MediValue Compact
About this plan
🥇 Best suited for families seeking affordable network healthcare with lower monthly contributions.
Principal Member
From
R2,907
per month
Adult Dependant
From
R2,541
per month
Child Dependant
From
R816
per month
What's covered
Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health
Waiting periods
- General
- 3 months
- Pre-existing conditions
- 12 months
MediValue Compact
Medshield MediValue Compact Medical Aid Plan (🇿🇦 2026)
Overall, the Medshield MediValue Compact Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and SmartCare to up to 3 Family Members. The Medshield MediValue Compact Medical Aid Plan starts from R2 907 ZAR.| 👤 Main Member Contribution | R2 907 |
| 👥 Adult Dependent Contribution | R2 541 |
| 🍼 Child Dependent Contribution | R816 |
| 🌎 International Cover | Yes, Subject to scheme tariff. |
| 📉 Annual Limit | Unlimited Hospital Cover |
| 🏥 Hospital Cover | Unlimited |
| 💶 Prescribed Minimum Benefits | ☑️ Yes |
| 😷 Screening and Prevention | ☑️ Yes |
| 💳 Medical Savings Account | None |
| 🔁 Gap Cover | None |
Medshield MediValue Compact Plan - 10 Key Point Quick Overview
- Medshield MediValue Compact Plan Overview
- Medshield MediValue Compact Plan Contributions
- Medshield MediValue Compact Plan Benefits and Cover Comprehensive Breakdown
- Medshield MOM Program and Benefits
- MediValue Compact SmartCare Services and Benefits
- MediValue Compact COVID-19 Benefits and Access to Care
- MediValue Compact Plan Exclusions and Waiting Periods
- Medshield MediValue Compact Plan vs. Similar Plans from other Medical Schemes
- Our Verdict on The MediValue Compact Plan
- MediValue Compact Plan Frequently Asked Questions
Medshield MediValue Compact Plan Overview
The Medshield MediValue Compact medical aid plan is one of 10, starting from R2,907, and includes SmartCare, chronic renal dialysis, mental health, oncology, specialized radiology, generous day-to-day benefit limits, and unlimited hospital cover within the Medshield network.
A Gap Cover is not available on the Medshield MediValue Compact Plan. However, Medshield offers 24/7 medical emergency assistance. According to the Trust Index, Medshield has a trust rating of 2.4 from hellopeter.
💙 MedShield has the following medical aid plans to offer:
- ✅MedShield MediCurve
- ✅MedShield PremiumPlus
- ✅MedShield MediValue Prime
- ✅MedShield Value Compact
- ✅MedShield MediSaver
- ✅MedShield MediPlus Prime
- ✅MedShield MediPlus Compact
- ✅MedShield MediPhila
- ✅MedShield MediCore
- ✅MedShield MediBonus
Medshield MediValue Compact Plan Contributions
| 👤 Main Member | 👥 +1 Adult Dependent | 🍼 +1 Child Dependent |
| R2 907 | R2 541 | R816 |
💙POLL: 5 Best Medical Aids with Value for Money
MediValue Compact Plan Benefits and Cover Comprehensive Breakdown
MediValue Compact Hospital-At-Home
- ✅ Medshield offers a Hospital-at-Home service delivered by Quro Medical.
- ✅ The Hospital-at-Home service offers an alternative to hospitals as the center of patient care and management.
- ✅ Hospital-at-Home provides active treatment at home instead of a general hospital ward for a specified period without compromising the quality of care.
- ✅ Patients more vulnerable to hospital-acquired infections and developing new health complications may benefit from care at home.
- ✅ Patients who usually need admission to a general hospital ward are eligible for Hospital-at-Home.
- ✅ Quro Medical works with each patient and their treating doctor to develop a personalized treatment plan to deliver at home.
- ✅ Treatment plans are amended accordingly if a patient’s medical needs change during treatment.
- ✅ The clinical team at Quro Medical arranges routine home visits customized to the individual’s specific needs that may occur daily or more frequently to provide the necessary treatment and care.
- ✅ Other channels allow patients to access advice and support outside of home visits.
