Fedhealth medicine benefit: 2017

Click here to compare medicine benefits across all schemes, or use the menu bar above for more options. Fedhealth home page.

Non-income limited plans

Income limited plans

Fedhealth Blue Door A: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMBs chronic: paid by scheme
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R776 R644 R369
Children: Pay for all children
Income limit: R0-R5,200 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • Unlimited if dispensed by network GP
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
6. Notes:
  • Chronic meds: if not on the formulary, 40% co-payment

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Fedhealth Blue Door B: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMBs chronic: paid by scheme
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R984 R813 R475
Children: Pay for all children
Income limit: R5,201-R8,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • Unlimited if dispensed by network GP
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
6. Notes:
  • Chronic meds: if not on the formulary, 40% co-payment

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Fedhealth Blue Door C: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMBs chronic: paid by scheme
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,380 R1,145 R522
Children: Pay for all children
Income limit: R8,501-R10,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • Unlimited if dispensed by network GP
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
6. Notes:
  • Chronic meds: if not on the formulary, 40% co-payment

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Fedhealth Blue Door D: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMBs chronic: paid by scheme
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,754 R1,375 R677
Children: Pay for all children
Income limit: R10,501-R12,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • Unlimited if dispensed by network GP
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
6. Notes:
  • Chronic meds: if not on the formulary, 40% co-payment

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Fedhealth Blue Door E: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMBs chronic: paid by scheme
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,378 R2,061 R895
Children: Pay for all children
Income limit: R12,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • Unlimited if dispensed by network GP
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
6. Notes:
  • Chronic meds: if not on the formulary, 40% co-payment

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