CompCare Medical Scheme
CM

CompCare Medical Scheme · CompCare Medical Scheme Plans

CompCare UltraCare Plus Medical Aid Plan

standard tier

GPs and Specialists

Covered up to 100% of the scheme rate.Unlimited.Subject to pre-authorisation andmanaged care protocols.

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 410 PMF applies, subject to overall ATB limit.Referral by GP required, and pre-authorisation 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 890 PB and subject to available AFB.ATB: No benefits.

Chronic Medicine

Covered 100% of reference price.First paid from AFB. Scheme willcover costs once AFB is depleted.DSP pharmacies apply to UltraCare.Subject to formularies, protocols and pre-authorisation.25% co-payment for non-formularymedicine, and use of a non-DSP.(27 CDL conditions)

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 740 PMF applies, subject to overall ATB limit.DSP pharmacies apply to UltraCare.Subject to formularies, protocols and pre-authorisation.25% co-payment for non-formularymedicine, and use of a non-DSP.Cover also provided for the 27 listedCDL conditions.

Monthly Premiums

family
R880

Effective from January 2026

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