On Thursday, the 19th of September 2019, Fedhealth Medical Scheme (‘Fedhealth’) launched their benefit and contribution changes for 2020. The scheme will implement an average weighted increase of 10.6%.

Fedhealth highlighted higher than excepted medical inflation as the main driver for the increase in contributions.

We have analysed the benefit changes that were introduced by Fedhealth and have compiled key highlights for your ease of reference. Please look out for the upcoming member information sessions during which we will unpack the detail and the impact of these changes and how they will affect you. Our consultants will be available for one-on-one interaction sessions to assist you with appropriate option selection.

2020 CONTRIBUTION INCREASE 10.6%

  • Chronic benefit enhancements
  • Benefit Maximiser renamed as Threshold benefit
  • Enhanced maternity benefits on maxima EXEC and maxima PLUS
  • Introduction of maternity benefits on flexiFED 4
  • Enhancement of the toddler programme
  • Additional chronic condition added on flexiFED 3, maxima EXEC and maxima PLUS
  • Introduction of wisdom tooth removal on flexiFED 1
  • Implementation of the Designated Service Provider (DSP) policy
  • Increment on the MediVault funds
  • Versatility of the MediVault
BENEFIT CHANGES
  • Benefit Maximiser renamed Threshold Benefit
  • The Threshold will be lower than the annual MediVault allocation therefore eliminating the potential self-payment gap between full usage of MediVault and the start of Threshold Benefit
  • Inflationary increase has been applied to all benefit limits (threshold levels, savings and OHEB) on Maxima Plus. On maxima EXEC grid, member procedure and non-network co-payments will also have an inflationary increase
  • MyFED contracted GP visits will remain unlimited with utilisation being monitored from the 10th visit as opposed to the 6th visit during 2019
  • The maternity benefits available on flexiFED 3 , which are paid from risk, have been added  to flexiFED 4
  • The Toddler Programme has been enhanced to include one (1) consultation with a pediatrician per annum on maxima EXEC, maxima PLUS and flexiFED 4
  • Extraction of wisdom teeth on flexiFED 1 has been introduced with a co-payment of R4,400.
CHRONIC CHANGES
An updated Designated Service Provider (‘DSP’) policy will be implemented for the chronic disease benefits across the FlexiFEDrange as follows:
  • Updated list of DSPs

  • FlexiFED 4, maxima EXEC and maxima PLUS will now include Acne for child dependants up to the age of 21 with Allergic Rhinitis and Eczema for children up to the age of 18.
  • ADHD, Depression, Generalised Anxiety Disorder and Post-Traumatic Stress Disorder will be covered up to R3,000 per family, per annum, on flexiFED3
  • The number of chronic conditions covered on the flexiFED 3maxima Exec and maxima Plus increased to 34, 56 and 70 respectively.

MEDIVAULT ENHANCEMENT

  • The funds available for MediVault have been increased for 2020 however, members will still have the choice on how to use available funds
  • MediVault funds have been standardised across all options. Members on GRID and Elect will have the same MediVault amount available as the main option
  • Members can now use the MediVault to fund all co-payments including the use of non-network hospitals and for appliances with nappi codes
  • Members can now determine their own payback period for funds used from the MediVault to a maximum of 12- months
  • MediVault fund repayments can be done directly from payroll empowering companies to determine the cap of the
    MediVault for employees during the year based on the company’s policy and subsidy levels

ZEST CONTRIBUTIONS