2026 Rules Active
2026 Validated
High-Income, High-Utilisation Cover with Unlimited Above-Threshold Benefit
Actuarial Objective
For high-income individuals or couples with multiple chronic conditions who need very large day‑to‑day and in-hospital funding, unlimited Above Threshold Benefit and enhanced chronic lists.
Running Actuarial Simulation...
More Plan Options
Save R601 pm
Sizwe Hosmed
Titanium Executive
Strategy: Titanium "Executive": Multi-Chronic High Transfer
Upgrade for +R-65 pm
Fedhealth
maxima EXEC
Strategy: maxima EXEC 10% Co-Pay Threshold Acceptor
Key Terms for this Strategy
- Medical Savings Account (MSA)
- A fund of R34,284 included in your premium. You use this for day-to-day expenses like GP visits and scripts.
People Also Ask
If I’m diagnosed with cancer, what happens if my treatment costs go above the plan’s oncology cover amount?
Approved cancer treatment is covered over a 12-month cycle, with the first R500,000 covered; if costs exceed that amount, subsequent treatment may be paid at up to 80% of the Discovery Health Rate unless it is PMB treatment or qualifies for the plan’s extended oncology arrangements.
Does the oncology cover amount apply per year, per diagnosis, or per treatment cycle?
The oncology cover amount is described as applying over a 12-month cycle for approved cancer treatment.
Will I ever face a co-payment for oncology treatment even if I’m on the Executive Plan?
Yes—once the initial oncology cover amount is exceeded, subsequent non-PMB/non-extended treatment may be paid at up to 80% of the Discovery Health Rate (effectively leaving a possible 20% shortfall).
If my cancer treatment is a Prescribed Minimum Benefit (PMB), can it still be affected by the oncology cover amount?
PMB cancer treatment is stated as always covered in full, even if treatment costs exceed the oncology cover amount.
Do I need to register or get approval before cancer treatment will be paid from the Oncology Benefit?
Yes—cancer treatment is described as being covered on the Oncology Care Programme once treatment is approved.
If my specialist charges above the Discovery Health Rate during cancer treatment, am I protected from shortfalls?
Not necessarily—cancer-related healthcare services are stated as covered up to 100% of the Discovery Health Rate, and a co-payment/shortfall can apply if the provider charges above that rate.
If I’m stable but I’m not using a designated service provider (DSP), what is the risk for PMB cover?
Where a designated service provider is required and not used, the brochure indicates payment can drop to 80% of the Discovery Health Rate, leaving the member liable for the difference.
Is hospital cover capped overall on the Executive Plan, or could I still hit an annual hospital limit?
The brochure states there is no overall annual limit for hospital cover on the Executive Plan, but some specific treatments and benefits can have limits and rules.
Do I have to preauthorise hospital admissions to avoid payment issues?
Yes—the brochure indicates planned hospital stays should be confirmed (preauthorised), and that not doing so can affect cover except where required under defined benefits or PMBs.
If I’m travelling and have a medical emergency, is it treated differently from a normal emergency back home?
The brochure states the plan covers medical emergencies when travelling, subject to the plan’s travel/emergency benefit rules and exclusions described in the document.