CompCare ExtraCare Medical Aid Plan (🇿🇦 2026)
Overall, the CompCare ExtraCare Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and extensive cover to up to its members. The CompCare ExtraCare Medical Aid Plan starts from R6,968 ZAR.| 🌎 International Cover | Subject to benefits per individual benefit category. |
| 👤 Main Member Contribution | R6,968 |
| 👥 Adult Dependent Contribution | R6,968 |
| 🍼 Child Dependent Contribution | R2,438 |
| ↪️ Gap Cover | No, optional extra. |
| 💶 Prescribed Minimum Benefits | ✅ Yes |
| 📉 Screening and Prevention | ✅ Yes |
| 💶 Medical Savings Account | ✅ Yes |
| ➡️ Hospital Cover | Unlimited |
| ☑️ Annual Limit | Unlimited |
CompCare ExtraCare Plan - 7 Key Point Quick Overview
- ☑️ CompCare ExtraCare Plan Overview
- ☑️ CompCare ExtraCare Plan Contributions and Day-to-Day Benefits
- ☑️ ExtraCare Plan Benefits and Cover Comprehensive Breakdown
- ☑️ ExtraCare Plan Exclusions and Waiting Periods
- ☑️ CompCare ExtraCare Plan vs. Similar Plans from Other Medical Schemes
- ☑️ Our Verdict on The ExtraCare Plan
- ☑️ ExtraCare Plan Frequently Asked Questions
CompCare ExtraCare Plan Overview
💙 The CompCare ExtraCare medical aid plan is one of 7, starting from R6,968 ZAR and providing comprehensive day-to-day benefits, extensive cover for 40 chronic conditions, emotional wellness benefits, active lifestyle programs, and more.
👉🏿 Other CompCare Plans include:
- 🏆 ExecuCare
- 🏆 ExecuCare Plus
- 🏆 UltraCare Plus
- 🏆 UltraCare
- 🏆 ExtraCare
- 🏆 SaverCare Plus
- 🏆 SelfCare Plus
- 🏆 DigiCare
- 🏆 SelfCare
- 🏆 SuperCare+
- 🏆 SaverCare
CompCare ExtraCare Plan Contributions and Day-to-Day Benefits
ExtraCare Contributions
| 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| R6,968 | R6,968 | R2,438 |
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ExtraCare Day-to-Day Benefits
| 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| R6,970 | R4,890 | R2,490 |
ExtraCare Day-to-Day Extender Benefit
| 👤 Per Beneficiary | 👥 Per Family |
| R6,970 | R10,880 |
ExtraCare Plan Benefits and Cover Comprehensive Breakdown
ExtraCare In-Hospital Benefits
| 🟥 Hospitalization (Private Hospitals, Nursing Homes) | Covered up to 100% of the scheme rate. Any Netcare or Mediclinic private hospital. Subject to pre-authorisation and scheme protocols. |
| 🟧 Overall Annual Limit | Unlimited |
| 🟨 GPs and Specialists | Covered up to 100% of the scheme rate. Subject to pre-authorisation and scheme protocols. |
| 🟩 Medication in-hospital | Covered up to 100% of the scheme rate. |
| 🟦 Medication upon discharge from the hospital | Subject to Reference Pricing (RP) and Formularies. Limited to 7 days’ supply. |
| 🟪 Surgical Prostheses | Subject to pre-authorisation and scheme protocols. Limited to an overall limit of R43,680. Sub-limits will apply according to categories. |
| 🟥 Auxiliary Services | Covered up to 100% of the scheme rate. Limited to combined sub-limit of R5 200 PMF, in-and-out of hospital. Subject to pre-authorisation and protocols. Separate pre-authorisation number is required - claim will not be paid under hospital pre-authorisation. 20% co-payment will apply if not pre-authorised. |
| 🟧 Psychiatric In-hospital Treatment | Covered up to 100% of the scheme rate. Subject to pre-authorization, protocols, and PMBs. Up to a maximum of 21 days’ admission OR 15 Consultations which will first be paid from the day-to-day benefit, thereafter it is paid from risk. |
| 🟨 Psychology (non-psychiatric admissions) | Limited to R3 260 per PMF. Subject to pre-authorisation and protocols. |
| 🟩 All specialized radiology (MRI scans & CT scans) | Covered up to 100% of the scheme rate. Pre-authorisation and medical motivation required for MRI, CT and high-resolution CT scans. Limited to R31 200 PMF unless otherwise pre-authorised. R3 950 co-payment for each scan. Combined limit in-and-out of hospital. |
| 🟦 Basic Radiology | Covered up to 100% of the scheme rate. Unlimited cover. Subject to scheme protocols. |
