Sign-up - CompCare Medical Scheme

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Begin Your Journey

Follow the simple sign-up process to become a member of the CompCare Medical Scheme.

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Pick Your Option*

We have two MUMED options for you to pick from. The one is the standard MUMED medical scheme and the other is the MUMED Efficiency Discount (ED) option. Please select your choice.

MUMED

FROM R4 826 per month

The standard MUMED plan, does not limit you to specific pharmacies or hospitals. 2024 rates applicable until 31 December.

Learn more about the standard MUMED option.

MUMED Efficiency Discounted (ED)

FROM R3 917 per month

Similar to the standard MUMED plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals. 2024 rates applicable until 31 December.

Learn more about the standard MUMED option.

First Dependant

Title*

First Name(s)*

Surname*

Initials*

Phone*

Email*

ID Number*

Race*

Gender*

Dependant Type*

Smoker*

Relation to member*

Date Of Birth*

Second Dependant

Title*

First Name(s)*

Surname*

Initials*

Phone*

Email*

ID Number*

Race*

Gender*

Dependant Type*

Smoker*

Relation to member*

Date Of Birth*

Third Dependant

Title*

First Name(s)*

Surname*

Initials*

Phone*

Email*

ID Number*

Race*

Gender*

Dependant Type*

Smoker*

Relation to member*

Date Of Birth*

Fourth Dependant

Title*

First Name(s)*

Surname*

Initials*

Phone*

Email*

ID Number*

Race*

Gender*

Dependant Type*

Smoker*

Relation to member*

Date Of Birth*

Fifth Dependant

Title*

First Name(s)*

Surname*

Initials*

Phone*

Email*

ID Number*

Race*

Gender*

Dependant Type*

Smoker*

Relation to member*

Date Of Birth*

Do you have an extra moment?*

Your Medical History

It is most important that the questions on the following page be answered as thoroughly as possible. The answers to these questions will be treated as confidential. It is important to note that any medical condition, of which you are aware, not disclosed in this application, can be excluded from benefit. Please advise whether you or any of your dependants suffer from, or have suffered from, or received treatment/consultation for any of the following conditions. Please ensure that you tick and complete the appropriate block/s.

Heart & Vascular System*

High blood pressure; high cholesterol; angina; heart attack; angiogram; previous coronary artery bypass; rheumatic fever; heart murmurs; valve problems / replacement; arrhythmias – insertion of pacemakers; heart failure; stroke; varicose veins; DVTs (deep vein thrombosis); pulmonary embolism.

Condition Details*

Emotional (psychological, psychosomatic problems)*

Depression; bipolar disorder; anxiety; stress; previous treatment for post traumatic stress syndrome; eating disorders – bulimia & anorexia; mental retardation; alcoholism; drug abuse. Have you or any of your dependants been on sleeping tablets or antidepressants?

Condition Details*

Gynaecological System*

Menopause; female hormone replacement; irregular menses; infertility; breast tumours (benign / malignant); ovarian tumours; cysts; prolapsed uterus / rectum / bladder; miscarriage; caesarean section; etc.

Condition Details*

Bone; Muscle & Joints*

Arthritis; rheumatism; gout; back, knee or neck problems; fibromyalgia; previous fractures; deformities; degenerative muscle disease; osteoporosis; etc.

Condition Details*

Nervous System*

Persistent headaches; epilepsy; paralysis; degenerative diseases – Alzheimer’s; Parkinson’s; multiple sclerosis; stroke; neuralgias; ADD (attention deficit disorder).

Condition Details*

Gland / Hormonal*

Over / under active thyroid; diabetes mellitus; Cushing’s syndrome; Addison’s disease; pituitary gland abnormality.

Condition Details*

Male Genital System*

Prostate problems (hypertrophy / cancer or infections); infertility; hernias – groin; scrotal swellings; testicular tumours; abnormalities of the penis; problems with urination.

Condition Details*

Ear, Nose & Throat*

Allergies (rhinitis, sinusitis); chronic infections (otitis, tonsillitis); nasal reconstruction; snoring; sleep apnoea; deafness – hearing aids.