MediValue Compact Major Medical Benefits In-Hospital
| 🔎 Overall Annual Limit | There is no overall annual limit. Members must use the Prime Hospital Network. |
| 🏥 Hospitalization | Unlimited cover. Subject to the relevant Management Healthcare Program. Pre-approval is needed for specialist services. Must use the Prime Hospital Network. |
| 📌 Surgical Procedures | Unlimited cover. |
| 💊 Medicine upon discharge | Limited to R550 per admission. Per the Maximum Generic Pricing of Medicine Price List and Medshield Formulary. |
| 🚑 Hospitalisation Alternatives Physical Rehabilitation Sub-Acute Facilities Nursing Services Hospice Terminal Care | Unlimited, use of Compact Hospital Network applies. R38 350 per family per annum. 30% upfront co-payment for the use of a non-network facility. |
| 📍 General, Medical, and Surgical Appliances | Limited to R3,450 per family yearly. Pre-authorization is required. Only DSP, Network Providers, or Preferred Providers can be used. |
| 💙 Peak Flow Meters, Nebulizers, Glucometers, and Blood Pressure Monitors (needs motivation) | Limited to R950 per beneficiary yearly. Subject to the Appliance Limit |
| 🦻 Hearing Aids (including repairs) | Subject to the Appliance Limit |
| 👩🏻🦼 Wheelchairs (including repairs) | Subject to the Appliance Limit |
| ➡️ Stoma Products and Incontinence Sheets relating to Stoma Therapy | Unlimited if pre-approved. |
| 💤 CPAP Apparatus for Sleep Apnea | Subject to the Appliance Limit |
| ☑️ Oxygen Therapy Equipment | Unlimited cover but subject to PMB and PMB level of care. Subject to pre-authorization and the relevant Managed Healthcare Program. Clinical Protocols will apply. |
| ✅ Home Ventilators | Unlimited cover but subject to PMB and PMB level of care. Subject to pre-authorization and the relevant Managed Healthcare Program. Clinical Protocols will apply. |
| 🩸 Blood, Blood Equivalents, and Blood Products | Unlimited cover. Subject to pre-authorization and the relevant Managed Healthcare Program. Must use the Prime Hospital Network. Clinical Protocols will apply. |
| 👩⚕️ Medical Practitioner Consultations and Visits during hospital admission | Clinical Protocols apply. Unlimited cover. |
| 😴 Sleep Studies Diagnostic Polysomnograms | Unlimited Cover Subject to pre-authorization by the relevant managed healthcare program. Clinical protocols will apply. |
| 📌 CPAP Titration | Unlimited cover. Subject to pre-authorization by the relevant managed healthcare program. Clinical protocols will apply. |
| ❤️ Organ, Tissue, and Haemopoietic Stem Cell (Bone Marrow) Transplants Immuno-Suppressive Medication Post Transplantation biopsies and scans. Related radiology and pathology | Subject to the relevant managed healthcare program. Service/treatment only from facilities in the Compact Hospital Network. Clinical protocols will apply Unlimited cover but subject to PMB and PMB level of care. 30% co-payment for using a non-MediValue Compact Network Hospital. Limited to harvests in South Africa. Solid organ transplant donor work-up fees. No international donor search benefits. Bone marrow transplantation is confined to allogenic and autologous grafts from the South African Bone Marrow Registry. |
| 🌎 International Corneal Grafts and Transplants | Limited to R54 250 per beneficiary. Subject to the OAL. Clinical protocols apply. |
| 👁️ Local Corneal Grafts and Transplants | Limited to R23 250 per beneficiary. Subject to the OAL. Clinical protocols apply. |
| 📈 Pathology and Medical Technology | Unlimited cover. The Preferred Provider Network applies. Must be part of an authorized event but excludes allergy and Vitamin D testing. |
| 🏈 Physiotherapy | Limited to R3 450 per beneficiary yearly. Once this is exhausted, the benefit is subject to the day-to-day limit unless specific authorization is obtained. Subject to the hospitalization limit and then the daily limit unless pre-approved for PMBs and PMB level of care. |
| 🦾 Internal Prostheses and Devices | All joint replacements are PMB and PMB level of care. |
| 🦵 External Prostheses | Must be pre-approved. Treatment can only be obtained from a DSP, Network Provider, or Preferred provider. The benefit includes Ocular Prostheses. Clinical protocols apply. Unlimited, but PMB and PMB level of care applies. |
