We’re All About Your Future
Affordable Medical Cover For Students From Only R520 Per Month*
If you are an international student and need medical cover to register at a
South African university, this is the plan for you!
We’re All About Your Future
Affordable Medical Cover For Students From Only R472 Per Month*
If you are an international student and need medical cover to register at a South African university, this is the plan for you!
The Low-down
Say hello to the Umbono option from CompCare. Umbono has been specifically designed for students and offers essential cover within a contracted provider network for in-and-out of hospital services. What’s more it is the most affordable student option on the South African medical schemes market and that’s a fact.
The Best Part
Real Benefits
When it comes to your healthcare needs, we’ve got you covered.
We Make It Easy
Access and view your medical scheme option, benefits and claims anywhere, anytime.
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The Umbono Benefits
Day-to-day services paid from the Annual Flexi Benefit (AFB) at 100% at the Agreed Tariff (AT)
Specialist consultations, basic dentistry, optometry, out of network visits and emergency room visits for
non-emergency consultations.
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Annual Flexi Benefit (AFB)
R3 600 per beneficiary per year
R5 400 per family per year
- Specialist consultations – limited to two per beneficiary, maximum of three per family, subject to referral by a Universal Network GP, pre-authorisation required. Referrals limited to specialists in DSP Network hospitals only
- Basic dentistry – limited to one consultation per beneficiary including preventative care, infection control, fillings, extractions and dental X-rays at a Universal Network dentist – R1 870 per beneficiary up to R3 120 per family, subject to AFB
- Optometry – limited to one test per beneficiary every 24 months, including lenses – clear plastic lenses for single vision and frames limited to R1 053 per beneficiary. Bi-focals and frames limited to R1 680 per beneficiary at a Universal Network optometrist, subject to AFB
- Out of hospital physiotherapy, subject to AFB
- Hospital emergency room/casualty emergency visits for non-emergency consultations
Services Covered in Hospital
100% of the agreed tariff (AT), subject to pre-authorisation and Network DSP hospitals. All treatment in hospital is subject to case management and scheme protocols.
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100% of the agreed tariff (AT), Unlimited, pre-authorisation and Network DSP hospitals. All treatment in hospital is subject to case management and scheme protocols.
- GPs and specialists
- Ward fees – general, ICU and high care
- Theatre fees
- Medication while in hospital
- Blood transfusions
- Oncology
- Surgical prostheses (PMB only)
- Clinical technologists limited to R12 000 per family
- Radiology – MRI, CT and PET scans
- Pathology
- Confinements
- Psychiatric treatment – subject to pre-authorisation and protocols (PMB only)
- Organ and bone marrow transplants, plasmapheresis and renal dialysis (PMB only)
- Cover for injuries sustained whilst participating in professional sports
- Emergency medical treatment for injuries resulting from accidents or trauma
- Physiotherapy – limited to R2 600 per family.
- Alcoholism, drug dependence and narcotism
Wellness: Lifestyle and Preventative Care
When it comes to your health and wellbeing, we’ve got you covered, having taken extra care to ensure that you have the necessary benefits at your disposal when you need them most.
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Paid From Risk
- Blood pressure, blood sugar, cholesterol, BMI and waist circumference – one measurement per beneficiary over the age of 18 years. Limited to R250 per event
- Flu vaccinations – one vaccination per beneficiary
- Unlimited telephonic counselling sessions through the Universal Wellness Care Centre, with an option for referral to one-on-one sessions with qualified psychologists, social workers or registered counsellors to a maximum of 3 referral sessions PB per year.
- Oral contraceptives limited to R160 per beneficiary per month. Subject to medication formulary
Unlimited Day-to-day services (not subject to the Annual Flexi Benefit AFB)
GP visits through the Universal Network of GPs, Acute medicine as prescribed by your Universal Network GP (medicine formulary applies), basic radiology and pathology as referred by your Universal Network GP (specific codes apply).
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Not Subject to The Annual Flexi Benefit (AFB)
Services Subject to the use of the Universal Provider Network.
