2026 Rules Active

2026 Strategy Validated
myFED Band 4: Income Cliff Warning
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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
Common Questions
If I don’t nominate a GP, will my day-to-day GP visits still be paid? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
Can I see a specialist directly, or do I need a GP referral first? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
What happens if I choose a hospital that is not in the myFED Hospital Network? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
If I go to casualty for stitches or a fracture and I’m not admitted, will it still be covered? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
Are chronic medicines covered for long-term conditions like asthma, diabetes or hypertension? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
Is cancer treatment covered, and do I have to use ICON? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
Is contraception covered, and are there restrictions on what it can be prescribed for? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
How does mental health cover work on myFED (out of hospital and in hospital)? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
Are MRI/CT scans covered if I need one urgently? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
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. Strategy reference: ned-2026.
How many child dependants can I add, and until what age do they count at child rates? [myFED Income Band 4 Cliff - Corporate Escalation Trap]
The option indicates a maximum number of child dependants and applies child rates up to a stated age threshold for child dependants. Strategy reference: ned-2026.
myFED Income Band 4 Cliff - Corporate Escalation Trap strategy verified
Covering 2 family members
2026 rates applied
