CompCare MEDICAL SCHEMEBegin Your JourneyWe’ll guide you through the sign-up process in 5 simple steps.Hi There! You ready?Let's startYou might need to upload copies of the following documents where applicable.Identity Documents / PassportsMembership certificate(s) from previous medical scheme(s) - if applicableProof of registration at educational institution / affidavit confirming financial dependency for adult dependants 21 years and olderProof of adopted or foster children Pick Your CompCare OptionFirst Name(s)*When Should Your Medical Aid Start?* Date Format: YYYY dash MM dash DD Surname*What CompCare Option Are You Interested In?*Select OptionMedXMedX Efficiency DiscountUnisaveSymmetrySymmetry Efficiency DiscountMumedMumed Efficiency DiscountDynamixDynamix Efficiency DiscountPinnaclePinnacle Efficiency DiscountPrerequisite For NetworX / NetworX ED ApplicationsPlease upload three of your latest salary slips, IRP5 or IT34 documents to continue with your NetworX or NetworX ED option application. Drop Your File(s) Here A Quick MEDX RecapYou will love MEDX if you’re a dynamic, successful businesswoman, businessman or young professional, and you know what you want. You spend your money carefully and you want the best value. You can take care of your day-to-day spending when you need to see a doctor or dentist yourself, using your credit card. What you need is the best hospital plan, affording you security and the best possible value.A Quick MEDX Efficiency Discounted (ED) RecapSimilar to the standard AXIS plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.A Quick UNISAVE RecapYou will love UniSave if you want to be in charge of your day-to-day spending and you’re looking for flexible savings to use as and when you want. You don’t want to lose what you don’t use. You expect your unused savings to be carried over year-after-year until you really need it. You want to make use of the healthcare provider of your choice, when necessary. You want choices.A Quick MUMED RecapYou will love Mumed if you’re young at heart, and part of the modern generation focused on getting traction in your career and making a success of your life. You recently got married and are planning to start a family, or perhaps you already have a toddler in your newly built first home, and are planning to have another? You’re naturally discerning when it comes to selecting a medical scheme option. Why wouldn’t you be? It’s an important decision. You’ve got responsibilities now, like looking after the medical needs of your family. Gone are the carefree varsity days. Now you need a comprehensive, traditional plan that allows you to know exactly what funds you have available for doctor visits, medicines, optometry, specialist visits and the like at a competitive rate.A Quick MUMED Efficiency Discounted (ED) RecapSimilar to the standard MUMED plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.A Quick SYMMETRY RecapYou will love Symmetry if you have a few more responsibilities than when you completed your studies (be careful – you could alienate a significant portion of the market by referring to university graduates only) and got married, and the small student car has had to make way for a family sedan or SUV. You want comprehensive day-to-day cover and cover for chronic illnesses. Naturally, you need great hospital benefits, offering comprehensive cover. It goes without saying that hospital cover should be unlimited at any private hospital. You can’t take any chances with your growing family responsibilities, and you want to know that if something unexpected happens, such as a cancer diagnosis, you’ve got the cover you need.A Quick SYMMETRY Efficiency Discounted (ED) RecapSimilar to the standard SYMMETRY plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.A Quick DYNAMIX RecapYou will love Dynamix if you’re an experienced and capable individual, you're kids are in high school or varsity, and life is good. You can take anything life throws at you and you need a medical plan that can do the same. You want a comprehensive medical scheme with a savings plan, and if you and the family have a rough year with unforeseen medical, specialist and dental expenses, you want to know that you have an additional safety net of above-threshold benefits to bail you out. With 64 chronic illnesses covered, you don't have to worry about that either.A Quick DYNAMIX Efficiency Discounted (ED) RecapSimilar to the standard DYNAMIX plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.A Quick PINNACLE RecapYou will love PINNACLE if you’re at the top of your game, and you deserve the best. Life is good and full of memories. You’ve made it. You want a no-nonsense healthcare plan with the best benefits, including unlimited GP visits, unlimited dental visits, 200% cover for specialists in hospital, access to a private ward if you need to be admitted, and cover for 72 chronic illnesses. Briefly, you want the best money can buy.A Quick PINNACLE Efficiency Discounted (ED) RecapSimilar to the standard PINNACLE plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals. Your DetailsTitle*Select TitleDrMs.Mr.Mrs.Prof.Hon.Rev.First Name(s)*Initials*Phone*Email* Gender*MaleFemaleRace*Select RaceAfricanColouredIndian / AsianWhiteIncome (Rand)*Surname*ID Number*Date Of Birth* Date Format: MM slash DD slash YYYY Marital Status*Select Marital StatusSingleDivorcedMarriedWidowedCommon LawTribal LawSeparatedTax NumberOccupation*Smoker*YesNoMembership certificate(s) from previous medical scheme(s) Drop Your File(s) Here Your Address DetailsPhysical Address* Street Address City State / Province / Region ZIP / Postal Code Postal Address My Postal Address Differs From My Physical AddressPostal Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Your DependantsWould you like to add dependants?