Announcements

What you need to know about Topmed’s amalgamation with Fedhealth

August 1, 2019

What happens next?

After amalgamation, all Topmed members joining Fedhealth are encouraged to register online on the Fedhealth Family Room member portal to manage their Fedhealth membership, and enjoy functionalities such as submitting claims and updating personal details; staying up to date on the latest Fedhealth news; joining interesting communities; and earning rewards. Topmed members will be able to register online on the Fedhealth Family Room member portal once their membership has been activated on Fedhealth’s system.

Will we be allowed to change plans if we don’t like the Fedhealth default?

Yes, you will be allowed to select another option. You will receive a communication from Topmed explaining what you would need to do before the amalgamation takes place.

Fedhealth will allow you to change options once the amalgamation has taken place for a period of 60 days following the amalgamation. All option changes during this period will be back-dated to the amalgamation date. You will have to complete an option change form that can be obtained here. The completed form must be emailed to topmed@fedhealth.co.za. You can also change your option in the Fedhealth Family Room. Click here to register if you have not already done so. Note that you will only be able to register once the amalgamation has been approved.

If you belong to a paypoint then you would need to have your option change done through your HR department as these option changes will not be done through the Fedhealth Family Room or customer contact centre.

How will I know which plan is best for me to join if I am not satisfied with my default option?

You can phone the Fedhealth Customer Contact Centre on 0860 002 153 and select the option for ‘Former Topmed members’ to ask one of the consultants for advice.

You can also visit the microsite that’s accessible from the Fedhealth website home page to do a needs and lifestyle analysis to see which flexiFED option is the best fit for you. You can also find more detail about the different Fedhealth options available on the Fedhealth website. You could also consult with your broker to discuss an option best suited to you.

I am planning to have surgery after the date of amalgamation. From which scheme must I obtain authorisation for the procedure?

If you have already received authorisation from Topmed:
Fedhealth will receive a data file that will include your current authorisation, and their system will be updated with the information to ensure that your procedure will be covered by Fedhealth.

Do I need to change providers due to this change?
Fedhealth will honour all existing authorisations including provider arrangements even if they are not Fedhealth network providers. This means that Fedhealth will not apply a co-payment for non-usage of a Fedhealth network hospital or specialist.

If you have not received authorisation from Topmed:
Procedures before amalgamation date: You need to contact Topmed to obtain authorisation and Topmed will cover the procedure according to the benefits and rules of your Topmed option. This will also apply if your hospitalisation extends after the date of amalgamation. Closer to the amalgamation, Fedhealth will receive a data file that will include your current authorisation. Fedhealth will update their system with the information to ensure your procedure will be covered. This means that they will know exactly for which procedure you have obtained authorisation, including which providers and hospital you will be using.

Procedures after amalgamation date: Please contact Fedhealth 48 hours before your procedure is booked, and they will provide authorisation. You can call the Fedhealth Customer Contact Centre on 0860 002 153 or use the Fedhealth Family Room for authorisation.

Who will be paying for these claims?
Topmed will be responsible for any part of the claim up to the date of amalgamation and Fedhealth will be responsible for any part of the claim after the date of amalgamation.

Please download this full FAQ guide in order to find answers to many more questions.