the difference is a shortfall. Gap cover is the product that pays shortfalls.
Factual information from Fedhealth Medical Scheme’s published documents. It is not advice. Compiled by Eldon de Waal, CFA, the licensed advisor behind AURA. Catalogue v175, built 2026-10-19.