*NoYesHow many dependants would you like to add to your option?*OneTwoThreeFourFive First DependantTitle*Select TitleDrMs.Mr.Mrs.Prof.Hon.Rev.First Name(s)*Phone*Gender*MaleFemaleRace*Select RaceAfricanColouredIndian / AsianWhiteRelation to member*Initials*Surname*ID Number*Email* Date Of Birth* Date Format: MM slash DD slash YYYY Smoker*YesNoSecond DependantTitle*Select TitleDrMs.Mr.Mrs.Prof.Hon.Rev.First Name(s)*Phone*Gender*MaleFemaleRace*Select RaceAfricanColouredIndian / AsianWhiteRelation to member*Initials*Surname*ID Number*Email* Date Of Birth* Date Format: MM slash DD slash YYYY Smoker*YesNoThird DependantTitle*Select TitleDrMs.Mr.Mrs.Prof.Hon.Rev.First Name(s)*Phone*Gender*MaleFemaleRace*Select RaceAfricanColouredIndian / AsianWhiteRelation to member*Initials*Surname*ID Number*Email* Date Of Birth* Date Format: MM slash DD slash YYYY Smoker*YesNoFourth DependantTitle*Select TitleDrMs.Mr.Mrs.Prof.Hon.Rev.First Name(s)*Phone*Gender*MaleFemaleRace*Select RaceAfricanColouredIndian / AsianWhiteRelation to member*Initials*Surname*ID Number*Email* Date Of Birth* Date Format: MM slash DD slash YYYY Smoker*YesNoFifth DependantTitle*Select TitleDrMs.Mr.Mrs.Prof.Hon.Rev.First Name(s)*Phone*Gender*MaleFemaleRace*Select RaceAfricanColouredIndian / AsianWhiteRelation to member*Initials*Surname*ID Number*Email* Date Of Birth* Date Format: MM slash DD slash YYYY Smoker*YesNo Do you have an extra moment?*I have a moment to answer some question relating to my medical historyI'll answer questions relating to my medical history at a later stageYour Medical HistoryIt 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.NoYesCondition 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?NoYesCondition 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.NoYesCondition Details*Bone; Muscle & Joints*Arthritis; rheumatism; gout; back, knee or neck problems; fibromyalgia; previous fractures; deformities; degenerative muscle disease; osteoporosis; etc.NoYesCondition Details*Nervous System*Persistent headaches; epilepsy; paralysis; degenerative diseases – Alzheimer’s; Parkinson’s; multiple sclerosis; stroke; neuralgias; ADD (attention deficit disorder).NoYesCondition Details*Gland / Hormonal*Over / under active thyroid; diabetes mellitus; Cushing’s syndrome; Addison’s disease; pituitary gland abnormality.NoYesCondition Details*Male Genital System*Prostate problems (hypertrophy / cancer or infections); infertility; hernias – groin; scrotal swellings; testicular tumours; abnormalities of the penis; problems with urination.NoYesCondition Details*Ear, Nose & Throat*Allergies (rhinitis, sinusitis); chronic infections (otitis, tonsillitis); nasal reconstruction; snoring; sleep apnoea; deafness – hearing aids.NoYesCondition Details*Eyes*Poor vision; birth defects; degenerative disease (glaucoma; retinitis pigmentosa; cataracts; keratoconus); allergies – pterygiums; anticipated / previous laser surgery; artificial eyes.NoYesCondition Details*Pregnancy*Are you or any of your dependants pregnant? If yes - how many weeks? Please give expected date of delivery.NoYesCondition Details*Lungs*Asthma; emphysema; chronic bronchitis; TB; chronic infections - bronchitis & pneumonia.NoYesCondition Details*Urinary Tract*Infections; stones; albumin / blood in urine; urinary incontinence; prolapsed bladder.NoYesCondition Details*Blood*Anaemia; bleeding disorders (haemophilia); leukaemia; Hodgkin’s disease.NoYesCondition 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.NoYesCondition 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?NoYesCondition 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.NoYesCondition 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?NoYesCondition 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?NoYesCondition Details*Infections / Tropical Diseases*Sexually transmitted diseases; genital warts; HIV / AIDS; hepatitis; ME-Virus (Yuppie Flu); malaria; bilharzias; cholera; typhoid.NoYesCondition Details*Skin Disorders*Acne; eczema; psoriasis; lesions (keloid hypertrophic scars); skin rashes; shingles; Kaposi sarcoma – tumours.NoYesCondition 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).NoYesCondition Details*Teeth & Gums*Impacted molars (wisdoms); previous / current orthodontic treatment; braces; crowns; recurrent infections - gums.NoYesCondition Details*Therapy/Treatments*Have you or any of your dependants ever received any form of physiotherapy, occupational therapy or chiropractic treatment?NoYesCondition Details*Connective Tissue Disorders*Systemic lupus erythromatosis; scleroderma; rheumatoid arthritis.NoYesCondition Details*Cancer*Cysts; growths; tumours of any kind.NoYesCondition Details* Your Payment DetailsAccount Holder*Branch Number*Branch Name*Account Type*CurrentSavingsTransmissionBank Name*Method Of Payment*Debit OrderDirect Payment / EFTI would like my claim refunds to be paid into a different account.*NoYesYour Claim Refund DetailsAccount Holder*Branch Number*Branch Name*Account Type*CurrentSavingsTransmissionBank Name*Branch*Account Type*CurrentSavingsTransmissionMethod Of Payment*Debit OrderDirect Payment / EFTCAPTCHAEmailThis field is for validation purposes and should be left unchanged.