CompCare SelfCare Plus Plan (🇿🇦 2025)

Overall, the CompCare SelfCare Plus Hospital Plan is a trustworthy and comprehensive hospital plan that offers 24/7 medical emergency assistance and PMB Benefits to its members. The CompCare SELFCARE PLUS Plan starts from R2,566 ZAR.

👤 Main Member Contribution	R2,566
👥 Adult Dependent Contribution	R2,566
🍼 Child Dependent Contribution	R898
📉 Annual Limit	Unlimited
🟦 Hospital Cover	Unlimited
💶 Prescribed Minimum Benefits	☑️ Yes
☑️ Screening and Prevention	☑️ Yes
💙 Medical Savings Account	☑️ Yes
👶 Maternity Benefits	☑️ Yes
🔁 Gap Cover	No, optional extra

👉🏿 Download the SelfCare Plus Guide for 2025

CompCare SelfCare Plus Plan – 7 Key Point Quick Overview

CompCare SelfCare Plus Plan Overview

💙 The CompCare SelfCare Plus medical aid plan is one of 7, starting from R2,566 and covers day-to-day medical expenses from a savings account. In addition, members have chronic medication benefits, wellness and preventative benefits, PMB benefits, and more.

👉🏿 Other CompCare Plans include:

💙 All CompCare plans will have a late joiner fee when you join over the age of 35 years old*.

💙 Gap Cover is not available on the CompCare SelfCare Plus Plan. CompCare offers 24/7 medical emergency assistance. According to the Trust Index, CompCare has a trust rating of 3.4.

CompCare SelfCare Plus Plan Contributions and Medical Savings Account

SelfCare Plus Contributions

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R2,566	R2,566	R898

SelfCare Plus Medical Savings (PMSA)

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R3,072	R3,072	R1,068

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SelfCare Plus Plan Benefits and Cover Comprehensive Breakdown

SelfCare Plus In-Hospital Benefits

🟥 Hospitalization (Private Hospitals, Nursing Homes)	Covered up to 100% of the scheme rate in Netcare or Mediclinic hospitals. Subject to pre-approval, case management, and scheme protocols.
🟧 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	Subject to pre-authorisation and protocols. Limited to an overall benefit amount of R32 000. Sub-limits per category apply
🟥 Auxiliary Services	100% of the scheme rate. Limited to a collective sub-limit of R3 000 PMF, in-and-out of hospital. Subject to pre-authorisation and protocols. A separate pre-authorisation number is required – the claim will not be paid under the hospital pre-authorisation. 20% co-payment will apply if not preauthorised.
🟧 Psychiatric In-hospital Treatment	100% of the scheme rate. Subject to pre-authorisation, protocols and PMBs. Up to a maximum of 21 days’ admission or 15 consultations.
🟨 Psychology (non-psychiatric admissions)	Paid from the PMSA.
🟩 All specialized radiology (MRI scans, CT scans)	Covered up to 100% of the scheme rate. Limited to R23,000 per year. R3 800 co-payment payable from the PMSA. Pre-Authorization is required. No benefit for PET scans. 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. Unlimited cover but subject to scheme 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)	Unlimited for PMBs. Subject to pre-authorization and clinical protocols.
🟨 Organ Transplants, Plasmapheresis, Renal Dialysis	Unlimited for PMBs. Subject to pre-authorisation and protocols. DSP may apply.
🟩 Professional Sports Injuries	Subject to pre-approval. Scheme protocols will apply.

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SelfCare Plus Hospitalisation Alternatives

🔴 Oncology (Chemotherapy , Radiotherapy)	100% of scheme rate. Unlimited for PMBs at our oncology DSP. Subject to pre-approval and protocols. The Oncology formulary will apply.
🟠 Biological agents and Specialised Medication	Unlimited for PMBs. Subject to pre-authorisation and PMB protocols.
🟡 Step-down facilities, hospice, rehabilitation	Unlimited coverage is offered. Subject to pre-authorization, protocols and clinical guidelines.
🟢 Surgical Procedures performed out-of-hospital	Unlimited cover. Subject to pre-authorization, protocols and clinical guidelines. Paid from funds in the PMSA.
🔵 Refractive Eye Surgery	Paid from funds in the PMSA.
🟣 Wound care instead of hospitalization	Unlimited cover provided. Subject to pre-authorization, protocols and clinical guidelines.

