This page has information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Compcare SaverCare Plus.
In-hospital Procedures (2022):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated |
| non-Network Specialists: |
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| network Specialists: |
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| non-Network GPs: |
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| network GPs: |
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| Hospital Choice: |
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| Day Hospitals: |
- No specific requirements for day hospital use are listed
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| Penalty for using other hospital: |
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| Other Co-payments: |
- Gastroscopy: R4,900 co-payment
- Colonoscopy: R4,900 co-payment
- Cystoscopy: R4,900 co-payment
- Proctoscopy: R4,900 co-payment
- Nasal or sinus endoscopy: R 4,900 co-payment
- Functional nasal surgery and septoplasty: R9,000 co-payment
- Hysteroscopy: R4,900 co-payment
- Flexible sigmoidoscopy: R4,900 co-payment
- Arthroscopy: R9,000 co-payment
- Minor gynaecological laparoscopic procedure: R4,900 co-payment
- Dental: R4,900 co-payment
- Excision lesion- benign and malignant: R4,900 co-payment
- Joint replacements- arthroplasty: No benefit co-payment
- Conservative back and neck treatment- spinal cord injections: No benefit
- Laminectomy and spinal fusion: No benefit
- Nissen fundoplication- reflux surgery: R23,000 co-payment
- Hysterectomy, except for cancer: R17,000 co-payment
- Laparoscopic hemi colectomy: R5,900 co-payment
- Laparoscopic inguinal hernia repair: R5,900 co-payment
- Laparoscopic appendectomy: R5,900 co-payment
- Adenoidectomy, myringotomy- grommets, tonsillectomy: R3,750 co-payment
- Laparoscopy, hysteroscopy, endometrial ablation: R9,000 co-payment
- Annual Limit for the above procedures: R31,500
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| Specialised Radiology: |
- MRI, CT and PET Scans: R24,000 per family, unless PMB or otherwise authorised
- No benefit for screening purposes
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| Scopes: |
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| Supplementary Services: (Physio, etc) |
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| Transplants: |
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| Dialysis: |
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| Exclusions: |
Exclusions:
- Deep brain implants (e.g. Parkinson’s Disease) and internal nerve stimulators
- Corneal transplants
- Cochlear implants
- Bunion surgery
- All spinal surgery (including neck), except in the event of acute injury
- All joint replacements, except in the event of acute injury.
- Laminectomy and spinal fusion
- Note: All schemes have extensive exclusions. We've tried to list the major ones here, but please consult your scheme or broker to get the full list.
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| Alternatives to hospitals: |
- Home nursing: PMBs only
- Step-down nursing, hospice and rehab: as authorised
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| Casualty: |
- One visit per child under 6 yrs: R1 300 paid by scheme
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| Other: |
- Pathology: R26,800 per family, in and out of hospital
- Post hospital care: Biokineticist, OT and physio. R3,800 per person and R2,800 per family
- Treatment for injuries due to extreme sports are covered
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| Note: |
- PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
- DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
- Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
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View all the other benefits for this plan:
In-hospital |
Out-of-hospital |
Medication |
Maternity
Cancer |
Mental Health |
Dentistry |
Optometry
Other/Extra Benefits |
Wellness |
Prosthetics
You can also:
Compare any two plans, side by side |
View all the Compcare plans, with costs and brief summary.
Find all other open medical aid plans here.
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Out-of-hospital Procedures (2022):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated |
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Main Member: |
Adult: |
Child: |
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- All medical aids must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
- This can include consults with specialists, blood or other tests, radiology and medicine
- The benefit is paid by the scheme, and not out of your savings account
- If you have no day-to-day funds, you still have cover for PMBs
- Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
- See our Guide to PMBs for more information.
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- One wellness consult, excluding procedures, paid by scheme
- Unlimited GP consultations and basic dentistry for children under 6yrs, paid by scheme
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- Baby Wellness consults: 2 per year, for 4m-18m
- Unlimited GP consultations and basic dentistry for children under 6yrs
- Initial Occupational Therapy consultation
- School readiness assessments
- Kid’s active benefit assessment and exercise prescription
programme
- Kid’s nutritional benefit assessment and healthy eating programme
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| Scopes: |
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- Speech therapists, social workers, podiatrists, occupational therapists, homeopaths and naturopaths, dietitians, chiropractors (X-rays excluded), audiologist, physiotherapy and biokinetics in-and-out of hospital:
PMBs only
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- PMBs: Prescribed Minimum Benefits. To read more about PMBs click here
- DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
- Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
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View all the other benefits for this plan:
In-hospital |
Out-of-hospital |
Medication |
Maternity
Cancer |
Mental Health |
Dentistry |
Optometry
Other/Extra Benefits |
Wellness |
Prosthetics
You can also:
Compare any two plans, side by side |
View all the Compcare plans, with costs and brief summary.
Find all other open medical aid plans here.
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All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.
Medication Benefit (2022):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, unless otherwise stated |
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Main Member: |
Adult: |
Child: |
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| Chronic: |
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- R2,950 per person, including devices
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- R160,000 per family, with 25% co-payment
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- Schemes have very strict rules about where you can get your medicine to get full benefit. We do not list the requirements here, so confirm with your scheme before you collect your medicine.
- Formulary: A pre-defined list of approved medicines. Each plan has a different list, and might not pay for non-listed medicine. Confirm with your scheme whether your required medicine is covered by them.
- PMBs: Prescribed Minimum Benfits. To read more about PMBs click here
- DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
- Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
|
View all the other benefits for this plan:
In-hospital |
Out-of-hospital |
Medication |
Maternity
Cancer |
Mental Health |
Dentistry |
Optometry
Other/Extra Benefits |
Wellness |
Prosthetics
You can also:
Compare any two plans, side by side |
View all the Compcare plans, with costs and brief summary.
Find all other open medical aid plans here.
|
| . |
All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.
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