Medical Aid Plan - Compcare

CompCare Medical Aid South Africa

 

Are you looking for affordable medical aid cover with a good range of benefits?

While we all know that medical aid can cost an arm-and-a-leg, we also all know that medical cover is necessary because of the crippling cost of private healthcare in South Africa today.

And, believe or not, there IS a medical scheme out there that serves the ordinary man-in-the-street who earns an average income.

Look no further than CompCare

That scheme is CompCare, winner of an industry Excellence Award and rated Number One when it comes to affordable premiums PLUS a solid range of benefits.

Earlier in 2018 GTC, a financial services company revealed a survey that put CompCare in the Number One, Two and Three spots in both the entry level low and mid-salary income bracket range.


CompCare premiums in 2019

For an entry-level medical aid package, income and monthly CompCare premiums are as follows: 

  • Income up to R4 000 – monthly premium R450
  • Income between R4 001 and R5 000 – monthly premium R576
  • Income between R5 001 and R6 000 – monthly premium R576

For a mid-salary package:

  • Income between R6 001and R8 000 – monthly premium R690
  • Income between R8 001 and R9 000 – monthly premium R690
  • Income between R9 001and R10 000 – monthly premium R732

CompCare was placed fifth in the high-salary package:

Income from R10 000+ - monthly premium R1 440
(These figures are based on a single membership)

Survey focus

The GTC survey analysed 272 medical scheme packages offered by 21 different companies. Broker Jill Larkan stated that the CompCareNetworx range of products gave consumers the “best bang for their buck.”

Larkan also investigated micro-elements such as monthly premiums and value for money.

The combination of these two elements determines a company’s long- term sustainability and CompCare was one of five medical schemes that came out tops.

Member-centric product range 

You’ve got to take your hat off to a company like CompCare.

It focuses its attention on an affordable member-centric range of medical aid products that are nevertheless packed with necessary benefits.

CompCare has made sure that everyone, no matter how modest their income, can afford one of its six different medical aid products.

These six packages incorporate a five-pronged healthcare approach:

 

  1. Health Promotion that includes regular check-ups, a disease management programme, healthy diets, exercise and emotional support.
  2. Prevention such as immunisations, pap smears, mammograms and optometry check-ups.
  3. Curative such asunlimited hospitalisation, GP visits, basic dentistry and oncology programmes, as well as a comprehensive range of day-to-day benefits.
  4. Rehabilitation that includes step-down facilities, post-operative benefits and home care.
  5. Supportive/Palliativeincluding emotional wellness, disease and HIV management programmes,home and hospice care.

 

The CompCareNetworx benefits

Basic but essential benefits are built into the CompCare medical aid packages. Some of these include:

  • Private hospital and nursing homes - 200% of the *specified scheme rate
  • Unlimited overall annual limits
  • Specialised radiology such as MRI, CT and PET scans – paid at 100% of the scheme rate (pre-authorisation required)
  • Oncology – unlimited chemo and radiotherapy (pre-authorisation is required)
  • Unlimited cover for step-down nursing facilities, hospice care and rehabilitation (pre-authorisation is required)
  • Day-to-day benefits are financed from Personal Medical Savings Accounts (PMSA)
  • When annual thresholds are exceeded, beneficiaries are limited to an additional R9 150 from Above Threshold Benefits (ATB), subject to additional sub-limits

*Specified scheme rates apply to all levels of medical aid cover.

These dependon the level of benefits paid for by the member. It is the responsibility of the principal medical aid policy to ensure that he/she reads and fully understands the content of the document. If unsure about any aspect of your cover, ask for advice from your medical scheme or insurance broker.


The 2019 CompCare medical cover product range


TheCompCare Wellness Medical Scheme has been operating in South Africa for the last 40 years.

Its holistic, preventative and promotional approach to healthcare is among the best in the industry.

There are six different options from which to choose but it’s the CompCareNetworx medical cover that has attracted so much attention. Not only is it affordable, but it also has an impressive array of built-in benefits.

Prescribed Minimum Benefits (PMBs)
*PMBs include:

  • Organ transplants
  • Renal dialysis
  • Step-down nursing facilities, hospice care and rehabilitation
  • Terminal care
  • Oncology including radio and chemotherapy
  • Surgical prostheses
  • Pacemakers
  • MRI, CT and PET scans

*All of these procedures are subject to being listed as a PMB and some require pre-authorisation or other stipulation. 

Chronic medication

 CompCare covers 27 chronic conditions that appear on the Chronic Disease list.

Once registered for chronic medication, members enjoy unlimited benefits with no co-payments. They will, however, be subject to a 25% co-payment for medication that does not appear on the scheme’s list. Also, full cover for medication only applies if the product is equal to or less than the amount shown on the reference price list. 

Emergencies 

The following *emergency care benefits apply:

  • Roadside assistance
  • Ambulance transportation
  • In-hospital emergency treatment
    *A 25% co-payment is applicable if a member fails to obtain authorisation within 24-hours of the emergency.

Women’s health 

  • Oral contraceptives up to R130 per beneficiary monthly
  • Receive a baby bag after registering on the maternity programme
  • Obtain pre-authorisation for confinement benefits
    Preventative Care
  • One annual GP wellness consultation
  • Check-ups for blood pressure, sugar levels, cholesterol
  • One annual flu vaccination 

Emotional wellness

  • In-hospital psychiatric treatment limited to 21 days per family
  • Alcoholism and drug dependency as a listed PMB
  • Unlimited telephonic counselling sessions with a network psychologist or social worker 


Mobile App

CompCare’s mobile app places information at your fingertips.
You can view your medical scheme plan and benefits, as well as lodge a claim anywhere and at any time.


Mobile App features include:

  • Submit and view your claims
  • Submit and view your hospital pre-authorisation requests
  • Submit your questions
  • View a digital version of your Membership Card
  • View your annual limits, available balances and benefits
  • Request your membership or tax certificates
  • View all your registered chronic conditions, register new conditions, update your scripts or apply for extended supplies
  • Access your personal details, dependant and scheme details
  •  Search for Network Specialists in your area 

CompCare Overview

Taking all these benefits into consideration leaves little doubt that CompCare medical cover is a great option when it comes to saving a ton of cash.

Remember, the onus is always on the policyholder to understand the benefits and shortfalls of his/her medical policy.

 

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Medical Aid QuoteNOTES:

Your medical aid quote will include options to suit your pocket. Please ensure that the cover you select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to ask questions about the medical aid or hospital cover you choose.