At a glance
- Plan type
- Comprehensive plan
- Hospitals
- Any private hospital
- Hospital and specialists
- 100% of Scheme tariff
- Savings account
- R0 a month for the main member (0%)
- Chronic conditions
- 85
- 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 Executive Plans Rates and Benefits Guide 2027, p7. Its 2027 benefits are not in our records yet. You pay for up to 3 children.
| Member | 2026 | 2027 | Change |
|---|---|---|---|
| Main member | R19 393 | R21 537 | +11.1% |
| Adult dependant | R16 739 | R18 590 | +11.1% |
| Child | R5 992 | R6 655 | +11.1% |
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
Any hospital
Hospitals
2027 not in our records yet. 2026: Any hospital
(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)
Chronic and cancer
Chronic conditions
85 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
Chronic conditions
2027 not in our records yet. 2026: 85 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
(2026)
Day to day
Medical savings account
0% of your contribution goes into a savings account for day-to-day costs.
Medical savings account
2027 not in our records yet. 2026: 0% of your contribution goes into a savings account for day-to-day costs.
(2026)
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
Network GP: Paid from Savings then unlimited from Risk. Once Savings is depleted, Fedhealth gives unlimited cover for GP consultations at a Network GP. 10% co-payment in Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
GP visits
2027 not in our records yet. 2026: Network GP: Paid from Savings then unlimited from Risk. Once Savings is depleted, Fedhealth gives unlimited cover for GP consultations at a Network GP. 10% co-payment in Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5 (2026)
Specialist visits
Network medical specialist consultations and visits (excluding psychiatrists): Paid from Savings. Accumulation to and refund from Threshold up to cost. 10% co-payment if GP referral not obtained.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Specialist visits
2027 not in our records yet. 2026: Network medical specialist consultations and visits (excluding psychiatrists): Paid from Savings. Accumulation to and refund from Threshold up to cost. 10% co-payment if GP referral not obtained.
Fedhealth maxima PLUS Individual Option brochure 2026, p5 (2026)
Prescribed medicine (acute)
Acute medicine — Paid from Savings and Threshold. R8 190 per beneficiary per year, R15 160 per family per year before and after Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Prescribed medicine (acute)
2027 not in our records yet. 2026: Acute medicine — Paid from Savings and Threshold. R8 190 per beneficiary per year, R15 160 per family per year before and after Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5 (2026)
Basic dentistry
Basic dentistry: Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Basic dentistry
2027 not in our records yet. 2026: Basic dentistry: Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5 (2026)
Eyes (optometry)
Optical benefit — Paid from Savings and Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Eyes (optometry)
2027 not in our records yet. 2026: Optical benefit — Paid from Savings and Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5 (2026)
Basic X-rays
General radiology — Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Basic X-rays
2027 not in our records yet. 2026: General radiology — Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5 (2026)
Blood tests (pathology)
Pathology and medical technology — Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Blood tests (pathology)
2027 not in our records yet. 2026: Pathology and medical technology — Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5 (2026)
Full benefit list
Every benefit we hold for maxima PLUS, in Fedhealth’s own wording, from its 2026 documents. Fedhealth’s full 2027 list is not in our records yet.
In hospital
Cancer treatment
ONCOLOGY LIMIT Unlimited at preferred provider and paid from Enhanced protocol.
Fedhealth maxima PLUS Individual Option brochure 2026, p11
MRI, CT and PET scans
MRI/CT: Unlimited at Fedhealth Rate; first R3 050 for non-PMB MRI/CT scans for the member's account. Oncology PET/PET-CT: 2 per family per annum, R5 670 co-payment for non-PET-Network provider.
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Medicine on discharge
7 days' supply of take-home medication, to a maximum of R412 per beneficiary per admission.
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Travel cover
Emergency Medical Benefit: Europ Assistance — R5 million per person per journey (up to 45 days).
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Hospital stay and theatre
Unlimited at negotiated tariff.
Fedhealth maxima PLUS Individual Option brochure 2026, p15
Surgery and anaesthetics
Up to the Fedhealth Rate; Other Healthcare Professionals paid up to 300% of the Fedhealth Rate (vs EXEC 100%).
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Organ and stem cell transplants
Unlimited (bone marrow / stem cell transplantation + immunosuppressive medication, biopsies, scans); corneal grafts R37 430 per beneficiary.
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Dialysis
Unlimited; DSP required, 40% co-payment if a non-DSP is used.
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Internal prostheses
Itemised internal-prosthesis sub-limits (several higher than EXEC: joint replacement R51 340, cardiac pacemakers R67 530); combined limit for all unlisted internal prosthesis R41 650.
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Step-down and sub-acute care
Sub-acute and physical rehabilitation facilities and nursing services: Unlimited at negotiated tariff.
Fedhealth maxima PLUS Individual Option brochure 2026, p15
Palliative care
Terminal Care Benefit R35 570; Alignd Serious Illness Benefit (incl. end-of-life care).
Fedhealth maxima PLUS Individual Option brochure 2026, p15
MRI, CT and PET scans
Specialised radiology Unlimited at the Fedhealth Rate; first R3 050 per non-PMB MRI/CT for the member's account; specific authorisation required.
Fedhealth maxima PLUS Individual Option brochure 2026, p16
Planned PMB procedures
Pre-authorisation for all planned admissions; PMBs in full via network providers/DSPs, else up to the Fedhealth Rate with co-payment.
Fedhealth maxima PLUS Individual Option brochure 2026, p14
Mental health admissions
R46 500 per family; PMB up to 21 days admission or 15 out-of-hospital consultations (higher than EXEC's R36 910).
