CompCare UltraCare Plus Medical Aid Plan (🇿🇦 2025)

Overall, the CompCare UltraCare Plus Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and unlimited hospital cover to its members. The CompCare UltraCare Medical Aid Plan starts from R9,056 ZAR.

👤 Main Member Contribution	R9,056
👥 Adult Dependent Contribution	R8,150
💙 Child Dependent Contribution	R3,170
📉 Annual Limit	Unlimited
➡️ Hospital Cover	Unlimited
🍼 Maternity Benefits	☑️ Yes
↪️ Preventative Care and Wellness	R15 000

👉🏿 Download the UltraCare Plus Plan for 2025

CompCare UltraCare Plus Plan – 7 Key Point Quick Overview

CompCare UltraCare Plus Plan Overview

💙 The CompCare UltraCare Plus medical aid plan is one of 7, starting from R9,056. With the UltraCare Plus option, you can enjoy comprehensive coverage that includes unlimited hospital coverage. In addition, you can also benefit from a savings account, flexible risk cover, and above-threshold benefits.

💙Gap Cover is not available on the CompCare UltraCare Plus Plan. CompCare offers 24/7 medical emergency assistance.

💙 According to the Trust Index, CompCare has a trust rating of 3.4.

CompCare UltraCare Plus Plan Contributions and Benefits

CompCare UltraCare Plus Contributions

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R9,056	R8,150	R3,170

CompCare UltraCare Plus Above Threshold Benefit (ATB)

👤 Per Beneficiary	👥 Per Family
R9,660	R17,200

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CompCare UltraCare Plus Annual Flexi Benefit (AFB)

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R16,000	R12,000	R4,600

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CompCare UltraCare Plus Threshold Amount

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R26,200	R19,600	R7,400

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CompCare UltraCare Plus Annual Self-Payment Gap (SPG)

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R10,200	R7,600	R2,800

UltraCare Plus Plan Benefits and Cover Comprehensive Breakdown

In-Hospital Benefits

🏥 Hospitalization (Private Hospitals, Nursing Homes)	Covered up to 100% of the scheme rate. Any private hospital. Subject to pre-authorisation and managed care protocols.
👩‍⚕️ GPs and Specialists	Covered up to 100% of the scheme rate. Unlimited. Subject to pre-authorisation and managed care protocols.
💊 Medication in-hospital	Covered up to 100% of the scheme rate.
☑️ Medication upon discharge from the hospital	Limited to 7 days per discharge. Subject to Reference Pricing (RP) and formularies.
🦾 Surgical Prostheses	Subject to pre-authorization and protocols. Limited to overall benefit amount of R60 000. Sub-limits per category apply.
✅ Auxiliary Services	Covered 100% of scheme rate. Limited to combined sub-limit of R12 500 PMF, in-and-out of hospital. Subject to pre-authorisation and protocols. Separate pre-authorisation number required – claim will not be paid as part of hospital pre-authorisation. 20% co-payment will apply if not pre-authorised.
🧠 Psychiatric In-hospital Treatment	Covered 100% of scheme rate. Subject to pre- authorisation, protocols and PMBs. Up to maximum of 21 days’ admission OR 15 consultations which will first be paid from AFB (where applicable), thereafter covered by the Scheme.
➡️ Psychology (non-psychiatric admissions)	Limited to R5 740 PMF. Subject to pre-authorisation and protocols.
↪️ All specialized radiology (MRI scans & CT scans)	Covered up to 100% of scheme rate. Unlimited – Pre-authorisation and medical motivation required for MRI, CT and high-resolution CT scans. No benefit for unauthorised scans, except for PMBs. R3 800 co-payment for each scan.
🔁 Basic Radiology	Covered up to 100% of scheme rate. Unlimited. Subject to protocols.
📈 Pathology	Covered up to 100% of scheme rate. Unlimited. Subject to protocols.
📉 Confinements	Covered up to 100% of scheme rate. Unlimited. Subject to 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	Covered up to 100% of scheme rate. Subject to pre-authorisation and protocols.

