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Evolve Option

It is for the individual or family that needs hospital cover, Day-to-day (subject to HealthSaver) and Chronic Benefits from State facilities.

from

R1 294 per month

What does it cover?

The Evolve Option provides cover for hospitalisation in the Evolve Network of private hospitals with no overall annual limit.

For chronic treatment, scripts and medication, you need to use State facilities.

Major Medical Benefit

This benefit covers hospitalisation as well as some out-of-hospital procedures that can be safely performed in a doctor's room, registered day clinic, or out-patient facility. A co-payment of R1 570 applies per authorisation, except for motor vehicle accidents, maternity confinements, and emergency treatment.

Major Medical Benefits are available at Evolve Network hospitals. Certain procedures are only covered in day facilities.

Our Health Platform Benefit provides cover for a range of benefits such as preventative screening tests, certain check-ups and more.

Hospitalisation
  • Associated specialists are covered in full. Other specialists are covered up to 100% of the Momentum Health Rate. Hospital accounts are covered in full at the rate agreed upon with the hospital group.
  • Oncology is covered at R200 000 per beneficiary per year, thereafter a 20% co-payment applies. Momentum Health reference pricing applies to chemotherapy and adjuvant medication. You need to get your oncology treatment and medication from the Evolve Network of Oncologists.
  • Organ transplant and renal dialysis, limited to Prescribed Minimum Benefits* at State facilities.
  • No annual limit for MRI and CT scans, magnetic resonance cholangiopancreatography, whole body radioisotope and PET scans. You will need to pay R2 620 per scan and obtain pre-authorisation.
  • Medical rehabilitation, private nursing, hospice and step-down facilities limited to R45 900 per family per year.
  • Trauma benefit for day-to-day claims that form part of your recovery following specific traumatic events.
  • Seven days’ supply of take home medication.
Specialised procedures/treatment
  • Certain specialised procedures/treatments are covered, when clinically appropriate, in and out of hospital.
*Prescribed Minimum Benefits (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable. Learn more
Chronic Benefit

This benefit takes care of certain life-threatening conditions, such as diabetes and heart disease, that need ongoing treatment.

It covers 26 conditions under Prescribed Minimum Benefits* according to the Chronic Disease List at State facilities.

*Prescribed Minimum Benefits (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable. Learn more

Day-to-day Benefit

Day-to-day needs such as GP visits, specialist visits, eye care, dentistry, prescribed medicine and mental health are paid by you or from HealthSaver+, if available.

Health Platform Benefit

A unique benefit that encourages health awareness, enhances quality of life and gives peace of mind through preventative care and early detection tests.

Preventative care
Includes baby immunisations, flu vaccines, as well as tetanus diphtheria injections.

Early detection tests
Includes pap smears, dental consultations, general physical examinations, prostate specific antigens, health assessments, cholesterol tests, blood sugar tests and HIV tests.

Maternity programme
Women registered on our maternity programme get 12 antenatal visits which include a urine test, two pregnancy scans, and two visits to the paediatrician during the baby's first year.

Health management programme
For the management of diabetes, hypertension, HIV/Aids, oncology, drug and alcohol rehabilitation, chronic renal failure, organ transplants and cholesterol.

Health line
24-hour emergency health advice.

Emergency evacuation
Emergency evacuation in South Africa by Netcare 911.

International emergency cover by ISOS, covered up to R5 million per 90-day journey.
Hello Doctor

Talk to a doctor, anytime, anywhere. This is a free service to all Momentum clients. Learn more

Want to know more?

For more information relating to this option, download the relevant document below.

Extra Feature

A convenient and innovative feature unique to Momentum

Take advantage of these extra features at no additional cost.

HealthSaver+

A savings account that works seamlessly with your medical aid. With no transaction or admin fees, it lets you save for additional day-to-day medical expenses, such as co-payments, refractive eye surgery, vitamins and more.

+ You can choose to make use of additional products available from Momentum, part of Momentum Metropolitan Life Limited, to seamlessly enhance your medical aid. Momentum is not a medical scheme, and is a separate entity to Momentum Medical Scheme. These voluntary complementary products range from a world-class lifestyle rewards programme, Multiply, to the innovative HealthReturns solution. These complementary products are not medical scheme benefits. You can be a member of Momentum Medical Scheme without taking any of the complementary products that Momentum offers.

ADD-ON MEDICAL AID COVER

Seamlessly enhance your medical aid cover

Avoid worrying about unexpected medical shortfalls and co-payments, and keep you and your family covered when you're unable to pay your medical aid contributions.

GapCover+

Helps you avoid unexpected shortfalls for in-hospital expenses, not covered by your medical aid option.


from


R190 per month

HealthWaiver+

This pays for your medical aid contributions when you die or become critically ill, so your family will still have medical cover.

from


R264 per month

+ You can choose to make use of additional products available from Momentum, part of Momentum Metropolitan Life Limited, to seamlessly enhance your medical aid. Momentum is not a medical scheme, and is a separate entity to Momentum Medical Scheme. These voluntary complementary products range from a world-class lifestyle rewards programme, Multiply, to the innovative HealthReturns solution. These complementary products are not medical scheme benefits. You can be a member of Momentum Medical Scheme without taking any of the complementary products that Momentum offers.

Leading a healthy lifestyle, an athletic lady in a red sporting gear, holding her cell phone with earphones in her ears with stairs in the background.

Momentum Multiply rewards and discounts

Enjoy discounts from a wide range of partners

Evolve members qualify for Multiply Premier membership, which will reward you with discounts and cashbacks from various partners, as well as on Momentum products.


Want a quote?

You'll get a quote reflecting the medical aid contribution at the end of the process.

Need advice?

An accredited healthcare consultant will call you to discuss our medical aid options and benefits.

You may also want to consider

Custom Option

From R1 642 per month

Incentive Option

From R2 141 per month

Extender Option

From R5 033 per month

Summit Option

From R10 187 per month

Ingwe option

From R439 per month

Contact Momentum Medical Scheme

For local emergencies



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

For international emergencies



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.

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