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 R5,812 ZAR.
| 🌎 International Cover | Subject to benefits per individual benefit category. |
| 👤 Main Member Contribution | R5,812 |
| 👥 Adult Dependent Contribution | R5,812 |
| 🍼 Child Dependent Contribution | R2,034 |
| ↪️ Gap Cover | No, optional extra. |
| 💶 Prescribed Minimum Benefits | ✅ Yes |
| 📉 Screening and Prevention | ✅ Yes |
| 💶 Medical Savings Account | ✅ Yes |
| ➡️ Hospital Cover | Unlimited |
| ☑️ Annual Limit | Unlimited |
👉🏿 Download the ExtraCare Plan for 2025
💙 The CompCare ExtraCare medical aid plan is one of 7, starting from R5,812 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:
👉🏿 All CompCare plans will have a late joiner fee if you join after the age of 35 years old.
💙 Gap Cover is not available on the CompCare ExtraCare Plan. CompCare offers 24/7 medical emergency assistance. According to the Trust Index, CompCare has a trust rating of 3.4.
| 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| R5,812 | R5,812 | R2,034 |
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| 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| R6,700 | R4,700 | R2,400 |
| 👤 Per Beneficiary | 👥 Per Family |
| R6,700 | R10,440 |
| 🟥 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 R42,000. Sub-limits will apply according to categories. |
| 🟥 Auxiliary Services | Covered up to 100% of the scheme rate. Limited to combined sub-limit of R5 000 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 130 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 R30 000 PMF unless otherwise pre-authorised. R3 800 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 R41 700 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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| 🅰️ 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. R185 000 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 500 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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| 📌 Day-to-day Benefits and Limits | Specified day-to-day benefits will be paid from the day-to-day benefit: P: R6 700 A: R4 700 C: R2 400 Out-of-hospital radiology, pathology, basic dentistry, physiotherapy and biokinetics paid from the day-to-day Extender Benefit to amounts of: PB: R6 700 PMF: R10 440 Optometry benefit: R6 500 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 R310 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 700 PB to a maximum of R10 400 PMF. Combined in-and-out of hospital limit of R41 700 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 R30 000 PMF unless otherwise pre-authorised. R3 800 co-payment applies for each scan. Combined limit in-and-out of hospital. |
| 📊 Pathology | Covered up to 100% of the scheme rate. Paid from day-to-day Extender Benefit. Combined benefit with radiology, basic dentistry, biokinetics and physiotherapy of R6 700 PB to a maximum of R10 400 PMF. Combined in-and-out of hospital amount of R41 700 PMF. Referral by a GP is required to avoid 35% co-payment. |
| 🪥 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 700 PB to a maximum of R10 400 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 500 PMF. |
| 🤓 Lenses and Contact Lenses | 100% of the scheme rate. Sub-limit of R1 140 for lenses or contact lenses PB, included in the R6 500 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 500 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 000 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 800 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. |
| 👩⚕️ 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 540, or IUD to a maximum of R3 540. |
| 🟦 Home Test Bundle | One Covid test; One Urinary tract test; One Ovulation test; One pregnancy test. Overall limit of R350 |
| 🟪 Pulse Oximeter | Limited to R850 per family. |
| 😮💨 Nebulizer | Limited to R550 per family. |
| 🌡️ Thermal Thermometer | Limited to R450 per family, |
| 🚼 Antenatal visit with a GP, specialist or midwife | 100% of the scheme rate. 12 antenatal visits. |
| 👶 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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💙 The following chronic conditions are covered under the SELFSURE plan:
The following are some of the exclusions on the CompCare ExtraCare Plan:
💙 Frail care services will not be covered, including accommodation and nursing care in convalescent or nursing homes catering to the aged or chronically ill.
💙 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:
💙 Members are responsible for submitting all claims within the required time frame.
| 🔎 Medical Aid Plan | 🥇 CompCare SELFSURE | 🥈 Medihelp MedPrime | 🥉 GEMS Emerald |
| 👤 Main Member Contribution | R5,812 | R5,304 | R3,554 – R4,410 |
| 👥 Adult Dependent Contribution | R5,812 | R4,482 | R2,707 – R3,381 |
| 🍼 Child Dependent Contribution | R2,034 | R1,548 | R1,319 – R1,649 |
| 💙 Hospital Cover | Unlimited | Unlimited | Unlimited |
| 📉 Annual Limit | Unlimited | Unlimited Hospital Cover | Unlimited Hospital Cover |
💙 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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Yes, CompCare ExtraCare does offer affordable medical coverage with no waiting periods for certain benefits. However, some benefits may have waiting periods.
Yes, the CompCare ExtraCare plan does offer co-payment options for certain medical services or treatments. However, this means that members may be required to pay a portion of the cost of the service or treatment, with the remaining balance covered by the plan.
Yes, the CompCare ExtraCare plan does cover pre-existing conditions, subject to certain terms and conditions. Therefore, it is important to check the plan’s terms and conditions to understand the extent of coverage for pre-existing conditions.
Yes, the CompCare SELFSURE plan covers emergency medical treatment and evacuation services. This can be especially important for individuals needing to travel or work in remote or high-risk areas.
Yes, the CompCare ExtraCare plan covers chronic medication as part of its day-to-day medical expenses. This can help individuals manage their chronic conditions and avoid high out-of-pocket costs.
Yes, the CompCare ExtraCare plan includes a 24-hour health advice line that members can access for medical assistance or advice.
Yes, CompCare offers customizable healthcare plans, including the ExtraCare plan, that allows individuals to choose the level of coverage that suits their needs and budget.
Yes, the CompCare ExtraCare plan covers in-hospital and day-to-day medical expenses, including specialist consultations, diagnostic tests, and preventative care services.
Yes, the CompCare ExtraCare plan includes funeral benefits as part of its benefits package. This can help ease the financial burden on families in the event of a loved one’s death.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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