2026 Rules Active
2026 Strategy Validated
flexiFED 3: R4K Extra via Health Assessment
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Actuarial Strategy Reference
This strategy is generated based on the 2026 Council for Medical Schemes (CMS) registered rules and actuarial pricing matrices.
VERIFIED: 2025-12-20 | SOURCE: SCHEME_BENEFIT_GUIDE_2026
Similar Situations
Key Terms Explained
Key Terms for this Strategy
- Medical Savings Account (MSA)
- A fund of R10,416 included in your premium. You use this for day-to-day expenses like GP visits and scripts. [Source: Council for Medical Schemes Official Benefit Rules]
Common Questions
Is my hip replacement fully covered? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
While the surgery has no co-payment if you use a Contracted Provider, the internal prosthesis (the device itself) is strictly limited to R28,760. You will be liable for any device cost above this amount, which is often significant. Strategy reference: ock-2026.
What is the limit for cancer treatment in 2026? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
Oncology is covered up to R360,850 per family per year at ICON. A 25% co-payment applies if you do not use a Designated Service Provider. Strategy reference: ock-2026.
Do I have to pay upfront for an MRI scan? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
Yes, you must pay the first R3,050 for any non-PMB MRI or CT scan, whether the scan is performed in or out of hospital. Strategy reference: ock-2026.
Is there a co-payment for a gastroscopy or colonoscopy? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
If performed in hospital, you will pay R5,540. However, if the scope is performed in a practitioner's rooms (non-surgical procedure), it is covered in full. Strategy reference: ock-2026.
Am I restricted to specific hospitals? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
No, this is the standard flexiFED 3 plan, which allows you to use 'Any' private hospital without an admission penalty. Strategy reference: ock-2026.
How many chronic conditions does flexiFED 3 cover? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
You are covered for 34 conditions in total: the 27 Prescribed Minimum Benefit (CDL) conditions plus 7 additional conditions including Acne, ADHD, and Depression. Strategy reference: ock-2026.
What happens if I go to the emergency room? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
Trauma treatment is paid from Risk (unlimited up to the Fedhealth Rate). However, an R880 co-payment applies for non-PMB visits if you are not admitted to the hospital. Strategy reference: ock-2026.
Does the plan cover my gynaecologist visits during pregnancy? [flexiFED 3 D2D+ Health Risk Assessment Unlocker]
Yes, the plan covers 12 antenatal or postnatal consultations with a midwife, network GP, or gynaecologist, funded from Risk. Strategy reference: ock-2026.
flexiFED 3 D2D+ Health Risk Assessment Unlocker strategy verified
Covering 2 family members
2026 rates applied