| 📉 Long Leg Callipers | Unlimited, but PMB and PMB level of care applies. |
| 📊 Basic Radiology | Unlimited cover. Must form part of the authorized event. Clinical protocols will apply. |
| 🧪 Specialized Radiology | Limited to R12,100 per family yearly for in- and out-of-hospital. Subject to pre-authorization by the Managed Healthcare Program. Services must be obtained from the Medshield DSP or Network Provider. |
| 1️⃣ CT Scans, MUGA Scans, MRI Scans, Radio Isotope Studies | Subject to the Specialised Radiology Limit. Clinical protocols will apply. |
| 2️⃣ CT Colonography (Virtual colonoscopy) | There is no co-payment on this benefit. Clinical protocols apply. |
| 3️⃣ Interventional Radiology replacing Surgical Procedures | Unlimited cover, but clinical protocols apply. |
| 4️⃣ Chronic Renal Dialysis Hemodialysis and Peritoneal Dialysis include the following: Material Medication Related Radiology and Pathology | Unlimited if PMB and PMB level of care are met. A non-DSP will incur a 30% upfront co-payment. Use of a DSP with Rand one for PMB admittance. |
| 5️⃣ Non-Surgical Procedures and Tests | Unlimited cover. |
| 🧠 Mental Health | Unlimited cover but subject to the PMB and PMB level of care. 30% upfront co-payment for non-Compact Network Hospitals. DSP from Rand one applies for PMB and non-PMB admissions. |
| 💉 Rehabilitation for Substance Abuse | Unlimited but subject to PMB and PMB level of care. |
| 👨⚕️ Consultations and Visits, Procedures, Assessments, Therapy, Treatment, or Counselling | Unlimited but subject to PMB and PMB level of care. |
| ➡️ HIV and Aids | According to the Managed Healthcare Protocols. Pre-authorization and Managed Healthcare Program registration are required. |
| ☑️ Anti-retroviral and related medicines | Voluntary out-of-formulary or PMB medication from a non-DSP supplier requires a 30% upfront co-payment. |
| ✅ HIV/AIDS-related Pathology and Consultations | Voluntary out-of-formulary or PMB medication from a non-DSP supplier requires a 30% upfront co-payment. |
| ✳️ National HIV Counselling and Testing (HCT) | Voluntary out-of-formulary or PMB medication from a non-DSP supplier requires a 30% upfront co-payment. |
| 😊 Infertility Interventions and Investigations | Clinical Protocols apply. Limited to interventions and investigations only. Pre-authorization and Managed Healthcare Program registration are required. |
MediValue Compact Oncology Benefits
| 1️⃣ Oncology Limit | Unlimited cover. Subject to PMB and PMB level of care. 40% co-payment upfront when using a non-DSP. |
| 2️⃣ Active Treatment (Includes Stoma Therapy, Incontinence Therapy, and Brachytherapy) | Subject to the Oncology Limit. ICON Standard Protocols apply. |
| 3️⃣ Oncology Medicine | Subject to the Oncology Limit. ICON Standard Protocols apply. |
| 4️⃣ Radiology and Pathology | Subject to the Oncology Limit. |
| 5️⃣ PET and PET-CT | Limited to 1 Scan per family per annum. Subject to the Oncology Limit. |
| 6️⃣ Integrated Continuous Cancer Care | Six visits per family per annum. Subject to the Oncology Limit |
| 7️⃣ Specialized Drugs for Oncology, Non-Oncology, and Biological Drugs | Pre-authorization is required from the Oncology Managed Healthcare provider. Clinical Protocols will apply. |
| 8️⃣ Vitreoretinal Benefit | Limited to R41,800 per family yearly. Clinical protocols apply. |
| 9️⃣ Breast Reconstruction (only after an oncology event) | Subject to pre-authorization. Clinical protocols apply. The benefit is only for Post Mastectomy (all stages) Services must be obtained from a DSP network or provider. Member must use the Medshield Specialist Network. Limited to R105,000 per family yearly and limited to (and included) in the hospitalization limit. Co-payments and prostheses limits will not apply for Breast Reconstruction. |
MediValue Compact Chronic Medicine Benefits
| 🅰️ Using a MediValue Compact Chronic Network Pharmacy from Rand one | Exclusive to PMB. Medicines will be approved according to the Medshield Formulary, with cover from Rand one. Use of a non-MediValue Compact Chronic Network Pharmacy will incur an upfront co-payment of 30%. |
