Overall, the CompCare MEDX Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and wellness benefits to up to 3 Family Members. The CompCare MEDX Medical Aid Plan starts from R3,428 ZAR.
👤 Main Member Contribution | R3,428 |
👥 Adult Dependent Contribution | R3,172 |
🍼 Child Dependent Contribution | R1,107 |
↪️ Gap Cover | None |
📉 Annual Limit | Unlimited |
💙 Hospital Cover | Unlimited |
🟦 Home Care | ☑️ Yes |
🔵 Screening and Prevention | ☑️ Yes |
💶 Medical Savings Account | ☑️ Yes |
🔁 Maternity Benefits | ☑️ Yes |
The CompCare MEDX medical aid plan is one of 9, starting from R3,428 and is a complete private hospital benefit plan that covers several benefits, including step-down facilities, wellness benefits, post-operative rehabilitation, 27 chronic conditions, and more.
Gap Cover is not available on the CompCare MEDX 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 |
R3,428 | R3,172 | R1,107 |
🟥 Hospitalization Private Hospitals Nursing Homes | Covered up to 100% of the scheme rate in Netcare or Mediclinic private hospitals. Subject to pre-approval, case management, specialist programs, and scheme protocols. |
🟧 Efficiency Discounted (ED) Members can choose Designated Service Providers (DSPs) for in-hospital services and chronic medicines to receive discounts. Voluntary admission to a non-Netcare facility requires a 30% co-payment of R7 500 – Not applicable to emergencies. Non-DSP pharmacies require a 25% co-payment. | Netcare hospitals must be used. Medicine must be obtained from Dis-Chem pharmacies, including Dis-Chem Courier pharmacies. |
🟨 Overall Annual Limit | Unlimited |
🟩 GPs and Specialists | Covered up to 100% of the scheme rate. Subject to pre-approval and scheme protocols. |
🟦 Medication in-hospital | Covered up to 100% of the cost. |
🟪 Medication upon discharge from the hospital | Subject to Reference Pricing (RP) and Formularies. Limited to 7 days’ supply. |
🟥 Surgical Prostheses | Limited to an overall limit of R34,650. Sub-limits will apply per category. Subject to pre-authorization. Limited to available funds for non-PMBs. |
🟧 Auxiliary Services | Limited to R3,400 per family. Subject to pre-approval and protocols. A medical practitioner must recommend treatment. |
🟨 Psychiatric In-hospital Treatment | Covered up to 100% of the scheme rate. Subject to pre-authorization, protocols, and PMBs. |
🟩 Psychology (non-psychiatric admissions) | Limited to R2,000 per family annually. |
🟦 All specialized radiology MRI scans CT scans PET scans | Covered up to 100% of the scheme rate. Limited to R27,500 per year. Authorization is required. PET scans require special motivation and approval. Unauthorized scans are not covered. Screening scans are not covered. |
🟪 Basic Radiology | Covered up to 100% of the scheme rate. Unlimited cover but subject to scheme protocols. |
🟥 Pathology | Covered up to 100% of the scheme rate. Limited to R30,000 for in and out-of-hospital. |
🟧 Confinements for Maternity | Covered up to 100% of the scheme tariff. Subject to pre-authorization and clinical protocols. |
🟨 Rehabilitation in-hospital Alcoholism Drug Dependence Narcotics | Subject to pre-approval, protocols, and PMBs. |
🟩 Organ Transplants, Plasmapheresis, Renal Dialysis | Subject to pre-approval, protocols, and PMBs. |
🟦 Professional Sports Injuries | Subject to pre-approval. Scheme protocols will apply. |
🔴 Oncology Chemotherapy Radiotherapy | Unlimited cover when using an Oncology DSP. Subject to pre-approval and protocols. The Oncology formulary will apply. |
🟠 Biological agents and Specialised Medication | Limited to R170,000 per family per year. Pre-approval is required. Protocols will apply. Non-PMB medicines attract a 25% co-payment. |
🟡 Step-down facilities, hospice, rehabilitation | Unlimited coverage is offered. Subject to pre-authorization and clinical guidelines. |
🟢 Surgical Procedures performed out-of-hospital | Not covered unless it is an alternative to hospitalization. Subject to pre-approval and protocols. |
🔵 Radial Keratotomy and Excimer Laser | Only PMBs are covered. |
🟣 Wound care instead of hospitalization | Unlimited cover provided. Subject to pre-approval and protocols. |
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☀️ Day-to-day Benefits and Limits | Post-operative rehabilitation is available, including physiotherapy, occupational therapy, and biokinetics. Limited to R4,200 per beneficiary yearly. Covers up to 14 days for non-PMBs. Pre-approval is required, and the benefits are subject to protocols. |
👩⚕️ General Practitioner (GPs) Consultations | Only PMBs are covered. Unlimited GP visits for children <6 years. |
👨⚕️ Specialist Consultations | Only PMBs are covered. |
🩹 Chronic Medicine | Subject to the formulary. Reference Pricing will apply. Unlimited cover for 27 CDL conditions. |
💊 Acute Medicine (Schedule 3>) | Only PMBs are covered. |
📈 Basic Radiology Black and White X-Rays Ultrasounds | Only covered in-hospital. |
📉 Specialized Radiation MRI scans CT scans PET scans | Only covered in-hospital. |
📊 Pathology | Only PMBs are covered. |
🦷 Conservative Dentistry Consultations Preventative Care Fillings Extractions Infection Control | Unlimited cover for children <6 years. |
🥰 Specialized Dentistry Maxillo-facial and oral surgery In and Out-of-hospital combined limit | Only PMBs are covered. |
🥸 Optometry | Only PMBs are covered. |
🤓 Lenses and Contact Lenses | Only PMBs are covered. |
😎 Frames | Only PMBs are covered. |
➡️ Allied Services Speech Therapists Social Workers Podiatrists Occupational Therapists Homeopaths and Naturopaths Dieticians Chiropractors, etc. | Only PMBs are covered. |
🧠 Clinical Psychologists | Only PMBs are covered. |
🩺 Surgical and Medical Appliances Wheelchairs Crutches Glucometers Artificial eyes External fixators | Only PMBs are covered. |
↪️ Psychiatry | Only PMBs are covered. |