Hospitalisation Alternatives

🎗️ Oncology (Chemotherapy & Radiotherapy)	Covered 100% of scheme rate. Unlimited cover when using an Oncology DSP. Subject to pre-approval and protocols. Oncology formulary will apply.
🧪 Biological agents and Specialised Medication	Pre-authorisation required. Protocols apply R261 000 PMF. 25% co-payment on non- PMB medicines.
⬇️ Step-down facilities, hospice, rehabilitation	Covered 100% of scheme rate. Unlimited. Subject to pre-authorisation and clinical guidelines.
🩺 Surgical Procedures performed out-of-hospital	Covered 100% of scheme rate. Unlimited. Subject to pre-authorisation, clinical guidelines and protocols.
🧬Refractive Eye Surgery	Annual limit of R8 350 per eye. Subject to pre-authorisation and protocols. Limit includes all services rendered: Hospitalisation and all related costs.
🩹 Wound care instead of hospitalization	Covered 100% of scheme rate. Unlimited. Subject to pre-authorisation, clinical guidelines and protocols.

Day-to-Day Benefits

🟥 Day-to-day Benefits and Limits	Day-to-day benefits first paid from the AFB: P: R16 000 A: R12 000 C: R4 600 (To a maximum of 3 children.) SPG: Self-Payment Gap applicable once AFB is depleted and before Annual Threshold is reached. Thereafter ATB becomes available. The annual SPG amounts are: P: R10 200 A: R7 600 C: R2 800 (GP and specialist consultations, prescribed acute medication, radiology and pathology will accumulate to Annual Threshold and then paid from ATB.) ATB: Once Annual Threshold reached, the following ATB amounts become available for specified day-to-day expenses: PB: R9 660 PF: R17 200.
🟧 General Practitioner (GPs) Consultations	Covered up to 100% of the scheme rate. First paid from AFB, SPG and then ATB once Annual Threshold is reached. Children <6 years have unlimited GP visits.
🟨 Specialist Consultations	Covered up to 100% of the scheme rate. First paid from AFB and SPG. Thereafter limit of R5 200 PMF applies, subject to overall ATB limit. Referral by GP required, and pre-authorisation required to avoid 35% co-payment.
🟩 Chronic Medicine	Covered 100% of reference price. First paid from AFB. Scheme will cover costs once AFB is depleted. DSP pharmacies apply to UltraCare. Subject to formularies, protocols and pre-authorisation. 25% co-payment for non-formulary medicine, and use of a non-DSP. (27 CDL conditions)
🟦 Acute Medicine (Schedule 3>)	First paid from AFB and SPG. Thereafter limit of R3 490 PMF applies, subject to overall ATB. 25% co-payment on medicines where no generic is available. MMAP applies.
⬛ Medicine for non- CDL conditions	Covered 100% of reference price. 38 non-CDL conditions. First paid from available AFB and SPG. Thereafter limit of R3 600 PMF applies, subject to overall ATB limit. DSP pharmacies apply to UltraCare. Subject to formularies, protocols and pre-authorisation. 25% co-payment for non-formulary medicine, and use of a non-DSP. Cover also provided for the 27 listed CDL conditions.
🟪 Over the Counter (OTC) Medicine	Covered 100% of scheme rate. Paid from AFB. Limited to maximum of R1 050 PB and R1 500 PMF and one prescription per day up to maximum of R240 per event. MMAP applies. ATB: No benefit.
🟥 Basic Radiology (Black and White X-Rays & Ultrasounds)	Covered 100% of scheme rate. Paid from AFB and SPG. Thereafter limit of R4 170 PMF applies subject to overall ATB. ATB benefit amount combined with pathology. Referral by GP is required to avoid 35% co-payment.
🟧 Specialized Radiation (MRI scans & CT scans)	Covered 100% of scheme rate. Unlimited. Pre-authorisation and medical motivation required for MRI, CT and high-resolution CT scans. R3 800 co-payment applies for each scan. Referral by GP is required to avoid 35% co-payment.
🟨 Pathology	Covered 100% of scheme rate. Paid from AFB and SPG. Thereafter limit of R4 170 PMF applies, subject to the overall ATB. ATB benefit amount combined with radiology. Referral by GP is required to avoid 35% co-payment.
🟩 Conservative Dentistry – Consultations – Preventative Care – Fillings – Extractions – Wisdom Teeth – Root Canal Treatment – Infection Control	Covered 100% of scheme rate. Paid from AFB. Limited to R4 700 PB and subject to available AFB. ATB: No benefits.
