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Health4Me Major Medical Event Benefits

A major medical event benefit or combination of major medical event benefits can be taken in conjunction with Health4Me day-to-day benefits. Major medical event benefits protect employees against the costs of higher risk events.

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Standard Option
Base Option

Benefit Base Standard
Accident Cover Emergency transportation, stabilisation and treatment cost paid in case of an accident that requires immediate medical treatment

Up to R150 000 per event covered at a private institution for accidents that fit the qualifying criteria

Should the benefit limit be exceeded, and further treatment be required, the member will be transported to a state facility for further care

An accident shall mean a medical emergency that is an external, unexpected event that is not traceable, directly or indirectly, to a member’s state of mental or physical health prior to the event

Medical emergencies that do not fit the qualifying criteria will warrant transportation, stabilisation and treatment at a state facility
Emergency transportation, stabilisation and treatment cost paid in case of an accident that requires immediate medical treatment

Up to R300 000 per event covered at a private institution for accidents that fit the qualifying criteria

Should the benefit limit be exceeded, and further treatment be required, the member will be transported to a state facility for further care

An accident shall mean a medical emergency that is an external, unexpected event that is not traceable, directly or indirectly, to a member’s state of mental or physical health prior to the event

Medical emergencies that do not fit the qualifying criteria will warrant transportation, stabilisation and treatment at a state facility
Hospital Cash Benefit R500 per day in hospital, paid from day 1, provided that hospitalisation is longer than 48 hours

Maximum of 40 days per beneficiary per year

Waiting periods may apply
R1 000 per day in hospital, paid from day 1, provided that hospitalisation is longer than 48 hours

Maximum of 20 days per beneficiary per year

Waiting periods may apply
Funeral Benefit Employee, spouse and children > 14: R10 000
Children 6 - 13 years: R5 000
Children 1 - 5 years: R2 500
Children < 1 year: R1 250
Stillborn babies (past 28 weeks gestation): R750
Waiting periods may apply (natural causes of death)
Employee, spouse and children > 14: R15 000
Children 6 - 13 years: R7 500
Children 1 - 5 years: R3 750
Children < 1 year: R1 875
Stillborn babies (past 28 weeks gestation): R1 125
Waiting periods may apply (natural causes of death)
Note: Staff Care Solutions is not a medical scheme product, and is not a substitute for medical scheme membership.

The information provided on this site does not constitute advice in terms of the Financial Advisory and Intermediary Services Act. Momentum is a division of MMI Group Limited. MMI Group Limited is an authorised financial services provider (FSP 6406) and a wholly owned subsidiary of MMI Holdings Limited.

Alternatively, if you are interested in medical aid, join Momentum Health, a flexible healthcare solution.

For more information

For more information about how it works and eligibility, download our brochure.

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