☑️ Psychosocial Counselling | Paid from risk. Unlimited telephonic counseling via the Universal Wellness Care Centre. The benefit provides one-on-one sessions with qualified psychologists, social workers, or registered counselors. Limited to 3 referral sessions per beneficiary yearly. |
😮💨 Oxygen Home Ventilation | Only PMBs are covered. |
💙 Home Nurse Visits | Only PMBs are covered. |
🍼 Antenatal Visits and Scans | 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) | Only PMBs are covered. |
⚕️ Lipogram | Limited to one fasting lipogram per beneficiary 20 years> once every 5 years. |
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👩⚕️ 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. |
🟢 Adult Pneumococcal Vaccine | Per beneficiary as required. Subject to pre-approval and protocols. |
⚽ Fitness Assessment and Exercise Prescription | Fitness assessment and exercise prescription: Annual fitness assessment, virtual consultations, exercise prescription, and monitoring by Universal Network biokinetics. |
🤰 Additional Assessment for pregnant members | Limited to one additional assessment. Strict protocols will apply. |
🍎 Nutritional Assessment and Healthy Eating Plan | Fitness assessment and exercise prescription: Annual fitness assessment, virtual consultations, exercise prescription, and monitoring by Universal Network biokinetics. |
💊 Contraceptives | Limited to R3,360 per beneficiary per year for female beneficiaries up to 55 years. Reference pricing will apply. CompCare only covers UID devices. |
😷 COVID-19 | Those who test positive for COVID-19 have access to several benefits in addition to PMBs. Subject to pre-approval and managed care protocols. |
😮💨 Pulse Oximeter | Limited to R850 per month. |
💨 Nebulizer | Limited to R550 per month. |
🌡️ Thermal Thermometer | Limited to R450 per month. |
👶 Newborn Hearing Screening and Congenital Hypothyroidism Test | Limited to three Paediatric consultations. Access is given to pediatric telephonic advisory services. |
💛 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 for children 5 – 7 years and 14 to 18. Pre-school eye and hearing screening for children between 5 and 6 years old. Dental Screening for children 5 – 7 years old. |
🥰 Kids Active Benefit | Universal Network biokinetics assesses and prescribes exercise for 8–12-year-olds. SporTeen: Universal Network bio kineticist-led annual fitness assessment, virtual consultations, and exercise prescription for 13 – 17-year-old children. |
🍎 Kids Nutritional Benefit | For 8-year-olds and older, Universal Network dietitians provide nutritional assessments and healthy eating plans. |
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The following chronic conditions are covered under the MEDX plan:
and many more.
The following are some of the exclusions on the CompCare MEDX 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 MEDX plan, the following applies:
Members are responsible for submitting all claims within the required time frame.
🔎 Medical Aid | 🥇 CompCare MEDX | 🥈 Momentum Incentive Plan | 🥉 Bestmed Beat 3 |
🌎 International Cover | Subject to benefits per individual benefit category. | Up to R8 million | R500,000 – R3 million |
👤 Main Member Contribution | R3,428 | R2,794 | R3,724 |
👥 Adult Dependent Contribution | R3,172 | R2,206 | R2,656 |
🍼 Child Dependent Contribution | R1,107 | R1,072 | R1,314 |
💙 Hospital Cover | Unlimited | Unlimited | Subject to scheme rules |
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The MEDX plan from CompCare is a medical aid plan that provides coverage for Prescribed Minimum Benefits (PMBs) with limited day-to-day benefits. MEDX covers all PMBs, including chronic medication, emergency medical treatment, and hospitalization, and offers access to an extensive network of healthcare providers.
The plan provides a basic set of day-to-day benefits, including primary healthcare, dentistry, optometry, and a limited amount of chronic medication. It also offers preventative care benefits, such as vaccinations and cancer screenings.
However, the plan’s day-to-day benefits are limited and may not cover all medical expenses.
You might also consider the following plans from CompCare:
MEDX is a medical aid plan offered by CompCare South Africa that provides coverage for Prescribed Minimum Benefits (PMBs) with limited day-to-day benefits.
MEDX provides coverage for PMBs, including chronic medication, emergency medical treatment, and hospitalization. It also offers basic day-to-day benefits, such as primary healthcare, dentistry, optometry, and a limited amount of chronic medication.
MEDX provides access to an extensive network of healthcare providers, including private hospitals, specialists, and general practitioners.
Premiums for MEDX are based on the type of plan chosen and the member’s age, gender, and overall health status.
Co-payments are the portions of medical expenses that members must pay out-of-pocket.
Yes, MEDX has waiting periods for certain benefits, such as hospitalization and chronic medication.
Yes, MEDX covers a limited amount of chronic medication.
Designated service providers (DSPs) are healthcare providers contracted with the medical scheme to provide certain services at a reduced cost to members.
Yes, hospitalization is covered under MEDX, but this benefit has strict limits.
MEDX may not cover certain elective medical procedures, such as cosmetic surgery.
Members can claim by submitting their invoices and receipts to CompCare for reimbursement.
Yes, family members can be added to MEDX, but additional premiums may apply.
Members can cancel their MEDX plan by submitting a written request to CompCare.
Yes, members can change their MEDX plan, but this may be subject to certain conditions and may result in a change in premiums.
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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