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Medical cover with a twist.

ARE YOU READY?

Leave your details and a CompCare customer specialist will give you a call to finalise your application.

"*" indicates required fields

You ready?

Your member application starts here.

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

Identity Documents / Passports

Membership certificate(s) from previous medical scheme(s) - if applicable

Proof of registration at educational institution / affidavit confirming financial dependency for adult dependants 21 years and older

Proof of adopted or foster children

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Pick Your CompCare Option

First Name(s)*

Surname*

When Should Your Medical Aid Start?*

What CompCare Option Are You Interested In?*

Selecting an option will display a quick summary of that option below.

Prerequisite For NetworX / NetworX ED Applications

Please upload three of your latest salary slips, IRP5 or IT34 documents to continue with your NetworX or NetworX ED option application.

Drop files here or

Max. file size: 32 MB.

SELFSURE

R3 458 per month

The standard SELFSURE plan, does not limit you to specific pharmacies or hospitals.

Learn more about the standard SELFSURE option.

MEDX

R2 150 per month

The standard MEDX plan, does not limit you to specific pharmacies or hospitals.

Learn more about the standard MEDX option.

MEDX Efficiency Discounted (ED)

R1 652 per month

Similar to the standard MEDX plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.

Learn more about the standard MEDX option.

UNISAVE

R2 585 per month

The standard UNISAVE plan, does not limit you to specific pharmacies or hospitals.

Learn more about the standard UNISAVE option.

MUMED

FROM R3 317 per month

The standard MUMED plan, does not limit you to specific pharmacies or hospitals.

Learn more about the standard MUMED option.

MUMED Efficiency Discounted (ED)

FROM R2 693 per month

Similar to the standard MUMED plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.

Learn more about the standard MUMED option.

SYMMETRY

From R4 172 per month

The standard SYMMETRY plan, does not limit you to specific pharmacies or hospitals.

Learn more about the standard SYMMETRY option.

SYMMETRY Efficiency Discounted (ED)

From R3 517 per month

Similar to the standard SYMMETRY plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.

Learn more about the standard SYMMETRY option.

DYNAMIX

FROM R5 278 per month

The standard DYNAMIX plan, does not limit you to specific pharmacies or hospitals.

Learn more about the standard DYNAMIX option.

DYNAMIX Efficiency Discounted (ED)

FROM R4 344 per month

Similar to the standard DYNAMIX plan, but you are limited to Dis-Chem pharmacies and Netcare hospitals.

Learn more about the standard DYNAMIX option.

PINNACLE

From R7 001 per month

The standard PINNACLE plan, does not limit you to specific pharmacies or hospitals.

Learn more about the standard PINNACLE option.

PINNACLE Efficiency Discounted (ED)

From R5 852 per month

Date Of Birth*

Smoker*

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*

Download Application Form

Medical aid with a twist.

ARE YOU READY?

Leave your details and a CompCare customer specialist will give you a call to finalise your application.

Redirecting…

ARE YOU READY?

You ready?

Your member application starts here.

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

Identity Documents / Passports Membership certificate(s) from previous medical scheme(s) - if applicable Proof of registration at educational institution / affidavit confirming financial dependency for adult dependants 21 years and older Proof of adopted or foster children

Pick Your CompCare Option

SELFSURE

R3 458 per month

MEDX

R2 150 per month

MEDX Efficiency Discounted (ED)

R1 652 per month

UNISAVE

R2 585 per month

MUMED

FROM R3 317 per month

MUMED Efficiency Discounted (ED)

FROM R2 693 per month

SYMMETRY

From R4 172 per month

SYMMETRY Efficiency Discounted (ED)

From R3 517 per month

DYNAMIX

FROM R5 278 per month

DYNAMIX Efficiency Discounted (ED)

FROM R4 344 per month

PINNACLE

From R7 001 per month

PINNACLE Efficiency Discounted (ED)

From R5 852 per month

Your Details

Your Address Details

Your Dependants

First Dependant

Second Dependant

Third Dependant

Fourth Dependant

Fifth Dependant

Your Medical History

Your Payment Details

Your Claim Refund Details

ARE YOU READY?

Identity Documents / Passports

Membership certificate(s) from previous medical scheme(s) - if applicable

Proof of registration at educational institution / affidavit confirming financial dependency for adult dependants 21 years and older

Proof of adopted or foster children