🟦 Specialized Dentistry – Maxillo-facial and oral surgery – In and Out-of-hospital combined limit	Covered 100% of scheme rate. Paid from AFB, subject to sub-limit of R15 400 PB and R20 800 PMF. Subject to protocols. ATB: No benefits.
🟪 Optometry	Paid from AFB. Two visits PB per annum. ATB: No benefits.
🟥 Lenses and Contact Lenses	Covered 100% of scheme rate. Paid from AFB, subject to sub-limit of R4 800 PB. Subject to protocols. ATB: No benefits
🟧 Frames	Covered 100% of scheme rate. Paid from AFB, subject to sub-limit of R2 080 per frame. One frame PB every 12 months (from date of service), included in the benefit amount for lenses.
🟨 Allied Services – Speech Therapists – Social Workers – Podiatrists – Occupational Therapists – Homeopaths and Naturopaths – Dieticians – Chiropractors, etc.	Covered 100% of scheme rate. Paid from AFB. Subject to combined sub-limit of R8 800 PMF, in-and-out of hospital. ATB: No benefits.
🟩 Clinical Psychologists & Psychiatry	Covered 100% of scheme rate. Clinical psychologists Paid from AFB, subject to sub-limit of R3 100 PMF. Psychiatry Paid from AFB, subject to sub-limit of R13 050 PMF. PMB benefit: Up to a maximum of 21 days’ admission OR 15 consultations. The 15 consultations will first be paid from AFB, thereafter covered by the Scheme.
🟦 Surgical and Medical Appliances – Wheelchairs – Crutches – Glucometers – Artificial eyes – External fixators	Covered up to 100% of the scheme rate. Paid from the AFB. Sub-limits & protocols apply.
🟥 Psychosocial Counselling	Paid from risk. Unlimited telephonic counselling sessions through Universal Wellness Care Centre, with option for referral to one-on-one sessions with qualified psychologists, social workers or registered counsellors to maximum of 3 referral sessions PB per year.
🟧 Oxygen Home Ventilation	Covered up to 100% of the scheme rate. Paid from AFB. Subject to protocols and pre-authorisation.
🟨 Home Nurse Visits	Covered up to 100% of the scheme rate. Limited to 40 days PMF. Paid from AFB. Subject to protocols and pre-authorisation.
🟩 Antenatal Classes	Covered up to 100% of scheme rate. Subject to AFB. Limited to 12 antenatal classes and lactation consultation with a midwife and limited to R1 800 per pregnancy.
🟦 Antenatal Visits and Scans	Covered 100% of scheme rate. Limited to 12 antenatal visits with a GP, specialist or midwife. First paid from the Care Maximiser. Foetal scans limited to 2 x 2D scans PB per year and can opt for 3D scan (paid at rate of a 2D scan). Maternity bag issued with registration on maternity programme.
◻️ Emergency room child benefit	One additional visit at an emergency room per annum per child younger than 6 years. Visit to emergency room limited to R1 550 per event. Paid from Care Maximiser.
🟪 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. Paid at South African rates. Register your journey and obtain a travel certificate on www.tic.co.za/compcare
🟧 Hospital Emergency room and casualty emergency visits (no admission and excluding facility fees)	Paid from AFB.
🟨 Hospital emergency as a result of physical injury caused by an external force	Covered 100% of scheme rate. Subject to protocols and PMBs.

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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>.
🟡 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.
🟠 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 maximum of R3 540, OR IUD to maximum of R3 540. Available up to age of 55 years.
🟣 Home Test Bundle	Overall limit of R350 • One Covid test • One urinary tract test • One ovulation test • One pregnancy test
🔴 Pulse Oximeter	Limited to R850 per family.
🟠 Nebulizer	Limited to R550 per family.
🟡 Thermal Thermometer	Limited to R450 per family.
🔵 Antenatal visits with a GP, specialist or midwife.	100% of scheme rate. 12 antenatal visits.

Newborn to Adult Benefit

🍼 Newborn Screening 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 Universal Network biokineticist.
🍎 Kids Nutritional Benefit	Access to dietitian for assessments and healthy eating plan for children aged 8-15.