| 🟪 Pathology | 100% of the scheme rate. Subject to scheme protocols. Combined in- and-out of hospital limit of R43 370 PMF. |
| 🟥 Confinements for Maternity | Covered up to 100% of the scheme tariff. Subject to pre-authorization and protocols. |
| 🟧 Rehabilitation in-hospital (Alcoholism, Drug Dependence, Narcotics) | Unlimited for PMBs. Subject to pre-authorisation and protocols. |
| 🟨 Organ Transplants, Plasmapheresis, Renal Dialysis | Unlimited for PMBs. Subject to pre-authorisation and protocols. DSP may apply. |
| 🟩 Professional Sports Injuries | 100% of the scheme rate. Subject to pre-authorisation and protocols. |
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ExtraCare Hospitalisation Alternatives
| 🅰️ Oncology (Chemotherapy & Radiotherapy) | 100% of the scheme rate. Unlimited at our oncology DSP. Subject to pre-authorisation and protocols. Oncology formulary applies. |
| 🅱️ Biological agents and Specialised Medication | Pre-authorisation required. R192 400 PMF. Protocols apply. 25% co-payment on non- PMB medicines. |
| ⬇️ Step-down facilities, hospice, rehabilitation | 100% of the scheme rate. Unlimited cover. Subject to pre-authorisation, clinical guidelines and protocols. |
| 🩺 Surgical Procedures performed out-of-hospital | 100% of the scheme rate. Unlimited cover. Subject to pre-authorisation, clinical guidelines and protocols. |
| 🧬 Refractive Eye Surgery | 100% of the scheme rate. Paid from available day-to-day benefit. Subject to available optometry benefit amount of R6 760 PMF. |
| 🩹 Wound care instead of hospitalization | 100% of the scheme rate. Unlimited cover. Subject to pre-authorisation, clinical guidelines and protocols. |
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ExtraCare Day-to-Day Benefits
| 📌 Day-to-day Benefits and Limits | Specified day-to-day benefits will be paid from the day-to-day benefit: P: R6 970 A: R4 890 C: R2 490 Out-of-hospital radiology, pathology, basic dentistry, physiotherapy and biokinetics paid from the day-to-day Extender Benefit to amounts of: PB: R6 970 PMF: R10 880 Optometry benefit: R6 760 PMF |
| 📍 General Practitioner (GPs) Consultations | Covered up to 100% of the scheme rate. Subject to the Day-to-Day Benefit. Children <6 years receive unlimited GP visits. |
| 👩⚕️ Specialist Consultations | Covered up to 100% of the scheme rate. Paid from the Day-to-Day Benefit. Members must be referred by a GP or face a 30% co-payment. |
| 💊 Chronic Medicine | 100% of reference price. First paid from day-to-day benefit. Scheme will cover costs once day-to-day benefit is depleted. DSP pharmacies apply. Subject to formularies, protocols and pre-authorisation. 25% co-payment for non-formulary medicine and use of non-DSP pharmacy. (27 CDL conditions) Medicine for non-CDL conditions: 13 non-CDL conditions. 100% of reference price. Paid from day-to-day benefit. DSP pharmacies apply. Subject to formularies, protocols and preauthorisation. 25% co-payment for non-formulary medicine. Cover is also provided for the 27 listed CDL conditions. |
| ☑️ Acute Medicine (Schedule 3>) | Paid from the Day-to-Day Benefit. There is a 25% co-payment for non-generic products. Subject to the MMAP. RP applies. |
| ✅ Over the Counter (OTC) Medicine | Paid from the Day-to-Day Benefit. Limited to R320 per event. RP applies. |
| 📈 Basic Radiology (Black and White X-Rays & Ultrasounds) | Covered up to 100% of the scheme rate. Paid from the day-to-day Extender Benefit. Combined benefit with pathology, basic dentistry, biokinetics and physiotherapy to amount of: PB: R6 970 PB to a maximum of R10 880 PMF. Combined in-and-out of hospital limit of R43 370 PMF. Referral by a GP is required to avoid a 35% co-payment |
| 📉 Specialized Radiation (MRI scans & CT scans) | Covered up to 100% of the scheme rate. Pre-authorisation and medical motivation are required for MRI, CT and High-resolution CT scans. Limited to R31 200 PMF unless otherwise pre-authorised. R3 950 co-payment applies for each scan. Combined limit in-and-out of hospital. |
