2026 Rules Active
2026 Validated
R21,652+ Household Income Forces R4,052 Premium Despite Network Restrictions
Actuarial Objective
Corporate employees with household income R21,652+ paying R4,052 (M+A+A = R9,385/month family) while locked into myFED network restrictions: R2,220 specialist family limit, R2,730 non-network family cap, 30% hospital co-payment, creating affordability crisis for middle-income earners
Running Actuarial Simulation...
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Strategy: Rhythm1 Entry-Level Earner (<R9k)
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Strategy: Gold Ascend "EDO": Network Hospital Price Leverage
People Also Ask
If I don’t nominate a GP, will my day-to-day GP visits still be paid?
GP cover is structured around using a nominated contracted GP in the myFED GP Network; limited cover exists for certain non-nominated/non-contracted GP visits, and protocols/utilisation monitoring can apply.
Can I see a specialist directly, or do I need a GP referral first?
Specialist benefits depend on using the Fedhealth Specialist Network and being referred by a contracted GP; going without a referral can trigger an upfront co-payment, and non-network specialist consultations have no benefit.
What happens if I choose a hospital that is not in the myFED Hospital Network?
Hospital cover is designed around the myFED Hospital Network; voluntary use of a non-network hospital attracts a co-payment, and after emergency stabilisation you may be expected to transfer to a network hospital to avoid additional cost.
If I go to casualty for stitches or a fracture and I’m not admitted, will it still be covered?
Emergency trauma treatment in a casualty/trauma unit is paid from Risk whether or not you are admitted, but authorisation timeframes apply and non-PMB visits can attract a co-payment per visit.
Are chronic medicines covered for long-term conditions like asthma, diabetes or hypertension?
Chronic medicine cover applies to PMB CDL conditions and is funded according to formulary rules and the Medicine Price List; designated pharmacy network rules apply and non-compliant use can trigger co-payments.
Is cancer treatment covered, and do I have to use ICON?
Oncology is covered at PMB level of care at the designated service provider (ICON), subject to protocols and registration on the oncology programme; using non-DSP arrangements can trigger a co-payment.
Is contraception covered, and are there restrictions on what it can be prescribed for?
Female contraception is covered subject to an approved list and must be prescribed by a GP or gynaecologist; it is not intended for pills prescribed for acne.
How does mental health cover work on myFED (out of hospital and in hospital)?
Out-of-hospital mental health consultations are linked to the GP benefit and are limited; in-hospital mental health treatment is covered at PMB level of care at the relevant network facility, while voluntary use of non-network facilities attracts a co-payment.
Are MRI/CT scans covered if I need one urgently?
Specialised radiology is not covered as a day-to-day (out-of-hospital) benefit on myFED, but in-hospital specialised radiology can be paid from Risk subject to authorisation and an annual limit.
How many child dependants can I add, and until what age do they count at child rates?
The option indicates a maximum number of child dependants and applies child rates up to a stated age threshold for child dependants.