| 🅱️ Supply of Medication (One month in advance) | Exclusive to PMB. Medicines will be approved according to the Medshield Formulary, with cover from Rand one. 25% upfront co-payment for the use of non-formulary medicine and a 30% upfront co-payment for the use of a non-DSP |
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MediValue Compact Chronic Disease List
- ✅ Addison’s disease
- ✅ Asthma
- ✅ Bi-polar mood Disorder
- ✅ Bronchiectasis
- ✅ Cardiac failure
- ✅ Cardiomyopathy
- ✅ Chronic renal disease
- ✅ Chronic obstructive pulmonary disease
- ✅ Coronary artery disease
- ✅ Crohn’s disease
MediValue Compact Dentistry Benefits
| 🦷 Basic Dentistry (Out-of-Hospital) | Subject to Specialised Dentistry Limit. Thereafter, subject to the Day to-Day Limit |
| 🏥 In-Hospital | Subject to the Specialised Dentistry Limit of R7 700 per family. The in-hospital cover is only for kids under 6 for comprehensive Basic Dental). Subject to Managed Healthcare Program pre-authorization. Treatment without authorization incurs a 20% penalty. Protocols and Medshield Dental Network apply. Compact Hospital Network services are required. |
| 🚑 Out-of-Hospital | Subject to the basic dentistry limit. After that, it is subject to the day-to-day limit. According to the Dental Managed Healthcare Program, protocols. Members must use the Medshield Dental Network. Pre-authorization is required for plastic dentures. A 20% penalty will be imposed if permission is not obtained before treatment. |
| 🅰️ Specialized Dentistry | There is a limit of R7,700 per family per year. All services are subject to pre-approval by the applicable Managed Healthcare Program. A 20% penalty will be imposed if permission is not obtained before treatment. Protocols and the Medshield Dental Network apply according to the Dental Managed Healthcare Program. |
| 🅱️ Impacted Teeth, Wisdom Teeth, and Apicectomy Only hospitalization, general anesthetics, or conscious sedation for bone impactions. Practitioners only cover out-of-hospital apicectomy of permanent teeth. Pre-authorization and Hospital Managed Healthcare Programs apply. Dental Managed Healthcare Programs, Protocols, and Medshield Dental Network apply. Pre-authorization for general anesthesia and conscious sedation pre-authorization, in- and out-of-hospital. No authorization is needed for local anesthetic apicectomy, impacted tooth removal, or wisdom tooth removal. | The Specialist Dentistry Restriction applies. An R800 co-payment is required for wisdom teeth extraction in a Day Clinic. An upfront co-payment of R4,000 is required if the procedure is performed in-hospital. There is no co-payment if the procedure is performed under conscious sedation in the Practitioners’ rooms. |
| ➡️ Dental Implants Covers implant-related services. Must be pre-approved. The Dental Managed Healthcare Programme, Protocols, and Medshield Dental Network apply. | Subject to the Specialised Dentistry Limit. |
| ☑️ Orthodontic Treatment Pre-approval is required. Protocols and the Medshield Dental Network apply according to the Dental Managed Healthcare Program. | The Specialist Dentistry Limit applies. |
| 👑 Crowns, Bridges, Inlays, Mounted Study Models, Partial Chrome Cobalt Frame Base Dentures, and Periodontics Includes consultations, visits, and treatment for all types of dentistry, including technician fees. Pre-approval is required. Protocols and the Medshield Dental Network apply according to the Dental Managed Healthcare Program. | The Specialist Dentistry Limit applies. Members must use the Compact Dentist Network |
| 😊 Maxillo-facial Surgery | Subject to pre-approval. The benefit is only for non-elective surgery. Subject to the Dental Management Healthcare Program and Protocols. Must use a provider from the Compact Hospital Network. It might be subject to using the Medshield specialist network. Limited to R9,150 per family yearly. |
MediValue Compact Maternity Benefits
- ✅ There will be benefits during pregnancy, after birth, and following delivery. However, pre-authorization with the applicable Managed Healthcare Program is required before hospital admission.
- ✅ Unless otherwise specified, benefits are allocated for each pregnancy subject to the Total Yearly Limit.