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Chronic Conditions Covered

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

☑️ Addison’s disease
☑️ Allergic rhinitis
☑️ Angina
☑️ Ankylosing spondylitis
☑️ Asthma
☑️ Attention deficit disorder
☑️ Bechet’s disease
☑️ Bipolar mood disorder
☑️ Bronchiectasis

UltraCare Plus Plan Exclusions and Waiting Periods

UltraCare Plus Exclusions

💙 The following are some of the exclusions on the CompCare UltraCare 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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UltraCare 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 UltraCare 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.

👉🏿 Aside from a waiting period, a late joiner fee will apply.

Medical Aid Comparison : CompCare UltraCare Plus Plan vs. Similar Plans from Other Medical Schemes

🔎 Medical Aid	🥇 CompCare UltraCare Plus	🥈 Cape Medical Plan MyHealth 200	🥉 Discovery Health Classic Smart Comprehensive
🌎 International Cover	Subject to benefits per individual benefit category. Paid at South African rates. Register your journey and obtain a travel certificate on www.tic.co.za/compcare	❎ None	R5 million
👤 Main Member Contribution	R9,056	R3,577	R7,945
👥 Adult Dependent Contribution	R8,150	R3,577	R7,337
🍼 Child Dependent Contribution	R3,170	R631	R1,885

Our Verdict on The UltraCare Plus Plan

💙 The UltraCare Plus plan from CompCare offers members several unique features and benefits. One of the most notable advantages of the plan is its comprehensive cover for hospitalization, which includes in-hospital specialist consultations, procedures, and medication.

💙 Members can receive top-quality medical care and treatment without worrying about unexpected costs. The plan also offers a range of benefits for chronic conditions such as cancer, diabetes, and hypertension.

💙 Overall, the UltraCare Plus plan offers members several unique features and advantages, such as its comprehensive hospitalization coverage and flexible day-to-day benefit options.

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Frequently Asked Questions

What is the UltraCare Plus plan from CompCare?

The UltraCare Plus plan from CompCare is a healthcare plan that offers comprehensive hospitalization coverage, chronic condition benefits, flexible day-to-day cover, and an extensive network of healthcare providers.

What is covered under the UltraCare Plus plan’s hospitalization cover?

The UltraCare Plus plan’s hospitalization cover includes in-hospital specialist consultations, procedures, and medication.

Does the UltraCare Plus plan offer benefits for chronic conditions?

Yes, the UltraCare Plus plan offers a range of benefits for chronic conditions such as cancer, diabetes, and hypertension.

Can I customize my benefits under the UltraCare Plus plan?

Yes, members can choose from various benefit options, such as primary healthcare, chronic medication, and wellness benefits, to customize their coverage according to their specific needs and budget.

What is the UltraCare Plus plan’s network of healthcare providers like?

The UltraCare Plus plan has an extensive network of healthcare providers, including general practitioners, specialists, and pharmacies, ensuring that members have access to quality care and treatment wherever they are.

Are there waiting periods for certain benefits under the UltraCare Plus plan?

Yes, there may be waiting periods for certain benefits under the UltraCare Plus plan.

Are there any limitations on the number of consultations or procedures covered under the UltraCare Plus plan?

Yes, there may be limitations on the number of consultations or procedures covered under the UltraCare Plus plan.

Is the UltraCare Plus plan affordable?

No, UltraCare Plus is one of the more expensive plans that CompCare offers, starting from R9,056 per month for the main member, which is on par with most competitors’ premium plans.

Does the UltraCare Plus plan offer health savings accounts?

Yes, an annual saving (PMSA) is available on UltraCare Plus in addition to day-to-day benefits, above the threshold, and more.

Will I have any out-of-pocket expenses under the UltraCare Plus plan?

Depending on the level of coverage and benefits selected, members may have some out-of-pocket expenses under the UltraCare Plus plan.

Does the UltraCare Plus plan offer any health and wellness programs?

Yes, UltraCare Plus offers health and wellness programs, preventative benefits, and more.

How do I enroll in the UltraCare Plus plan?

Members can enroll in the UltraCare Plus plan by contacting CompCare directly or through a registered broker.

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.