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Overall, the CompCare MUMED Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and flexible risk cover to up to 3 Family Members. The CompCare MUMED Medical Aid Plan starts from R4,826 ZAR.
🌎 International Cover | Subject to benefits per individual benefit category. |
👤 Main Member Contribution | R4,826 |
👥 Adult Dependent Contribution | R3,762 |
🍼 Child Dependent Contribution | R1,356 |
↪️ Gap Cover | None |
📉 Annual Limit | Unlimited |
☑️ Hospital Cover | Unlimited |
💙 Screening and Prevention | ☑️ Yes |
💶 Medical Savings Account | ☑️ Yes |
👶 Maternity Benefits | ☑️ Yes |
The CompCare MUMED medical aid plan is one of 9, starting from R4,826. Other CompCare plans include:
Additionally, it should be noted that a Late Joiner Fee applies to all Plans.
It offers flexible risk cover, additional cover for specific services, and an annual flexible benefit (AFB) that covers medical expenses, saving members from paying out-of-pocket.
Gap Cover is not available on the CompCare MUMED 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 |
R4,826 | R3,762 | R1,356 |
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👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
R7,320 | R4,560 | R1,860 |
🟥 Hospitalization Private Hospitals Nursing Homes | Covered up to 100% of the scheme rate. Subject to pre-approval, case management, 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 can be used. Medicine can be obtained from Dis-Chem pharmacies. |
🟨 Overall Annual Limit | Unlimited |
🟩 GPs and Specialists | Covered up to 100% of the scheme rate. |
🟦 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 | Subject to pre-authorization. Limited to an overall limit of R40,000. Sub-limits will apply according to categories. |
🟧 Auxiliary Services | Limited to R3,600 per family. There is a combined limit for in and out-of-hospital treatment. 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 R2,800 per family. |
🟦 All specialized radiology MRI scans CT scans PET scans | Covered up to 100% of the scheme rate. Limited to R30,500 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. Subject to pre-approval and protocols. |
🟧 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-authorization, protocols, and PMBs. |
🟩 Organ Transplants, Plasmapheresis, Renal Dialysis | Subject to pre-authorization, protocols, and PMBs. |
🟦 Professional Sports Injuries | Subject to pre-approval. Scheme protocols will apply. |
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1️⃣ Oncology Chemotherapy Radiotherapy | Unlimited cover when using an Oncology DSP. Subject to pre-approval and protocols. The Oncology formulary will apply. |
2️⃣ 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. |
3️⃣ Step-down facilities, hospice, rehabilitation | Unlimited cover is offered. Subject to pre-authorization and clinical guidelines. |
4️⃣ Surgical Procedures performed out-of-hospital | Unlimited cover. Subject to pre-approval and protocols. |
5️⃣ Radial Keratotomy and Excimer Laser | Subject to the optical benefit. Pre-authorization is required, and protocols will apply. |
6️⃣ Wound care instead of hospitalization | Unlimited cover provided. Subject to pre-approval and protocols. |
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🔎 Day-to-day Benefits and Limits | Claims are paid from the AFB Once the AFB is depleted, additional benefits become available. The total day-to-day benefits are as follows: Main Member – R7,320 Adult Dependent – R4,560 Child Dependent – R1,860 Once the AFB is depleted, additional benefits are available for members. |
👩⚕️ General Practitioner (GPs) Consultations | Covered up to 100% of the scheme rate. Includes procedure, material, and virtual consultation fees. Paid from the AFB, limited to the following: Main – 6 visits Main + 2 – 10 visits Main +3> – 11 visits Once the AFB is exhausted, the balance of visits is available and paid from risk. Children <6 years have unlimited GP visits. |
👨⚕️ Specialist Consultations | Covered up to 100% of the scheme rate. Paid from AFB. Members must be referred by a GP or face a 30% co-payment. |
💊 Chronic Medicine | Subject to the formulary. Reference Pricing will apply. Unlimited cover for 48 conditions (27 CDL and 13 non-CDL conditions). Non-CDL conditions are subject to the AFB. |
💉 Acute Medicine (Schedule 3>) | Paid from the AFB. There is a 25% co-payment for non-generic products. Subject to the MMAP. |
🥰 Over the Counter (OTC) Medicine | Paid from the AFB. Limited to R710 per beneficiary and R1,380 per family, with an R220 maximum per event. Subject to reference pricing. Includes sports supplements if there is a valid NAPPI code. |
📈 Basic Radiology Black and White X-Rays Ultrasounds | Covered up to 100% of the scheme rate. Paid from the AFB. |
📉 Specialized Radiation MRI scans CT scans PET scans | Combined in and out-of-hospital specialized radiology benefits. Limited to R30,500 per family. |
📊 Pathology | Covered up to 100% of the scheme rate. Paid from the AFB. |
