Fedhealth - Blue Door Plus Medical Aid Plan

Fedhealth - Blue Door Plus

Fedhealth Blue Door Plus offers salary-banded cover for low-income, first-time buyers of medical aid in South Africa. The plan provides cover for major medical procedures at state or network private hospitals. Organ transplants and renal dialysis are covered as Prescribed Minimum Benefits (PMBs) at state facilities only, and there’s cover for cancer as a PMB at designated service providers.

The plan also provides day-to-day benefits for GP and specialist consultations, dentistry, optometry, X-rays and blood tests at network providers.

In Hospital Benefits

Overall Annual Limit

Unlimited at Network up to 100% (Fedhealth Rate)

Provider

Unlimited at network hospitals only.
R11 000 co-payment on voluntary use of non-network hospitals

GP's & Specialists

GPs & specialists: Unlimited
Radiology & pathology: Unlimited
Oncology: PMBs
Organ transplants: PMBs
Dialysis: PMBs
Internal prostheses: PMBs
Mental health: R8 400

Chronic

25 conditions at network service provider: Medi-Rite Pharmacy, Dischem, Clicks or Pharmacy Direct

Out of Hospital Benefits

Saving / Day to Day / OHEB

Unlimited network GP visits, subject to protocols after 6th visit
2 specialist visits via referral only
2 non-network GP consultations per year

Pooled Day to Day Benefit

Not applicable

Threshhold / Safety Net

Not applicable

Self-Payment Gap Before Threshold

Not applicable

Above Threshold Limits

Not applicable

Maternity Care

Scans as per radiology benefit

Contributions

Contributions

Income: R1 - R5 564
Member: R844
Adult: R714
Child: R401

 

Income: R5 565 - R9 095
Member: R1 070
Adult: R901
Child: R516

 

Income: R9 096 - R11 235
Member: R1 500
Adult: R1 269
Child: R568

 

Income: R11 236 - R12 840
Member: R1 907
Adult: R1 524
Child: R736

 

Income: R12 841+
Member: R2 585
Adult: R2 284
Child: R973

 

 

 

 


Finding it difficult to make sense of all this? Not to worry, you can:

Finding it difficult to make sense of all this? Not to worry, you can:

Get free quotes & medical aid advice