- ✅ A complimentary baby bag from Medshield can be obtained during the third trimester.
| 🤰 Antenatal Consultations | Six Consultations per pregnancy. It might be subject to the use of the Medshield Specialist Network. |
| 👩⚕️ Antenatal Classes and Postnatal Midwife Consults | Eight Visits per event. |
| 📉 Scans | Two 2D scans per pregnancy. |
| 🅰️ Amniocentesis Test | One per pregnancy. |
| 🅱️ Confinement In-Hospital | Unlimited cover. Must use the Prime Hospitalisation Network. |
| 👨⚕️ Delivery by a Family Practitioner or Medical Specialist | Unlimited cover. Must use the Prime Hospitalisation Network. |
| 🚑 Confinement in a registered birthing unit or out-of-hospital | Unlimited cover Must use the Prime Network. |
| 💙 Delivery by a registered Midwife or a Practitioner | Covered up to 200% of the Medshield Private rates (only for a registered Midwife). |
| 🛁 Hire of a water bath and oxygen cylinder | Unlimited cover. |
Medshield MOM Program and Benefits
To support women on their journey to motherhood, Medshield MOM has launched a dedicated website that provides information and resources for all stages of pregnancy, birth, and postpartum. This website is an easily accessible hub of valuable health, fitness, nutrition, motherhood, babies, toddlers, and more content tailored to the pre- and post-partum phases. As a Medshield member, you can take advantage of the pregnancy-related benefits. The Medshield MOM website will ensure you are fully informed of your options. 💙 Some of the features and advantages include, but are not limited to, the following:- ✅ A guide for your journey from start to finish.
- ✅ Convenient, dependable, and easily accessible pregnancy resources.
- ✅ A toddler benefit includes information on child immunization, child nutrition, a nurse helpline available 24/7, and digital/online kid yoga.
- ✅ Advice formulated by professionals.
- ✅ Reminders through email to arrange doctor’s appointments, request hospital pre-authorizations, etc.
- ✅ Emails containing updates on your unborn child’s growth and development.
- ✅ Mothers can register and enter the specific week of their pregnancy journey. Then, they will begin getting content based on that time and continuing ahead.
- ✅ The Medshield MOM bags are made locally utilizing recyclable, eco-friendly materials. These distinctive bags are filled with excellent Bennetts products for your child.
| 🅰️ Pharmacy/clinic private nurse practitioner consultations | Unlimited cover. |
| 🅱️ Nurse-led Videomed family practitioner (FP) consultations | One visit per family is subject to the Overall Yearly Limit, followed by the Family Practitioner (FP) Consultations and Visits Limit. |
| ✅ WhatsApp doc advice line | Unlimited cover. |
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MediValue Compact SmartCare Services and Benefits
SmartCare gives access to Videomed and telephone video consultations through a select group of healthcare professionals. SmartCare is a developing healthcare benefit aiming to provide members convenient care access. SmartCare services include the following:- ✅ Acute Consultations – Infections of the chest and upper respiratory tract, urinary tract, eyes, ears, etc.
- ✅ Chronic Consultations – Medication and refills for hypertension, diabetes, excessive cholesterol, etc. Then, members are advised to utilize the Medshield Chronic Medication Courier Service DSP to have their chronic medication delivered directly to their home or place of business.
MediValue Compact Day-to-Day Benefits
| 📌 Day-to-Day Limits | Limited to the following: Main Member – R8,500 Main Member +1 – R10,200 Main Member +2 – R10,600 Main Member +3 – R12,000 Main Member +4 – R13,000 |
| 📍 Family Practitioner (FP) Consultations and Visits Out-of-Hospital FP consults and visits are available in person, over the phone, and remotely. Each beneficiary is required to select one Family Practitioner from the Family Practitioner (FP) Network. From Rand one, the FP Network is applicable. | A maximum of 2 Family Practitioners (FP) from the Medshield FP Network can be nominated by each beneficiary. Subject to your nominated Family Practitioner’s daily limit. |
| 🩺 Non-Nominated FP/Emergency visits | Limited to two visits per family. Included in the day-to-day limit. Once the limit is depleted, there is a 40% co-payment. |