Fedhealth maxima PLUS Individual Option brochure 2026, p10
Birth (in hospital)
Confinement: Unlimited; network delivery in full.
Fedhealth maxima PLUS Individual Option brochure 2026, p15
HIV/AIDS
HIV/AIDS is managed scheme-wide through the Scheme's HIV infection management programme (Aid for AIDS / AfA) adopted under Main Rule 4.43; the programme applies to all beneficiaries on every option, and members registered on AfA have access to the HIV medicine benefit. HIV/AIDS is a Prescribed Minimum Benefit, so cover is compulsory on this option.
fedhealth medical scheme main rules id 1104844 2026, p7
Day to day
GP visits
Network GP: Paid from Savings then unlimited from Risk. Once Savings is depleted, Fedhealth gives unlimited cover for GP consultations at a Network GP. 10% co-payment in Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
GP visits
Non-network GP: Paid from Savings and Threshold. Does not accumulate to Threshold. Paid from Threshold up to the Fedhealth Rate.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Specialist visits
Network medical specialist consultations and visits (excluding psychiatrists): Paid from Savings. Accumulation to and refund from Threshold up to cost. 10% co-payment if GP referral not obtained.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Psychologist and counselling visits
Psychiatrists: Paid from Savings; paid from Threshold up to the Additional Medical Services limit of R20 000 per family per year. 10% co-payment if no GP referral.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Basic dentistry
Basic dentistry: Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Specialised dentistry
Advanced dentistry: R8 530 per beneficiary per year, R25 470 per family per year before and after Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Auxiliary services
Additional medical services: paid from Savings; from Threshold up to R20 000 per family per year.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Casualty visits
Emergency treatment at a casualty ward paid whether admitted or not (unlimited up to the Fedhealth Rate). A co-payment of R880 per visit for non-PMBs applies.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Chronic medicine (Chronic Disease List)
Unlimited cover for CDL conditions. Any pharmacy on maxima. Basic formulary or 30% co-payment.
Fedhealth maxima PLUS Individual Option brochure 2026, p11
Care after a hospital stay
30-day post-hospitalisation benefit paid from Risk (physiotherapy, OT, speech, ultrasound, general radiology, pathology).
Fedhealth maxima PLUS Individual Option brochure 2026, p11
Prescribed medicine (acute)
Acute medicine — Paid from Savings and Threshold. R8 190 per beneficiary per year, R15 160 per family per year before and after Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Alternative healthcare
Alternative healthcare (acupuncture, homeopathy, naturopathy, osteopathy, phytotherapy) — Paid from Savings and Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Medical appliances
Appliances, external accessories and orthotics — Paid from Savings and Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Chronic medicine (other conditions)
Depression medication: R2 400 per beneficiary per annum subject to an approved list of medication.
Fedhealth maxima PLUS Individual Option brochure 2026, p11
Contraceptives
Certain oral and injectable female contraceptives covered from Risk.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Hearing aids
Hearing aids including repairs — Paid from Savings and Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Maternity care (out of hospital)
Maternity and childhood benefits — antenatal and postnatal consultations, scans, and Baby Programme.
Fedhealth maxima PLUS Individual Option brochure 2026, p10
Eyes (optometry)
Optical benefit — Paid from Savings and Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Over-the-counter medicine
Over-the-counter medicine — Paid from Savings.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Blood tests (pathology)
Pathology and medical technology — Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Physiotherapy and other therapists
Physical therapy (chiropractics, biokinetics and physiotherapy) — Paid from Savings and Threshold.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Basic X-rays
General radiology — Paid from Savings and Threshold. Unlimited once Threshold is reached.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
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 maxima PLUS Individual Option brochure 2026, p5
Procedures in the doctor’s rooms
Selected procedures in day wards, day clinics and doctor's rooms on the Fedhealth Day Surgery Network.
Fedhealth maxima PLUS Individual Option brochure 2026, p5
Screening and prevention
Screening and prevention
Screening & wellness benefit — lifestyle, wellness and physical screenings tailored to age group.
Fedhealth maxima PLUS Individual Option brochure 2026, p6
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 maxima PLUS’s 2026 chronic list:
- ADHD
- Allergic Rhinitis
- Ankylosing Spondylitis
- Anxiety Disorders
- Depression
- Eczema / Atopic Dermatitis
- Endometriosis
- Gastroesophageal Reflux Disease (GERD)
- Gout
- Menopause & HRT
- Obsessive-Compulsive Disorder (OCD)
- Osteoarthritis
- Osteoporosis
- Psoriasis
- PTSD
- Stroke
Others on its list have no page of ours yet.
Questions about maxima PLUS
Answered from Fedhealth’s documents.
Who is maxima PLUS for?
In Fedhealth’s own words (Fedhealth Executive Plans Rates and Benefits Guide 2027, p5): “Medical aid doesn’t get more comprehensive than maxima PLUS! Premium cover with a balanced approach to comprehensive healthcare. Ideal for members seeking extensive benefits with excellent value.”
How much does maxima PLUS cost in 2027?
From 1 January 2027: R21 537 a month for the main member, R18 590 for an adult dependant and R6 655 for a child. You pay for up to 3 children.
How much is maxima PLUS going up for 2027?
For the main member, from R19 393 to R21 537 a month, +11.1%.
Does maxima PLUS have a medical savings account?
Yes. 0% of your contribution goes into a savings account, which pays for day-to-day costs such as GP visits and medicine.
How many chronic conditions does maxima PLUS cover?
85: the 27 on the Chronic Disease List and others the scheme adds.
Until what age can children stay on as dependants?
Up to age 27.
Will I have a shortfall if my specialist charges more?
maxima PLUS 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.