- GP visits – unlimited at a Universal Network GP, subject to clinical necessity. Clinical motivation may be required to authorise more than three GP visits per beneficiary per year
- Two out-of-network visits per beneficiary per year. A 20% co-payment applies. Members are required to pay at point of service and claim back from the scheme. Benefits per event (including medicines, pathology and radiology) and excluding facility fees are limited to R1 320 per event
- Acute medication – unlimited if prescribed by a Universal Network GP, or by a specialist provided member referred by a Universal Network GP. Subject to formulary. A 25% co-payment will apply if medicine is not on the formulary. No cover for non-formulary medicines unless otherwise pre-authorised. No cover in case of voluntary use of non-Universal providers, or voluntary use of specialist without referral by a Universal Network GP
- X-rays for Visa purposes – one chest X-ray paid from risk
- Basic radiology – unlimited, subject to specific codes- referral by a Universal Network GP required
- Basic pathology – unlimited, subject to specific codes- referral by a Universal Network GP required
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R3 780 per beneficiary per year
R5 570 per family per year
- Specialist consultations – limited to two per beneficiary, maximum of three per family, subject to referral by a Universal Network GP, pre-authorisation required. Referrals limited to specialists in DSP Network hospitals only
- Basic dentistry – limited to one consultation per beneficiary including preventative care, infection control, fillings, extractions and dental X-rays at a Universal Network dentist – R1 950 per beneficiary up to R3 300 per family, subject to AFB
- Optometry – limited to one test per beneficiary every 24 months, including lenses – clear plastic lenses for single vision and frames limited to R1 100 per beneficiary. Bi-focals and frames limited to R1 750 per beneficiary at a Universal Network optometrist, subject to AFB
- Out of hospital physiotherapy
- Hospital emergency room/casualty emergency visits for non-emergency consultations
More Info
- GPs and specialists
- Ward fees – general, ICU and high care
- Theatre fees
- Medication while in hospital
- Blood transfusions
- Oncology
- Surgical prostheses (PMB only)
- Clinical technologists limited to R12 000 per family
- Radiology – MRI, CT and PET scans
- Pathology
- Confinements
- Psychiatric treatment – subject to pre-authorisation and protocols (PMB only)
- Organ and bone marrow transplants, plasmapheresis and renal dialysis (PMB only)
- Cover for injuries sustained whilst participating in professional sports
- Emergency medical treatment for injuries resulting from accidents or trauma
- Physiotherapy – limited to R2 970 per family. Combined auxiliary services limit in and out of hospital
- Alcoholism, drug dependence and narcotism
More Info
- Blood pressure, blood sugar, cholesterol, BMI and waist circumference – one measurement per beneficiary over the age of 18 years. Limited to R275 per event
- Flu vaccinations – one vaccination per beneficiary
- Unlimited telephonic counselling sessions through the Universal Wellness Care Centre, with an option for referral to one-on-one sessions with qualified psychologists, social workers or registered counsellors to a maximum of 3 referral sessions PB per year.
- Oral contraceptives limited to R180 per beneficiary per month. Subject to medication formulary
- Pap smear: One per female beneficiary over the age of 18 per annum ± paid from risk
- Mammogram: One per female beneficiary over the age of 35 every second year – paid from risk
- Prostate-specific antigen (PSA) blood test: Paid from risk, one test per male beneficiary over the age of 40 per annum
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Not Subject to The Annual Flexi Benefit (AFB)
Services Subject to the use of the Universal Provider Network.
- GPs · In-Network: Unlimited for clinically necessary services subject to network rules and guidelines · Unlimited face-to-face consultations within the Universal Network. The 1st 4 visits not authorised. Member to choose two doctors (close to home and work) from the 5th visit. Pre-authorisation required from 6th visit · Virtual consultations unlimited at participating providers · Out-of-Network: 2 visits PB · Limited to R1 950 per event including medicines, pathology, radiology (all related costs). A 20% co-payment applies. Member to pay at point of service and claim back from the Scheme
- Acute medication – unlimited if prescribed by a Universal Network GP, or by a specialist provided member referred by a Universal Network GP. Subject to formulary. A 25% co-payment will apply if medicine is not on the formulary. No cover for non-formulary medicines unless otherwise pre-authorised. No cover in case of voluntary use of non-Universal providers, or voluntary use of specialist without referral by a Universal Network GP
- X-rays for Visa purposes – one chest X-ray paid from risk
- Basic radiology: Unlimited subject to Universal Care approved codes. Referral from a Network GP required
- Basic pathology: Unlimited subject to Universal Care approved codes and managed care protocols. Referral from a Network GP required
In-Hospital Benefits
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Prescribed Minimum Benefits:
Unlimited for non-PMB and elective admissions.
Cover for Chronic Conditions
32 chronic conditions covered.
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27 chronic conditions covered
Chronic medication is subject to the Core Formulary list of medicines and a Formulary Reference Price (FRP). Members are required to register for all chronic conditions.
- Chronic medication is unlimited, subject to medicine formulary and if prescribed by a Universal Network Provider and dispensed within a Universal Network pharmacy or by a dispensing Universal Network GP. Any voluntary use of chronic medicine prescribed by an out-of-network provider and any non-formulary medicines are for the member’s own account, unless pre-authorised by the medical advisor. (PMB rules apply)
- Subject to formulary reference pricing
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Unlimited – subject to scheme protocols
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Chronic medication is subject to the Core Formulary list of medicines and a Formulary Reference Price (FRP). Members are required to register for all chronic conditions.
- Chronic medication is unlimited, subject to medicine formulary and if prescribed by a Universal Network Provider and dispensed within a Universal Network pharmacy or by a dispensing Universal Network GP. Any voluntary use of chronic medicine prescribed by an out-of-network provider and any non-formulary medicines are for the member’s own account, unless pre-authorised by the medical advisor. (PMB rules apply)
- Subject to formulary reference pricing
To obtain the registered scheme rules approved by the Council of Medical Schemes, please email your request through to [email protected].
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