| 🧪 Additional FP Consultations and visits to a nominated provider | This benefit is only active once your daily limit has been exhausted. There is a limit of 2 visits per beneficiary from the OAL after daily limits are depleted. This benefit is subject to the Compact FP Network. The visit must be to a nominated FP. |
| 🅰️ Extended FP visits for emergency and chronic FP consultations | Registration in the Disease Management Program is required. Pre-approval is needed. Chronic Disease List and Clinical Protocols Apply. Unlimited cover if the daily limit and Care Plan FP visits have been depleted. Members must use a nominated FP on the Medshield network. There is a limit of one FP consultation per beneficiary. |
| 🅱️ Medical Specialist Consultations and Visits | Two visits per family per year are included in the OAL. Once these visits have been used, the benefit is limited to the day-to-day limit. If a member has not been referred, a 40% co-payment will apply. |
| ⚠️ Casualty and emergency visits | Subject to the day-to-day limit. |
| 💊 Acute Medicine | Subject to the daily limit. |
| ⚕️ Pharmacy Advised Therapy (PAT) | Subject to the day-to-day limit. Limited to R700 per script and one script per beneficiary daily. |
| 🤓 Optometry | Subjected to applicable Optometry Managed Healthcare Program and Procedures. One set of Optical Lenses and a frame or contact lenses per beneficiary every two years. Benefit determined by the Optical Service Date Cycle. |
| 👓 Optometric Refraction Eye Tests | One test per beneficiary per 24-month optical cycle. Subject to the OAL. |
| 👁️ Spectacles or Contact Lenses (Single Vision Lenses, Bifocal Lenses, Multifocal Lenses, Contact Lenses) | 1 pair of Optical Lenses or Contact Lenses per beneficiary, every 24 months. Subject to the Optical Limit. |
| 👁️🗨️ Reading Glasses | There is a limit of R220 per beneficiary. Subject to OAL. Must be supplied by a registered Optometrist, Ophthalmologist, Supplementary Optical Practitioner, or a registered Pharmacy. |
| 👓Frames | R2 230 per beneficiary included in the Optical Limit. |
| ☑️ Pathology and Medical Technology | Subject to the day-to-day limit. Subject to the relevant Pathology Managed Healthcare program and protocols. |
| 😷 Covid-19 Vaccination | Limited to Scheme Vaccination Formulary. Excludes consultation costs. Subject to the Overall Annual Limit. Protocols apply |
| 🏈 Physiotherapy, Biokinetics, and chiropractics | Subject to the day-to-day limit. |
| 📈 Basic Radiology | Subject to the day-to-day limit. There is a limit of one bone densitometry scan per beneficiary yearly in or out-of-hospital. Subject to the Radiology Managed Healthcare Program and Protocols. Subject to the Medshield Basic Radiology formulary. Only covered when referred by a Network GP. |
| 📉 Specialized Radiology | Limited to R12,100 In- and Out-of-Hospital, per family yearly. Limited to (and included in) the Specialised Radiology Limit. Subject to pre-authorization by the relevant Managed Healthcare Program |
| 📊 Non-Surgical Procedures | Subject to the day-to-day limit. |
| 📌 Procedures and Tests performed in the Practitioner’s rooms | Unlimited cover. |
| 📍 Routine diagnostic Endoscopic Procedures performed in the Practitioner’s rooms | If done in practitioner’s rooms, it is limited to and included in the overall annual limit. There is an R2,000 upfront co-payment applicable if done In-Hospital. In-Hospital co-payment is not required for children aged 8 and under. |
| 🧠 Mental Health Includes the following: Consultations and Visits Procedures Assessments Therapy Treatment or Counselling | Members must use the Medshield Specialist Network. Limited to (and included in) the day-to-day limit. |
| ➡️ Intrauterine Devices and Alternatives | Covers consultation, pelvic ultrasound, sterile tray, device, and insertion, if performed the same day. Subject to the applicable clinical protocols. The Medshield Specialist Network must be utilized. It should be performed at the practitioner’s office. Only covered if no hormonal contraceptives are taken, but only upon application Limited to 1 per female recipient. Subject to the Yearly Maximum Limit. Included are all IUD brands up to the cost of the Mirena device. One Mirena/Kyleena device per female patient every five years. Implanon – one per female recipient every three years. One Nova T/Copper device per female patient every two years. |
