2026 Rules Active
2026 Strategy Validated
maxima EXEC: 10% Co-Pay Savings Trade
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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 R12,528 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]
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries that are not emergencies. [Source: Council for Medical Schemes Official Benefit Rules]
Common Questions
Why is maxima EXEC the best match for maxima EXEC 10% Co-Pay Threshold Acceptor?
Single R12,273/month (saves R7,120/month vs maxima PLUS). Savings R12,528, self-pay gap R9,332, threshold R21,860. After threshold: unlimited benefits with CONSISTENT 10% CO-PAYMENT. 72 total chronic conditions (27 CDL + 45 additional), cap R8,130 per beneficiary / R14,950 family then CDL unlimited. Mental health R20,000 family limit includes psychiatrist, psychologist, physical therapy combined. (Verified via Actuarial Strategy Logic 2026) [Strategy: nic-2026]
What are the hospital rules for maxima EXEC 10% Co-Pay Threshold Acceptor on maxima EXEC?
maxima EXEC 10% Co-Pay Threshold Acceptor can use any private hospital in South Africa without penalty on this plan. (Verified via Actuarial Strategy Logic 2026)
Does maxima EXEC cover maternity for Cost-Optimized Executive members?
Yes. maxima EXEC 10% Co-Pay Threshold Acceptor receives a separate 'Risk Benefit' covering 12 antenatal visits. (Verified via Actuarial Strategy Logic 2026)
maxima EXEC 10% Co-Pay Threshold Acceptor strategy verified
Covering 0 family members
2026 rates applied