SelfCare Plus Day-to-Day Benefits

✅ Day-to-day Benefits and Limits	10% PMSA (Personal Medical Savings Account)
👩‍⚕️ General Practitioner (GPs) Consultations	Covered up to 100% of the scheme rate. Unlimited face-to-face consultations – R100 co-payment per consultation funded from the PMSA. Pre-authorisation required after the 6th visit. Virtual consultations at the uConsult. Universal Network of GPs.
👨‍⚕️ Specialist Consultations	Covered up to 100% of the scheme rate. 2 Consultations PMF up to a maximum of R2 260. R120 co-payment per consultation funded from the PMSA. Referral by GP is required, and pre-authorisation to avoid a 35% co-payment.
💊 Chronic Medicine	Reference Pricing & DSP pharmacies apply. Unlimited cover for 27 CDL conditions. Subject to formularies, protocols and pre-authorisation. 25% co-payment for non-formulary medicine / use of non-DSP pharmacy.
📌 Acute Medicine (Schedule 3>)	Paid from the PMSA. (except for PMBs). 25% co-payment on medicines where no generic is available. MMAP will apply.
📍 Over the Counter (OTC) Medicine	Paid from the PMSA. This benefit covers specified sports supplements if there is a valid NAPPI code.
📈 Basic Radiology (Black and White X-Rays, Ultrasounds)	100% of the scheme rate. PB: R1 730 Tests are limited to the Universal Care Approved List of Radiology codes. 35% co-payment applies which can be funded from the available PMSA. Referral by GP required to avoid 35% co-payment.
📉 Specialized Radiation (MRI scans & CT scans)	100% of the scheme rate. Pre-authorisation and a medical motivation are required for MRI, CT and high-resolution CT scans. Limited to R23 000 PMF unless otherwise pre-authorised. R3 800 co-payment payable from the PMSA. Combined limit in-and-out of hospital.
📊 Pathology	Covered up to 100% of the scheme rate. Limited to Universal Care Approved List of Pathology Codes. Referral by a GP required to avoid 35% co-payment.
🪥 Conservative Dentistry – Consultations – Preventative Care – Fillings – Extractions – Wisdom Teeth – Root Canal Treatment – Infection Control	Paid up to 100% of the scheme rate. Paid from the PMSA. 1 consultation per beneficiary (PB) paid from risk.
🪥 Specialized Dentistry – Maxillo-facial and oral surgery – In and Out-of-hospital combined limit	Covered up to 100% of the scheme rate. Paid from the PMSA. Quotation must be submitted for approval prior to commencement of treatment. Orthodontic treatment for patients older than 18 excluded.
🥸 Optometry	One eye test PB every 12 months paid from risk in addition to the PMSA. All other optometry visits paid from PMSA.
🤓 Lenses and Contact Lenses	Paid from the PMSA.
😎 Frames	Paid from the PMSA.
🚩 Allied Services – Speech Therapists – Social Workers – Podiatrists – Occupational Therapists – Homeopaths and Naturopaths – Dieticians – Chiropractors, etc.	Paid from the PMSA.
💗 Clinical Psychologists	Paid from the PMSA.
🩺 Surgical and Medical Appliances – Wheelchairs – Crutches – Glucometers – Artificial eyes – External fixators	Paid from the PMSA. Pre-authorisation required and protocols apply.
🧠 Psychiatry	Unlimited for PMBs.
💙 Psychosocial Counselling	Paid based on risk. Unlimited telephonic counseling sessions through Universal Wellness Care Centre. Member can opt for referral to one-on-one sessions with qualified psychologists, social workers, or registered counselors up to a maximum of three referral sessions PB per year.
😮‍💨 Oxygen Home Ventilation	Covered up to 100% of the scheme rate. PMBs only. Pre-authorisation required and protocols apply.
🥰 Home Nurse Visits	Covered up to 100% of the scheme rate. Paid from the PMSA. Pre-authorisation required and protocols apply.
🤰 Antenatal Classes	Covered up to 100% of the scheme rate. Paid from the PMSA. Limited to 8 antenatal classes and a lactation consultation with a midwife limited to R1 800 per pregnancy.
🍼 Antenatal Visits and Scans	Covered up to 100% of the scheme rate. Limited to 8 antenatal visits with a GP, specialist or midwife. Paid from PMSA and Care Maximiser. Foetal scans limited to 2 x 2D scans PB per year. Can opt for a 3D scan (paid at the rate of a 2D scan). Maternity bag issued with registration on maternity programme. Pre-authorisation required and subject to protocols.
⚠️ 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 not requiring admission. Excluding facility fees.	Covered up to 100% of the scheme rate. Non-PMBs paid from available PSMA.

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SelfCare Plus 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>. Limited to R287 per event.
↪️ Rapid HIV Test	One test per beneficiary yearly.
💉 Flu Vaccine	One vaccine per beneficiary yearly.
➡️ Tetanus Vaccine	One injection as required.
🟩 Pap Smear	One per female beneficiary 18 years> once yearly.
🟦 Mammogram	One test per female beneficiary 35 years> every two years.
📌 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.
🤰 Additional Assessment for pregnant members	Limited to one additional assessment. Strict protocols will 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.
🍼 Contraceptives (Oral/IUD device)	13 scripts to a maximum of R3 540, OR IUD to a maximum of R3 540. Up to the age of 55 years.
😷 COVID-19	To the maximum value of R1 850.
✳️ BP monitor	Limited to R850 per family.
😮‍💨 Nebulizer	Limited to R550 per family.
🌡️ Thermal Thermometer	Limited to R450 per family.
🏠 Home test bundle	Overall limit of R110. • One Covid test • One urinary tract test

SelfCare Plus 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 for children 5 – 7 years. 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 – 15 years old, Universal Network dietitians provide nutritional assessments and healthy eating plans.

