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Compcare Pinnacle ED:
dentistry, optometry and wellness (2024)

This page has information on: Costs, Dentistry , Optometry Wellness and Preventative and Other benefits for Compcare Pinnacle ED

We also have information on: In-hospital, Out of Hospital, Medicine, Maternity, Cancer, Mental Health and Prosthetics benefits.

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Monthly Costs:

Pinnacle ED 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R8,172
  • R6,359
  • R2,276
  • Only pay for 3 children
Savings:
  • R19,608
  • R15,252
  • R5,460
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • R4,032
  • R3,144
  • R1,116
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R3,660
  • R2,520
  • R756
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Main= R10,700
  • Main+1= R22,050
Children Rates:
  • Under 21 yrs, unless student or financially dependent. Then, under 27yrs.
  • Only pay for 3 children
Note:
  • Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list.
  • All treatments and procedures are subject to authorisation and protocols
  • All benefits are listed as an indication only. Please verify with your broker and scheme
♦️View all the other benefits for this plan:♦️
Inhospital | 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
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Dentistry benefits (2022):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Compcare: Pinnacle ED
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:
  • From from day-to-day benefit
  • Unlimited once day-to-day is depleted.
Specialised Dentistry:
  • From day-to-day benefit
In-Hospital Dentistry:
  • Maxillofacial and oral surgery- in-and-out of hospital combined limit: shared with Specialised Dentistry benefit
 PMBs are always covered by the scheme, and cannot have sublimits or co-payments imposed. These include fracture of face bones, orbit and/or jaw. You can see a full list of maxillo facial PMB benefits here.
Orthodontics:
  • See "Specialised dentistry", above
Note:
  • 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:♦️
Inhospital | 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
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Optometry benefits (2022):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Compcare: Pinnacle ED
Assume scheme pays all these costs, unless otherwise stated
Optometry:
  • Lenses and contact lenses:
  • R5,200 per person, (but not from above-threshold benefit)
  • Frames:
  • R2,600 per person, as part of above limit
  • Radial keratotomy and excimer laser: R7,800 per eye
Note:
  • This section does not apply to opthamology benefits, which fall under "in-hospital" benefits. Some of those are PMBs, and are paid for in full by your scheme. You can read more about PMBs here.
♦️View all the other benefits for this plan:♦️
Inhospital | 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
.
.
.

Wellness/Preventative benefits (2022):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Compcare: Pinnacle ED
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • Covered
Pneumonia vaccines:
  • As required
Biometric Screening:
  • Covered
Child Immunisation: .
Pap Smear:
  • Covered , 18+ every year
Mammogram:
  • Covered , 35yrs+ every 2 yrs
PAS Test:
  • Covered
HIV Test:
  • Covered
Other:
  • Preventative malaria medication
  • Tetanus vaccine
  • Glaucoma test
  • Colorectal cancer screening test, 45-75yrs
♦️View all the other benefits for this plan:♦️
Inhospital | 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
.
.
.

Other benefits for 2022:

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Pinnacle ED
International Insurance:
  • Access to emergency medical care when travelling outside of South Africa
Other: .
♦️View all the other benefits for this plan:♦️
Inhospital | 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
.

    Important!
  • Unless specified, assume that all benefits are paid are paid at 100% scheme rate
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • "Unlimited" benefits are still subject to authorisation, protocols and sublimits
  • Assume that all benefits need to be pre-authorised

Also see these:




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