Condition Details*

Eyes*

Poor vision; birth defects; degenerative disease (glaucoma; retinitis pigmentosa; cataracts; keratoconus); allergies – pterygiums; anticipated / previous laser surgery; artificial eyes.

Condition Details*

Pregnancy*

Are you or any of your dependants pregnant? If yes - how many weeks? Please give expected date of delivery.

Condition Details*

Lungs*

Asthma; emphysema; chronic bronchitis; TB; chronic infections - bronchitis & pneumonia.

Condition Details*

Urinary Tract*

Infections; stones; albumin / blood in urine; urinary incontinence; prolapsed bladder.

Condition Details*

Blood*

Anaemia; bleeding disorders (haemophilia); leukaemia; Hodgkin’s disease.

Condition Details*

Digestive System, Gallbladder; Liver*

Dyspeptic disease (heartburn; hiatus hernia; peptic ulcers; reflux); irritable bowel syndrome (spastic colon; inflammatory bowel disease e.g. Crohn's & ulcerative colitis; chronic diarrhoea / constipation); gallstones & jaundice; hepatitis; pancreatitis; haemorrhoids; incontinence; bowel prolapse.

Condition Details*

Immuno-Suppressive Treatment*

Have you or any of your dependants ever had or expecting to undergo an organ treatment transplant? Have you or any of your dependants ever suffered from any condition requiring Immunosuppressive treatment?

Condition Details*

Chronic Conditions*

Do you or any of your dependants have a chronic condition requiring ongoing medication? If yes, please give the name and dosage of all the medication you or any of your dependants are currently taking.

Condition Details*

Medical Treatment*

Are you or any of your dependants expecting to undergo any medical treatment, e.g. hospitalisation, operation, specialised dentistry etc, within the next twelve months?

Condition Details*

Medical Attention*

Have you or any of your dependants ever received any medical attention of any nature, e.g., hospitalisation, operation, specialised dentistry etc, not mentioned above?

Condition Details*

Infections / Tropical Diseases*

Sexually transmitted diseases; genital warts; HIV / AIDS; hepatitis; ME-Virus (Yuppie Flu); malaria; bilharzias; cholera; typhoid.

Condition Details*

Skin Disorders*

Acne; eczema; psoriasis; lesions (keloid hypertrophic scars); skin rashes; shingles; Kaposi sarcoma – tumours.

Condition Details*

Allergies*

Are you or any of your dependants allergic to any specific type of medication (e.g. penicillin, aspirin, sulphas, morphine, NSAIDS); pollen dust; animals; specific food types (e.g. nuts).

Condition Details*

Teeth & Gums*

Impacted molars (wisdoms); previous / current orthodontic treatment; braces; crowns; recurrent infections - gums.

Condition Details*

Therapy/Treatments*

Have you or any of your dependants ever received any form of physiotherapy, occupational therapy or chiropractic treatment?

Condition Details*

Connective Tissue Disorders*

Systemic lupus erythromatosis; scleroderma; rheumatoid arthritis.

Condition Details*

Cancer*

Cysts; growths; tumours of any kind.

Condition Details*

Thank you for your assistance. I deal with medical aids on a daily basis and it usually leaves me less than impressed. I am very impressed with the service I received from you. You were very professional and helpful with my enquiry, you are most definitely a sterling representative of your company. Keep up the good work.

Nicci

I am sending this mail just to extend my appreciation and say thank you very much for the awesome, amazing service that I have received from you yesterday, I am really grateful and amazed at the quality of service that I have received.

Please keep up the awesome work!!!

Ricardo Minadoo

SIGN UP

Begin Your Journey

Follow the simple sign-up process to become a member of the CompCare Medical Scheme.

MUMED

FROM R4 826 per month

Learn more about the standard MUMED option.

MUMED Efficiency Discounted (ED)

FROM R3 917 per month

Learn more about the standard MUMED option.

Quick Note

You might need to upload digital copies of the following documents where applicable.

Your Details

Your Address Details

Your Dependants

First Dependant

Second Dependant

Third Dependant

Fourth Dependant

Fifth Dependant

Your Medical History

Option Cost

Your Payment Details

Your Claim Refund Details

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