| 📊 Pathology | Covered up to 100% of the scheme rate. Overall limit: Combined in- and-out of hospital limit of R43 370 PMF. Subject to protocols. |
| 🪥 Conservative Dentistry - Consultations - Preventative Care - Fillings - Extractions - Wisdom Teeth - Root Canal Treatment - Infection Control | Covered up to 100% of the scheme rate. Paid from the day-to-day Extender Benefit. Combined benefit with radiology, biokinetics and physiotherapy to the amount of R6 970 PB to a maximum of R10 880 PMF. |
| 🦷 Specialized Dentistry - Maxillo-facial and oral surgery - In and Out-of-hospital combined limit | Covered up to 100% of the scheme rate. Paid from day-to-day Benefit. Co-payment of R2 080 applies. (Quotation must be submitted for approval prior to commencement of treatment. Orthodontic treatment for patients older than 18 is excluded. |
| 😎 Optometry | Limited to one visit per beneficiary every 2 years. Optometry benefit: R6 760 PMF. |
| 🤓 Lenses and Contact Lenses | 100% of the scheme rate. Sub-limit of R1 190 for lenses or contact lenses PB, included in the R6 760 PMF optometry benefit amount, every 24 months. Subject to protocols. |
| 🥸 Frames | 100% of the scheme rate. Available benefit of R650 PB, included in the R6 760 PMF optometry benefit amount, every 24 months. |
| 1️⃣ Allied Services - Speech Therapists - Social Workers - Podiatrists, etc. | Covered up to 100% of the scheme rate. Paid from the Day-to-Day Benefit. Biokinetics and physiotherapy paid from day-to-day Extender Benefit, limited to a collective sub-limit of R5 200 PMF, in-and-out of hospital. |
| 2️⃣ Clinical Psychologists | 100% of the scheme rate. Limited to the day-to-day Benefit. PMB benefit: Up to a maximum of 21 days’ admission OR 15 consultations. The 15 consultations will first be paid from day-to-day Benefit, thereafter covered by the Scheme. |
| 3️⃣ Surgical and Medical Appliances - Wheelchairs - Crutches - Glucometers - Artificial eyes - External fixators | Covered up to 100% of the scheme rate. Pre-authorisation is required. Subject to sub-limits and protocols. Paid from the Day-to-Day Benefit. |
| 🧠 Psychiatry | 100% of the scheme rate. Limited to the day-to-day Benefit. PMB benefit: Up to a maximum of 21 days’ admission OR 15 consultations. The 15 consultations will first be paid from day-to-day Benefit, thereafter covered by the Scheme. |
| 💗 Psychosocial Counselling | Paid from risk. Unlimited telephonic counseling sessions through the Universal Wellness Care Centre Member can opt for referral to one-on-one sessions with qualified psychologists, social workers, or registered counselors up to three referral sessions PB per year. |
| 😮💨 Oxygen Home Ventilation | Covered up to 100% of the scheme rate. Paid from the Day-to-Day Benefit. Subject to protocols and preauthorisation. |
| 🏠 Home Nurse Visits | Covered up to 100% of the scheme rate. Subject to protocols and preauthorisation. Paid from the Day-to-Day Benefit. |
| 🤰 Antenatal Classes | Covered up to 100% of the scheme rate. Subject to the AFB. Limited to 12 antenatal classes and a lactation consultation with a midwife and limited to R1 870 per pregnancy. |
| 👶 Antenatal Visits and Scans | Covered up to 100% of the scheme rate. Limited to 12 visits with a GP, midwife, or specialist. The benefit is paid from risk. Limited to 2 x 2D fetal scans per beneficiary per year. Members can opt for one 3D scan, which is paid at the rate of a 2D scan. A maternity bag is issued once a pregnant member registers for the maternity program. |
| 🚑 Emergency roadside assistance and ambulance transport (Netcare 911) | Covered up to 100% of the scheme rate. Netcare 911 must authorize non-emergency transportation within 24 hours or risk a 25% co-payment. |
| ✈️ International Travel Benefit (Healthcare services outside South Africa) | Subject to benefits per individual benefit category. All claims are paid according to South African rates. Members must register their journey and get a travel certificate to qualify for cover. |
