menu
Contact us Log in
A cute young girl smiles while an optometrist holds out red-framed glasses for her to try on.

Day-to-day Benefit

For everyday medical expenses. The Day-to-day Benefit covers routine medical costs like doctor's visits and prescribed medication.

What does it cover?

This benefit pays for day-to-day medical expenses, such as out-of-hospital doctor’s visits, eye care, dentistry, and prescribed medication.

For example, when you get the flu and go to your General Practitioner (GP), the doctor is paid using your Day-to-day Benefits. The same applies when you go to your dentist and optician. This benefit also pays for prescribed medication and over-the-counter medication, x-rays, and so much more.

Why do I need it?

Even if you and your family are relatively healthy, consider what your out-of-pocket medical expenses might be in a year in which each member of the family gets secondary infections after the flu, one of you develops complications such as a lung infection and requires x-rays and visits to a specialist. Paying for these medical expenses out of your own pocket can be quite expensive.

How does it work?


Lady laughing

Ingwe Option

On the Ingwe Option, you get your day-to-day services from Ingwe Primary Care Network providers. You have unlimited GP visits (from the 11th visit onwards, you need to obtain pre-authorisation), basic eye care and dentistry, prescribed medicine, specialist visits, and much more.

lady speaking to child

Impact Option

On the Impact Option, you get your day-to-day services from Impact Primary Care Network providers. You have 10 GP visits per beneficiary (from the 11th visit onwards, you need to obtain pre-authorisation and pay a co-payment), basic eye care and dentistry, prescribed medicine, specialist visits, and much more.

Guy smiling playing guitar

Custom Option

On the Custom Option, day-to-day healthcare expenses like GP visits, optometry, dentistry and specialists can be funded from Momentum's voluntary HealthSaver+ account.

+ This extra feature is a complementary product available from Momentum, a division of Momentum Metropolitan Life Limited. Momentum is not a medical scheme, and is a separate entity to Momentum Health. You can be a member of Momentum Health without taking any of the complementary products that Momentum offers.

#

Incentive Option

On the Incentive Option, 10% of your total contribution goes to a Medical Savings account. This is advanced upfront for the year and any unused funds at the end of the year will be carried forward to the following year. Once your medical savings have been depleted, you will pay out-of-pocket for day-to-day expenses like GP visits and dentistry. Alternatively, you can use HealthSaver to pay for these expenses.

Guy smiling in back seat of car

Extender Option

On the Extender Option, 25% of your total contribution goes to a Medical Savings account to cover day-to-day healthcare expenses like GP visits, dentistry, and specialists. This is advanced upfront for the year and any unused funds at the end of the year will be carried forward to the following year.

Once medical savings have been depleted, you will fall into the self-funding gap which means that you will have out-of-pocket expenses up until the Threshold, determined by your family size. Alternatively, you can add HealthSaver to cover your out-of-pocket expenses. You must still submit your claims in this period so that we know when you move into Above Threshold.

Once the Threshold has been reached, claims will be paid from Extended Cover at the Momentum Health Rate, subject to certain sub-limits.

The annual Threshold levels for 2019 are:

Principal Member
R20 800

Per adult dependant
R18 000

Per child dependant
R6 200
(up to a maximum of 3 children)

Family and a kid at the beach

Summit Option

On the Summit Option, day-to-day claims are paid at 100% of the Momentum Health Rate, subject to certain sub-limits. The overall day-to-day limit is R24 700 per beneficiary for 2019. Any expenses over this amount you will need to pay for. Alternatively, you can use HealthSaver to fund additional expenses.


Want a quote?

Let us call you back with a quote that suits your needs.

Need advice?

Discuss the benefits of having medical aid with a certified financial adviser.

Other benefits

Major Medical
Benefit

Chronic
Benefit

Health Platform
Benefit

Hello
Doctor

Contact Momentum Health

Emergency services




Available 24 hours a day, 7 days a week, 365 days a year.

Client service, claims and authorisations






Business hours are Monday to Friday from 07:30 to 17:00. Saturdays from 08:00 to 12:00. Closed on Sundays and public holidays.

We use cookies to provide the best experience. View our Cookie Policy.

Internet Explorer is out of date. Update your browser to ensure our website functions correctly.

Your browser's cookies are disabled. Enable cookies to ensure our website functions correctly. View our Cookie Policy.