| 💙 Additional Medical Services Including the following: Audiology Genetic Counselling Hearing Aid Acoustics Occupational Therapy Orthoptics Podiatry Speech Therapy and Private Nurse Practitioners Dietetics | The in-hospital referral is subject to authorization. Subject to the day-to-day limit. |
| 🩹 Alternative Healthcare Service (Only applies to Acupuncturists, Homeopaths, Naturopaths, Osteopaths, and Phytotherapists) | Subject to the day-to-day limit. |
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MediValue Compact Wellness Benefits
Medshield’s Wellness Benefit program empowers members to proactively manage their health by undergoing preventative tests and procedures. The company strongly advises its members to schedule the necessary tests at least once per year. Medshield members must use pharmacies included in their benefit options’ Pharmacy Network to access the Wellness Benefits. Members must note that benefits are subject to the Overall Annual Limit. Once that limit has been reached, the benefits will be subject to the Day-to-Day limit. However, consultations for specific services are excluded from these limits.| 💉 Adult Vaccination | Limited to R520 per family yearly. Once this limit is reached, payment is made from the day-to-day limit. |
| 💊 Birth Control (Contraceptive Medicine) | Limited to a maximum of 13 prescriptions per year per female recipient between the ages of 14 and 55, with an R235 limit per prescription. Subject to Acute Medical Benefit Limit. Only relevant in the absence of intrauterine devices and alternatives. |
| 😷 COVID-19 Vaccines | Subject to the Overall Annual Limit. Protocols apply. |
| 🤒 Flu Vaccines | One per beneficiary aged 18 or older is included in the Yearly limit. There is no benefit after that. |
| ☑️ Pap Smear | One per female beneficiary. |
| 📈 Health Risk Assessment on the SmartCare Network Cholesterol Blood Glucose Blood Pressure Body Mass Index (BMI) | One per beneficiary 18> |
| 📉 Pneumococcal Vaccination | One per annum for high-risk individuals and beneficiaries 60 years>. |
| 📊 National HIV Counselling Testing (HCT) | One test per beneficiary. |
| 📌 HPV Vaccination | One course of two injections per female beneficiary between 9 to 13 years old. Subject to qualifying criteria. |
| 📍 PSA Screening for Male Beneficiaries | Subject to the OAL. |
| 💙 Tuberculosis Test | One test per beneficiary. |
| 🩺 Mammogram (Breast Screening) | One screening per female beneficiary 40> |
Wellness Benefits – Child Immunisations
This benefit and immunization program as per the Department of Health Protocols according to these age groups:| ❤️ At Birth | Tuberculosis (BCG) Polio OPV |
| 🧡 6 Weeks | Polio (OPV) Diphtheria Tetanus, Pertussis (Whooping Cough) Hepatitis B Hemophilus Influenza B (HIB) Rotavirus Pneumococcal |
| 💛 10 Weeks | Polio Diphtheria Tetanus Pertussis (Whooping Cough) Hepatitis B Hemophilus Influenza B (HIB) Pneumococcal Rotavirus (Optional) |
| 💚 14 Weeks | Polio Diphtheria Tetanus Pertussis (Whooping Cough) Hepatitis B Hemophilus Influenza B (HIB) Rotavirus Pneumococcal |
| 💙 6 Months | Measles MV (1) |
| 💜 9 Months | Measles, Pneumococcal, and Chickenpox CP |
| ❤️ 12 Months | Measles MV (2) |
| 🧡 15 Months | Chickenpox CP |
| 💛 18 Months | Polio, Diphtheria, Tetanus, Pertussis (Whooping Cough) Measles Mumps and Rubella (MMR) |
| 💚 6 Years | Polio Diphtheria and Tetanus (DT) |
MediValue Compact Ambulance and Emergency Services
A 24-hour Hotline will be available to members and their registered dependents. In addition, members can dial 086 100 6337 to reach the Ambulance and Emergency Services, provider. Medshield Emergency Medical Services- ✅ Subject to pre-approval by the supplier of Ambulance and Emergency Services.
- ✅ Air Evacuation necessitates scheme approval.
- ✅ Applying Clinical Procedures.
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MediValue Compact Prescribed Minimum Benefits
Medshield members are entitled to cover Prescribed Minimum Benefits (PMBs), regardless of their chosen benefit option. Medshield assumes the cost of PMB treatments if they are provided by one of Medshield’s Designated Service Providers (DSPs) in compliance with the Scheme Rules. The Medical Schemes Act 131 of 1998 mandates that all medical plans must cover the costs associated with the following:- ✅ Any potentially fatal medical emergency
- ✅ A set of 26 Chronic Disease List (CDL) diseases that are well-defined
- ✅ 271 DTP diagnoses.