🦷 Conservative Dentistry Consultations Preventative Care Fillings Extractions Infection Control | Paid up to 100% of the scheme rate. Paid from the AFB. Unlimited cover for children <6 years. |
➡️ Specialized Dentistry Maxillo-facial and oral surgery In and Out-of-hospital combined limit | Covered up to 100% of the scheme rate. Limited to R2,600 per beneficiary. Subject to scheme protocols. |
🥸 Optometry | Paid from the AFB. Limited to one visit per beneficiary every second year. |
🤓 Lenses and Contact Lenses | Paid up to 100% of the scheme rate. Paid from the AFB. Subject to a sub-limit of R1,900 per beneficiary and R5,450 per family every two years. Subject to protocols. |
😎 Frames | A sub-limit of R1000 applies per frame. There is a limit of one frame per beneficiary per second year included in the lens limit. |
↪️ Allied Services Speech Therapists Social Workers Podiatrists, etc. | Covered up to 100% of the scheme rate. Paid from the AFB. Collectively limited to R3,600 per family in and out-of-hospital. |
🧠 Clinical Psychologists | Covered up to 100% of the scheme rate. Paid from the AFB. Subject to a sub-limit of R2,000 per family. |
🩺 Surgical and Medical Appliances Wheelchairs Crutches Glucometers Artificial eyes External fixators | Covered up to 100% of the scheme rate. Subject to sub-limits and protocols. Paid from the AFB. |
💗 Psychiatry | Covered up to 100% of the scheme rate. Paid from the AFB up to a sub-limit of R5,400 per family. |
💖 Psychosocial Counselling | Paid from risk. Unlimited telephonic counseling sessions through the Universal Wellness Care Centre. Members can opt for referral to one-on-one sessions with qualified psychologists, social workers, or registered counselors up to three referral sessions per beneficiary per year. |
😮💨 Oxygen Home Ventilation | Covered up to 100% of the scheme rate. Paid from the AFB. |
🏠 Home Nurse Visits | Covered up to 100% of the scheme rate. Limited to 30 days per family. Paid from the AFB. |
👶 Antenatal Classes | Covered up to 100% of the scheme rate. Paid from the AFB. Limited to 12 antenatal classes and one lactation consultation with a midwife. Limited to R1000 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. |
🟦 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. |
🍎 Nutritional Assessment and Healthy Eating Plan | 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. |
📌 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 MUMED plan:
and many more.
The following are some of the exclusions on the CompCare MUMED 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.
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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 MUMED plan, the following applies:
Members are responsible for submitting all claims within the required time frame.
🔎 Medical Aid Plan | 🥇 CompCare MUMED | 🥈 Profmed ProSecure Savvy | 🥉 Fedhealth FlexiFED 4 |
🌎 International Cover | Subject to benefits per individual benefit category. | R8 million | None |
👤 Main Member Contribution | R4,826 | R3,464 | R3,805 – R5,081 |
👥 Adult Dependent Contribution | R3,762 | R3,464 | R3,546 – R4,637 |
🍼 Child Dependent Contribution | R1,356 | R1,570 | R1,167 – R1,528 |
💙 Hospital Cover | Unlimited | Covers up to 100% of the negotiated tariff | Unlimited |
The MUMED plan from CompCare is a comprehensive healthcare plan that covers both in-hospital and day-to-day medical expenses. In addition, the plan offers different options to suit individuals’ needs and budgets, with affordable premiums and various benefits.
Furthermore, members can access specialist consultations, diagnostic tests, and preventative care services under the plan. One of the key benefits of the MUMED plan is its flexibility, allowing individuals to customize their cover to suit their needs and budget.
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The CompCare MUMED plan is a comprehensive healthcare plan that covers both in-hospital and day-to-day medical expenses, including specialist consultations, diagnostic tests, and preventative care services.
Yes, the CompCare MUMED plan offers different options to suit individuals’ needs and budgets, allowing members to customize their cover.
The MUMED plan includes a wellness program that offers health assessments and coaching to help members maintain a healthy lifestyle.
Yes, the MUMED plan may require co-payments for certain medical services or treatments.
Yes, there may be waiting periods for certain benefits under the MUMED plan.
There are restrictions on certain medical services under the MUMED plan, such as certain prescription medications and elective cosmetic procedures.
Yes, the MUMED plan includes cover for emergency medical treatment and evacuation services.
Yes, chronic medication is covered under the MUMED plan as part of its day-to-day medical expenses.
Yes, the MUMED plan includes a 24-hour health advice line that members can access for medical assistance or advice.
The MUMED plan does not appear to include funeral benefits.
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