| 🏥 Hospital Emergency room and casualty emergency visits (no admission and excluding facility fees) | Paid from the AFB. |
| ✔️ Lipogram | Limited to one fasting lipogram per beneficiary 20 years> once every 5 years. |
ExtraCare Wellness, Lifestyle, and Preventative Care Benefits
| 👩⚕️ GP Wellness Consultation | Limited to one visit per beneficiary yearly. |
| 🩸 Blood Pressure, Blood Sugar, Cholesterol, BMI, and Waist Circumference | Limited to one measurement per beneficiary yearly for those 18 years>. |
| 🎗️ Rapid HIV Test | One test per beneficiary yearly. |
| 🤧 Flu Vaccine | One vaccine per beneficiary yearly. |
| 💉 Tetanus Vaccine | One injection as required. |
| 🅰️ Prostate Specific Antigen (PSA) | One per male beneficiary 40 years>. |
| 🅱️ Bowel Cancer Screening | One screening per beneficiary between 45 and 75 every two years. |
| 📌 Glaucoma Test | One per beneficiary per year. |
| 📍 Pap Smear | One per female beneficiary 18 years> once yearly. |
| 🟥 Mammogram | One test per female beneficiary 35 years> every two years. |
| 🟧 HPV Vaccine | One course per female beneficiary between 12 and 18 years per lifetime. |
| 🟨 Adult Pneumococcal Vaccine | Per beneficiary as required. Subject to pre-approval and protocols. |
| ⚽ Fitness Assessment and Exercise Prescription | Access to Universal’s Network of biokineticists for annual fitness assessments, virtual consultations, exercise prescription and regular monitoring. One additional assessment per pregnant member per pregnancy. Strict protocols apply. |
| 🍎 Nutritional Assessment and Healthy Eating Plan | Access to Universal’s Network of dietitians for annual assessment, virtual consultations, healthy eating plan prescription and regular monitoring. One additional assessment per pregnant member per pregnancy. Strict protocols apply. |
| 🤰 Additional Assessment for pregnant members | Limited to one additional assessment. Strict protocols will apply. |
| 🟩 Contraceptives (Oral/IUD device) | Up to the age of 55 years. 13 scripts to a maximum of R3 680, or IUD to a maximum of R3 680. |
| 🟦 Home Test Bundle | One Covid test; One Urinary tract test; One Ovulation test; One pregnancy test. Overall limit of R360 |
| 🟪 Pulse Oximeter | Limited to R880 per family. |
| 😮💨 Nebulizer | Limited to R570 per family. |
| 🌡️ Thermal Thermometer | Limited to R470 per family, |
| 🚼 Antenatal visit with a GP, specialist or midwife | 100% of the scheme rate. 12 antenatal visits. |
ExtraCare Newborn to Adult Benefit
| 👶 Newborn Screenings and Paediatric Consultations | Newborn screenings: Hearing screening and congenital hypothyroidism test. Paediatric consultations: Three visits to track development and milestones. |
| 💙 Baby Wellness Visit | Two visits yearly for children between 4 weeks and 18 months. Members must use a DSP. |
| 💉 Childhood Immunisations | Available for children up to 12 years old, as per the Department of Health. |
| 🎓 School Readiness Assessment | Psychometric testing (ages 5-7). Preschool eye and hearing screenings (ages 5-6). Dental screenings (ages 5-7). |
| 🏈 Kids Active Benefit | Fitness assessment and exercise plan for children aged 8-12 with Universal Network biokineticist. SporTeen: Annual fitness assessment, virtual consultations, and exercise plan for children aged 13-17 with a Universal Network biokineticist. |
| 🍎 Kids Nutritional Benefit | Access to dietitian for assessments and a healthy eating plan for children aged 8-15. |
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ExtraCare Chronic Conditions Covered
The following chronic conditions are covered under the SELFSURE plan:- ☑️ Addison’s disease
- ☑️ Angina
- ☑️ Ankylosing spondylitis
- ☑️ Asthma
- ☑️ Bipolar mood disorder
- ☑️ Bronchiectasis
- ☑️ Cardiac arrhythmias
- ☑️ Cardiomyopathy
- ☑️ Chronic renal failure
- ☑️ Congestive cardiac failure
ExtraCare Plan Exclusions and Waiting Periods
ExtraCare Exclusions
The following are some of the exclusions on the CompCare ExtraCare Plan:- ☑️ The scheme will not pay for expenses that exceed the annual maximum benefit.
