CompCare Dynamix ED medical aid plan: 2017 vs 2018

View all plans in this scheme.
Please note that these benefits are still being updated as more information is made available to us. Always consult with your broker before making final decisions regarding your healthcare cover.

COSTS and OVERVIEW:
Dynamix ED
2018 costs In brief:
What’s new in 2018?
Main: Adult: Child:
Cost 2018: R R R
Cost 2017: (R3,306) (R2,580) (R930)
Gap (optional): KaeloXelus: R350 per family
(R600 per family if anyone is 60yrs+)
Overal Limit: Unlimited
PMBs: Day-to-day expenses for PMBs (eg. cancer) are always paid for by the scheme, according to protocols. Find out more
Children:

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Avoid bills! Get up to: 800% scheme rate;  R12,800 per ER visit; unlimited cancer cover;  

co-payments paid and cash payout for hospital stay. R350pm per family


IN HOSPITAL PROCEDURES:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
Payout Rate for Specialists: 2018 benefits will be posted soon!
  • Up to 500% of scheme rate
  • In case of admission related to accident:
    • R300 per day, for days 1-13
    • R600 per day for days 14-20
    • R1,200 per day for days 21-30

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Hospital Choice: 2018 benefits will be posted soon!
  • R12,800 per person per year for use of a non-network hospital
Specialised Radiology: 2018 benefits will be posted soon!
Supplementary Services: (Physio, etc) 2018 benefits will be posted soon!
Transplants: 2018 benefits will be posted soon!
Co-payments: 2018 benefits coming soon. 2017 benefits:
  • Excision lesion: R1,000
  • Gastroscopy, colonoscopy, cystoscopy, nasal/sinus endoscopy, functional nasal surgery, hysteroscopy, flexible sigmoidoscopy, arthroscopy, diagnostic laparoscopy, dental, joint replacements, conservative back and neck treatment, laminectomy and spinal fusion and nissen fundoplication (reflux surgery), hysterectomy (except for cancer), laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy: R1,500
  • Specialised radiology: R2,500 co-payment
  • Gap covers co-payments for most scopes and a defined list of other procedures, incl MRIs etc See full list
Alternatives to hospitals: 2018 benefits will be posted soon!
Casualty: 2018 benefits will be posted soon!
Other: 2018 benefits will be posted soon!
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OUT OF HOSPITAL BENEFITS:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
GP consultations: 2018 benefits will be posted soon!

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Childcare:
  • No benefit
Specialists consultations: 2018 benefits will be posted soon!
Pathology: 2018 benefits will be posted soon!
General radiology: 2018 benefits will be posted soon!
Specialised radiology: 2018 benefits will be posted soon!
Supplementary Services: (Physio, etc) 2018 benefits will be posted soon!
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MATERNITY BENEFITS:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
Hospital stay: 2018 benefits will be posted soon!
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Consultations: 2018 benefits will be posted soon!
Scans: 2018 benefits will be posted soon!
  • No benefit
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CANCER (ONCOLOGY):
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
Overall coverage (in and out of hospital): 2018 benefits will be posted soon! All oncology benefits are assessed on a case-by-case basis, and are subject to protocols, preferred providers and scheme rules. Benefit covers out-of-hospital treatment too, like chemotherapy.
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DENTISTRY:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
Dentistry: 2018 benefits will be posted soon!
  • Dental reconstruction due to due to trauma or oncology treatment: R40,000 per event
  • Full cover for in-hospital co-payments

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Orthodontics: 2018 benefits will be posted soon!
  • No benefit
Maxillo Facial Surgery: 2018 benefits will be posted soon!
  • Dental reconstruction as result of trauma or oncology: R40,000 per event

Avoid bills! Get up to: 800% scheme rate;  R12,800 per ER visit; unlimited cancer cover;  

co-payments paid and cash payout for hospital stay. R350pm per family

MEDICATION:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
Chronic: 2018 benefits will be posted soon!
  • No benefit

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Acute (presrcibed) medication: 2018 benefits coming soon. 2017 benefits:
  • Paid from day-to-day benefit
  • Limited to R2,800 per family from above-threshold
Over-the-counter: 2018 benefits coming soon. 2017 benefits:
  • R190 per event>, from day-to-day benefit
  • Limited to R800 per person and R1,200 per family
  • Not payable from above-threshold benefit, and does not accumulate to threshold
  • No benefit
Birth Control: 2018 benefits coming soon. 2017 benefits:
  • R120 per person per month
On Discharge: 2018 benefits coming soon. 2017 benefits:
  • 7 days supply
  • No benefit
Biological: 2018 benefits coming soon. 2017 benefits:
  • R235,960
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OPTOMETRY:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
Optometry: 2018 benefits will be posted soon!
  • No benefit

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MENTAL HEALTH:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
In-hospital: 2018 benefits will be posted soon!
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Out-of-hospital: 2018 benefits will be posted soon!
Trauma:
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OTHER BENEFITS:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
General Appliances: 2018 benefits will be posted soon!
  • No benefit

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1.1. Hearing Aids: 2018 benefits will be posted soon!
  • No benefit
1.2. Wheelchairs: 2018 benefits will be posted soon!
  • No benefit
Dialysis: 2018 benefits will be posted soon!
HIV: 2018 benefits will be posted soon!
  • No benefit
Emergency Transport:
  • No benefit
International Insurance: 2018 benefits will be posted soon!
  • No benefit
Other: 2018 benefits will be posted soon!
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WELLNESS/PREVENTATIVE BENEFITS:
Dynamix ED
2017 v 2018 benefits Gap benefits Notes
Flu vaccination: 2018 benefits will be posted soon!
  • No benefit

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Pneumonia vaccines: 2018 benefits will be posted soon!
  • No benefit
Back Rehabilitation Programme: 2018 benefits will be posted soon!
  • No benefit
Biometric Screening: 2018 benefits will be posted soon!
  • No benefit
Child Immunisation: 2018 benefits will be posted soon!
  • No benefit
Pap Smear: 2018 benefits will be posted soon!
  • No benefit
Mammogram: 2018 benefits will be posted soon!
  • No benefit
PAS Test: 2018 benefits will be posted soon!
  • No benefit
HIV Test: 2018 benefits will be posted soon!
  • No benefit
Other: 2018 benefits coming soon. 2017 benefits:
  • HPV vaccine, 12yrs-18yrs
  • Tetanus vaccine
  • Glaucoma screen tests
  • Quit smoking program
  • School readiness assessment and psychometric testing
  • Eye and hearing screening for pre-school, 5 and 6yrs
  • No benefit

Avoid bills! Get up to: 800% scheme rate;  R12,800 per ER visit; unlimited cancer cover;  

co-payments paid and cash payout for hospital stay. R350pm per family

2017 v 2018 benefits Gap benefits Notes
Overal Limit:
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Sub-limits:
  • An additional R40,000 per sublimit, per event

    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