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Chronic Conditions Covered

💙 The following chronic conditions are covered under the SelfCare Plus plan:

✅ Addison’s Disease
✅ Asthma
✅ Bipolar Mood Disorder
✅ Bronchiectasis
✅ Cardiac Arrhythmias
✅ Cardiomyopathy
✅ Chronic Kidney Failure
✅ Congestive Cardiac Failure
✅ Chronic Obstructive Pulmonary Disease
✅ Coronary Artery Disease

SelfCare Plus Plan Exclusions and Waiting Periods

SelfCare Plus Exclusions

💙 The following are some of the exclusions on the CompCare SelfCare Plus 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.

💙 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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SelfCare Plus 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 SelfCare Plus 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.

💙 Members are responsible for submitting all claims within the required time frame.

Medical Aid Comparisons : SelfCare Plus Plan vs. Similar Plans from Other Medical Schemes

🔎 Medical Aid Plan	🥇 CompCare Selfcare Plus	🥈 Sizwe Hosmed Essential Copper	🥉 LA Health KeyPlus
🌎 International Cover	Subject to benefits per individual benefit category.	Covered up to 100% of the scheme rates	R5 million
👤 Main Member Contribution	R2,566	R3,023	1,500 – 2,381 ZAR
👥 Adult Dependent Contribution	R2,566	R3,023	1,310 – 2,119 ZAR
🍼 Child Dependent Contribution	R898	R1,046	548 – 889 ZAR
💙 Hospital Cover	Unlimited	Unlimited for PMBs	Unlimited

Our Verdict on The SelfCare Plus Plan

💙 The CompCare SelfCare Plus plan is a comprehensive health insurance offering from CompCare, aimed at individuals and families seeking high-quality medical care at an affordable cost.

💙 The plan offers a range of benefits, including cover for in-hospital expenses, chronic medication, and day-to-day healthcare needs, all at competitive prices. One of the plan’s key features is its flexibility, with members able to choose from various options to create a package that best suits their health needs.

💙 This includes a choice of three different levels of cover and the option to add on additional benefits such as dental and optical cover.

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SelfCare Plus Plan Frequently Asked Questions

What is the CompCare SelfCare Plus plan?

CompCare SelfCare Plus is a comprehensive health insurance plan that provides individuals and families with high-quality medical care at affordable costs. The plan offers a range of benefits, including cover for in-hospital expenses, chronic medication, and day-to-day healthcare needs.

What are the benefits of the CompCare SelfCare Plus plan?

The benefits of the CompCare SelfCare Plus plan include flexibility, a range of cover options, the ability to choose healthcare providers, coverage for preventative healthcare, and optional add-ons such as dental and optical cover.

Can I choose my healthcare provider with the CompCare SelfCare Plus plan?

Yes, customers can choose their healthcare providers with the CompCare SelfCare Plus plan, allowing them to select doctors and hospitals with which they are comfortable.

Does the CompCare SelfCare Plus plan cover pre-existing conditions?

Yes, the CompCare SelfCare Plus plan covers pre-existing conditions, subject to a waiting period of up to 12 months.

What is the waiting period for certain conditions under the CompCare SelfCare Plus plan?

The waiting period for certain conditions under the CompCare SelfCare Plus plan is up to 12 months.

Are there limits to the amount of coverage provided for certain treatments and procedures under the CompCare SelfCare Plus plan?

Yes, the CompCare SelfCare PlusT plan limits the cover provided for certain treatments and procedures, meaning customers may have to pay out of their own pockets for more expensive treatments.

Does the CompCare SelfCare Plus plan include coverage for chronic medication?

Yes, the CompCare SelfCare Plus plan includes coverage for chronic medication.

Does the CompCare SelfCare Plus plan cover in-hospital expenses?

Yes, the CompCare SelfCare Plus plan covers in-hospital expenses.

Can I add additional benefits, such as dental and optical cover, to the CompCare SelfCare Plus plan?

Yes, customers can add dental and optical cover benefits to the CompCare SelfCare Plus plan.

Is the CompCare SelfCare Plus plan a flexible health insurance plan?

Yes, the CompCare SelfCare Plus plan is a flexible health insurance plan that offers a range of options to create a package that best suits the member’s needs.

Adriaan Schoeman

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.