CompCare Networx ED E 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:
Networx ED E
2018 costs In brief:
What’s new in 2018?
Main: Adult: Child:
Cost 2018: R R R
Cost 2017: (R668) (R636) (R318)
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:
Income band: This plan is only available to households with income in pm band.
View other income bands

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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:
Networx ED E
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:
  • 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:
Networx ED E
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:
Networx ED E
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):
Networx ED E
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:
Networx ED E
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:
Networx ED E
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 by scheme
Over-the-counter: 2018 benefits coming soon. 2017 benefits:
  • No benefit
  • No benefit
Birth Control: 2018 benefits coming soon. 2017 benefits:
  • R95 per month
On Discharge: 2018 benefits coming soon. 2017 benefits:
  • 7 days supply and R 280 per discharge
  • No benefit
Biological:
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OPTOMETRY:
Networx ED E
2017 v 2018 benefits Gap benefits Notes
Optometry: 2018 benefits will be posted soon!
  • No benefit

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MENTAL HEALTH:
Networx ED E
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:
Networx ED E
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:
Networx ED E
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:
  • 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