| 1️⃣ In-Hospital Admissions for treating PMBs | If you are diagnosed with a PMB disease requiring hospitalization, you must comply with the Medshield hospital authorization process. It would help if you utilized a hospital that is a part of the Hospital Network for your selected insurance package, as all stay, and treatment fees have negotiated prices. Specialist services obtained during hospitalization are reimbursed at the Scheme rate. If the Scheme rate does not cover the entire claim amount, you must apply to the Scheme and request that the Specialist’s rate be paid at cost instead of the Scheme rate. |
| 2️⃣ Out-of-Hospital treatment and managing PMBs | Members diagnosed with any 26 CDL conditions covered by Medshield and MediValue Compact must apply to Mediscor for approval. The member automatically receives a Care Plan (treatment plan) notification from the Scheme after the healthcare provider claims with the ICD-code as authorized. The Care Plan details and approves benefits like radiography, pathology, and doctors’ visits. After using the Care Plan, the member and their treating provider must fill out a PMB Application form to seek clearance for further treatment. If approved, a revised Care Plan will include the additional treatment. |
| 3️⃣ MediValue Compact Option Payment for PMB conditions | The Day-to-Day limit on your benefit option or plan is a risk allocation made available to members. As a result, a PMB will pay from your Day-to-Day limit until it is empty, then pay from Risk until the services on your Care Plan have been used. Suppose you require additional services that are not included in your Care Plan. In that case, you and your treating provider must complete a new PMB Application form. |
| 4️⃣ 271 DTP Conditions | Members with DTP must complete a PMB application form with their doctor. If they do not complete a PMB Application form, the Day-to-Day or Savings will pay for treatment. The Care Plan (treatment plan) will list the covered treatments for the condition after clinical assessment and approval. |
| 5️⃣ COVID-19 as a PMB | Respiratory DTP PMB includes Covid-19. After seeing a doctor, members might need a COVID-19 PCR or SARS-CoV-2 Antigen test. According to the Plan Regulations, this benefit requires a doctor or nurse referral and payment. MediValue Compact covers either a PCR or an antigen test, but not both. |
MediValue Compact COVID-19 Vaccines
The COVID-19 PCR Test or Antigen Tests have the following features and conditions:- ✅ Limited to Scheme Vaccination Formulary. Excludes consultation costs.
- ✅ Subject to the Overall Annual Limit. Protocols apply.
MediValue Compact Plan Exclusions and Waiting Periods
MediValue Compact Exclusions
MediValue Compact does not cover the following:- ☑️ Primary (milk) teeth root canal treatment
- ☑️ Procedures for direct and indirect pulp capping
- ☑️ From a metal base to full dentures, including laboratory fees
- ☑️ Acrylic with a high impact
- ☑️ Gold, precious metal, semi-precious metal, and platinum foil prices
- ☑️ Fees for laboratory delivery.
- ☑️ Equipment, devices, and procedures that have not been scientifically proven or are not acceptable
- ☑️ Chair backrests and seats
- ☑️ Bandages and dressings (except for medicated dressings and dressings used during a procedure or treatment)
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MediValue Compact Waiting Periods
Often, there is a waiting period for pre-existing conditions. According to the Medical Schemes Act No. 131 of 1998, the following waiting periods may apply:- ☑️ A 3 (three) month general waiting time for all benefits.
- ☑️ A maximum 12 (twelve) month exclusion for a previous ailment.
- ☑️ A late joiner contribution penalty.
MediValue Compact Plan vs. Similar Plans from Other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 Medshield MediValue Compact (2026) | 🥈 Momentum Custom | 🥉 Discovery Essential Core |
| 🌎 International Cover | Yes, subject to scheme tariff. | R5 million per year | R5 million |
| 👤 Main Member Contribution | R2 907 | R2,353/month | 3,138 |
| 👥 Adult Dependent Contribution | R2 541 | R2,353/month | 2,354 |
| 🍼 Child Dependent Contribution | R816 | R786 per child | R1,260 |
| 💙 Hospital Cover | Unlimited | Unlimited | Unlimited |
| ➡️ Oncology Cover | Unlimited, subject to PMBs | Oncology cover subject to the Momentum Scheme's rules. | R250,000 |
Our Verdict on The MediValue Compact Plan
Medshield MediValue Compact is a healthcare plan offered by Medshield Medical Aid in South Africa. This plan is designed to offer affordable healthcare coverage while providing its members comprehensive benefits and services.
The MediValue Compact plan has the same benefits, treatments, limits, and services as the MediValue Prime plan. However, MediValue Compact has a 40% co-payment on specific treatments if certain conditions are not met before treatment.
The features of the Medshield MediValue Compact plan include cover for a range of healthcare needs, including maternity benefits, vision care benefits, dental care benefits, and chronic medication.
Members can also access a network of healthcare providers to help manage their healthcare needs. The plan is designed to be affordable for those who want comprehensive coverage but also need to manage their healthcare costs.
The MediValue Compact plan differs primarily from the MediValue Prime plan only in its co-payment feature. As a result, the MediValue Compact is better for those who do not require frequent or ongoing treatments and who will not deplete their available benefits, resulting in co-payments.
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