2026 Rules Active
2026 Validated
Unlimited Network GP Without Threshold Wait
Actuarial Objective
Families with high GP utilization leveraging flexiFED 4's unique 'from Rand 1' network GP benefit before reaching R22,308 threshold
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Market Floor
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Bonitas
BonCore
Strategy: BonCore Disaster Cover Single
Key Terms for this Strategy
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries (like hip/knee replacements) that are not emergencies.
- PMB (Prescribed Minimum Benefits)
- By law, this plan must cover the costs of 27 specific chronic conditions and emergency treatments, even though it is a basic Hospital Plan.
People Also Ask
If I land in a non-network hospital for an emergency, will Fedhealth still pay?
Emergency treatment can be accessed at any hospital, but once stabilised you may need to transfer to a network hospital to avoid network-related co-payments and penalties.
Do I have to nominate a specific GP, or can I just visit any GP when I’m sick?
Full cover rules rely on using a nominated Fedhealth Network GP, and using non-network GP routes is limited and conditional.
If I see a specialist without my GP referring me first, will the scheme still pay?
Specialist access is tied to the referral pathway, and non-referral use can trigger scheme-rule consequences (including co-payments) depending on the situation.
Is oncology fully covered, or only at a specific provider?
Oncology is funded at PMB level of care and is tied to the designated service provider arrangement (ICON), with a co-payment risk if a non-DSP route is used.
Will my cancer scans like PET-CT be covered if my doctor sends me to a non-network provider?
High-cost oncology imaging is subject to PMB/DSP rules and scheme protocols, and non-DSP use can trigger a co-payment requirement.
If I go to casualty for stitches or a fracture but I’m not admitted, will it count?
Trauma treatment in a casualty ward is covered under specific authorisation rules, and non-PMB casualty use can result in a co-payment.
Do I need authorisation for planned admissions, and what happens if I forget?
Planned hospital admissions require pre-authorisation, and late/no authorisation can lead to penalties under the scheme rules.
Are MRI/CT scans really unlimited, and do I need approval first?
MRI/CT scans are covered subject to authorisation requirements and scheme protocols, so approval rules still apply even where the benefit is described as broad.
Is depression medication covered as a chronic benefit on this plan?
Depression is listed as an additional chronic condition on this option, but formulary/DSP rules and approved medication lists still apply.
If I want a C-section for non-medical reasons, will I be penalised?
Elective (non-medically indicated) Caesarean sections are shown as attracting a co-payment on this option, so the clinical reason and authorisation pathway matter.