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Overall, the CompCare SELFSURE Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and extensive cover to up to 3 Family Members. The CompCare SELFSURE Medical Aid Plan starts from R5,032 ZAR.
🌎 International Cover | Subject to benefits per individual benefit category. |
👤 Main Member Contribution | R5,032 |
👥 Adult Dependent Contribution | R5,032 |
🍼 Child Dependent Contribution | R1,260 |
↪️ Gap Cover | None |
💶 Prescribed Minimum Benefits | ✅ Yes |
📉 Screening and Prevention | ✅ Yes |
💶 Medical Savings Account | ✅ Yes |
➡️ Hospital Cover | Unlimited |
☑️ Annual Limit | Unlimited |
The CompCare SELFSURE medical aid plan is one of 9, starting from R5,032 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.
Gap Cover is not available on the CompCare SELFSURE 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 |
R5,032 | R5,032 | R1,260 |
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👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
R6,500 | R4,500 | R2,310 |
🟥 Hospitalization Private Hospitals Nursing Homes | Covered up to 100% of the scheme rate. DSP network of private hospitals available. Subject to pre-approval, case management, and scheme protocols. |
🟧 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 R42,000. Sub-limits will apply according to categories. |
🟥 Auxiliary Services | Limited to R5,000 per family. The 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 R3,000 per family. |
🟩 All specialized radiology MRI scans CT scans PET scans | Covered up to 100% of the scheme rate. Limited to R30,000 per year. Authorization is required. PET scans require special motivation and approval. Unauthorized scans are not covered. Screening scans are not covered. There is a co-payment of R2,500 on this benefit. |
🟦 Basic Radiology | Covered up to 100% of the scheme rate. Unlimited cover but subject to scheme protocols. |
🟪 Pathology | There is a combined limit of R40,000 per family. 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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🅰️ 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 | Unlimited cover. Subject to pre-approval and protocols. |
🧬 Radial Keratotomy and Excimer Laser | Subject to the optical benefit. Pre-authorization is required, and protocols will apply. |
🩹 Wound care instead of hospitalization | Unlimited cover provided. Subject to pre-approval and protocols. |
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📌 Day-to-day Benefits and Limits | Out-of-hospital radiology, pathology, basic dentistry, physiotherapy, and biokinetics are paid from the Day-to-Day Extender, limited to the following: R6,500 per beneficiary. R9,096 per family. All other out-of-hospital benefits will be paid from the Day-to-Day benefits, with the following limits: Main Member – R6,500 Adult Dependent – R4,500 Child Dependent – R2,310 (maximum 3) |
📍 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 | Subject to the formulary. Reference Pricing will apply. Unlimited cover for 40 conditions (27 CDL and 13 non-CDL conditions). Non-CDL conditions are subject to Day-to-Day Benefits. |
☑️ 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. |
✅ Over the Counter (OTC) Medicine | Paid from the Day-to-Day Benefit. Limited to R300 per event. |
📈 Basic Radiology Black and White X-Rays Ultrasounds | Covered up to 100% of the scheme rate. There is a joint limit with pathology, basic dentistry, biokinetics, and physiotherapy up to R6,500 per beneficiary and R9,096 per family. Paid from the Day-to-Day Extender Benefit. |
📉 Specialized Radiation MRI scans CT scans PET scans | Combined in and out-of-hospital specialized radiology benefits. Limited to R30,000 per family. There is a co-payment of R2,500 on this benefit. |
📊 Pathology | Covered up to 100% of the scheme rate. Shares a limit with radiology, basic dentistry, biokinetics, and physiotherapy to R6,500 per beneficiary or R9,096 per family. Combined in and out-of-hospital limit of R40,000 per year. |
🪥 Conservative Dentistry Consultations Preventative Care Fillings Extractions Infection Control | Covered up to 100% of the scheme rate. Shares a limit with radiology, pathology, biokinetics, and physiotherapy to R6,500 per beneficiary or R9,096 per family. Combined in and out-of-hospital limit of R36,000 per year. 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 R2,400 per beneficiary. Subject to scheme protocols. Paid from the Day-to-Day Benefit. A co-payment of R2,000 applies. |
😎 Optometry | Limited to one visit per beneficiary every 2 years. Included in the R6,300 per family optometry limit. |
🤓 Lenses and Contact Lenses | Paid up to 100% of the scheme rate. Included in the R6,300 per family optometry limit. Subject to a sub-limit of R1,100 per for lenses or contact lenses. Subject to protocols. |
🥸 Frames | A sub-limit of R630 applies per frame. Included in the optometry limit. |
1️⃣ Allied Services Speech Therapists Social Workers Podiatrists, etc. | Covered up to 100% of the scheme rate. Paid from the Day-to-Day Benefit. Collectively limited to R5,000 per family in and out-of-hospital. |
2️⃣ Clinical Psychologists | Covered up to 100% of the scheme rate. Paid from the Day-to-Day Benefit. Subject to a sub-limit of R1,900 per family. |
3️⃣ 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 Day-to-Day Benefit. |
🧠 Psychiatry | Covered up to 100% of the scheme rate. Paid from the Day-to-Day Benefit up to a sub-limit of R4,950 per family. |
💗 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. |
🏠 Home Nurse Visits | Covered up to 100% of the scheme rate. Limited to 25 days per family. Paid from the Day-to-Day Benefit. |
🤰 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 R1,100 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 Day-to-Day Benefit. |
✔️ 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 SELFSURE plan:
and many more.
The following are some of the exclusions on the CompCare SELFSURE 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 SELFSURE 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 | R5,032 | R4,782 | R3,554 – R4,410 |
👥 Adult Dependent Contribution | R5,032 | R4,044 | R2,707 – R3,381 |
🍼 Child Dependent Contribution | R1,260 | R1,398 | R1,319 – R1,649 |
💙 Hospital Cover | Unlimited | Unlimited | Unlimited |
📉 Annual Limit | Unlimited | Unlimited Hospital Cover | Unlimited Hospital Cover |
The CompCare SELFSURE 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 SELFSURE does offer affordable medical coverage with no waiting periods for certain benefits. However, some benefits may have waiting periods.
Yes, the CompCare SELFSURE 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 SELFSURE 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 SELFSURE 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 SELFSURE 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 SELFSURE plan, that allows individuals to choose the level of coverage that suits their needs and budget.
Yes, the CompCare SELFSURE plan covers in-hospital and day-to-day medical expenses, including specialist consultations, diagnostic tests, and preventative care services.
Yes, the CompCare SELFSURE 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.
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