- ☑️ A general waiting period of 3 months may be applied to new members and their dependents according to the scheme rules.
- ☑️ According to the scheme rules, a condition-specific waiting period of up to 12 months may be applied for pre-existing sickness conditions.
- ☑️ The scheme will not cover any costs incurred during waiting periods.
- ☑️ Certain professional fees and expenses incurred by healthcare professionals will not be covered, such as after-hours consultations at the member’s choice, unattended appointments, interest charges by healthcare providers, costs incurred for insurance medical purposes, fees for medical reports, and motivations unless required by the scheme, and discretionary conditions and services with unauthorized hospital admissions.
- ☑️ Costs for services rendered by unregistered professionals or institutions, except state or provincial hospitals registered under South African law, will not be covered.
ExtraCare Waiting Periods
Prospective members must disclose all details of any past medical condition or treatment. Furthermore, waiting periods are applied when joining the scheme or registering new dependents. In terms of the CompCare ExtraCare plan, the following applies:- ☑️ A general waiting period of 3 months and a 12-month condition-specific waiting period may be imposed for pre-existing medical conditions if not covered on a medical scheme for more than 90 days.
- ☑️ A condition-specific waiting period of 12 months may be imposed if applying for membership within 3 months of termination from a previous scheme and having been on a medical scheme for less than 24 months.
- ☑️ If applying for membership within 3 months of termination from a previous scheme and having been on a medical scheme for more than 24 months, a general waiting period of 3 months will apply.
- ☑️ Prescribed Minimum Benefits are available during waiting periods.
- ☑️ The scheme may impose any unexpired balances by the previous scheme if the beneficiary suffers from any pre-existing condition.
- ☑️ New members and their dependents have a 3-month general waiting period.
- ☑️ Prescribed Minimum Benefits are available during the general waiting period.
- ☑️ The waiting period does not apply to emergency medical treatment.
- ☑️ Any costs incurred during waiting periods will not be covered.
CompCare ExtraCare Plan vs. Similar Plans from Other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 CompCare EctraCare (2026) | 🥈 Medihelp MedPrime (2026) | 🥉 GEMS Emerald (2026) |
| 👤 Main Member Contribution | R6,968 | R5,790 | R3,554 – R4,410 |
| 👥 Adult Dependent Contribution | R6,968 | R4,896 | R2,707 – R3,381 |
| 🍼 Child Dependent Contribution | R2,438 | R1,692 | R1,319 – R1,649 |
| 💙 Hospital Cover | Unlimited | Unlimited | Unlimited |
| 📉 Annual Limit | Unlimited | Unlimited Hospital Cover | Unlimited Hospital Cover |
Our Verdict on The ExtraCare Plan
💙 The CompCare ExtraCare plan is a comprehensive healthcare plan offering its members various benefits and advantages. The plan covers in-hospital and day-to-day medical expenses, including specialist consultations, chronic medication, and preventative care services.
💙 It also includes cover for emergency medical treatment, evacuation services, and funeral benefits. The plan offers affordable premiums, with different options to suit individuals’ needs and budgets.
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