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Incentive Option

Provides extensive hospital cover through a choice of providers, 10% savings for day-to-day medical expenses (can be increased through HealthSaver), and additional chronic benefits.

from

R2 009 per month

What does it cover?

The Incentive Option provides cover for hospitalisation in private hospitals with no overall annual limit. You can choose to have access to any hospital, or choose to receive a discount on your contribution by electing to use a specific list of private hospitals (referred to as Associated hospitals).

For chronic treatment you can choose to have access to any doctor for your prescriptions and any pharmacy for your chronic medication. Or, you can choose to receive a further discount on your contribution by electing to use a list of Associated doctorsfor your chronic prescription and Medipost courier pharmacy for your chronic medication. Alternatively, you can elect to use State facilities for your chronic prescription and chronic medication to obtain the maximum contribution discount.

10% of your contribution goes to a dedicated medical savings account to cover your day-to-day expenses. If you need more day-to-day cover, you can make use of the HealthSaver.

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

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.

Major Medical Benefits are available at Any or Associated hospitals.

Hospitalisation
  • Associated specialists are covered in full, while other specialists are covered up to 200% of the Momentum Health Rate. Hospital accounts are covered in full at the rate agreed upon with the hospital group.
  • No annual limit on high and intensive care.
  • No annual limit on maternity confinement and neonatal intensive care.
  • R400 000 oncology cover per beneficiary every year, thereafter a 20% co-payment applies. Momentum Health reference pricing applies to chemotherapy and adjuvant medication.
  • No annual limit for organ transplant recipients.
  • No annual limit for MRI and CT scans, magnetic resonance cholangiopancreatography, whole body radioisotope and PET scans (in- and out-of-hospital). You need to pay a co-payment of R2 250 per scan and obtain pre-authorisation.
  • R51 000 per family for medical rehabilitation, private nursing, hospice and step-down facilities.
  • 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.

Chronic Benefit


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

Chronic Benefits are available at Any, Associated, or State providers.

It covers 26 conditions under Prescribed Minimum Benefits* according to the Chronic Disease List with no annual limit. The 6 additional conditions are subject to a limit of R9 800 per family every year.

*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


This benefit covers your everyday medical expenses, such as doctors' visits and prescribed medication.

Day-to-day Benefits are available at Any or Associated providers.

Savings
10% of your contribution goes to a dedicated Medical Savings account, to cover your day-to-day expenses, such as GP visits and prescribed medicine. If you need more day-to-day cover, you can choose to make use of HealthSaver.

General practitioners
Subject to Savings. If no savings available, paid out-of-pocket or from HealthSaver if applicable.

Eye care
Subject to Savings. If no savings available, paid out-of-pocket or from HealthSaver if applicable.

Dentistry
Subject to Savings. If no savings available, paid out-of-pocket or from HealthSaver if applicable.

General anaesthesia for children under 7, maxillo-facial surgery (excluding implants) and impacted wisdom teeth are covered in-hospital. The anaesthetist account is covered up to 200% of the Momentum Health Rate. Hospital accounts are paid in full at the negotiated rate, and the dentist, dental specialist and maxillo-facial surgeon accounts are payable from Savings or HealthSaver, if available.

In the case of maxillo-facial trauma, the in-hospital dentist, dental specialist or maxillo-facial surgeon accounts will be payable from the Major Medical Benefit.

Dental implants, including the cost of implants, and the anaesthetist and hospital accounts, are payable from Savings or HealthSaver, if available.

In-hospital dentistry is subject to pre-authorisation and a co-payment of R1 700 applies per authorisation.

Medicine
Subject to Savings. If no savings available, paid out-of-pocket or from HealthSaver if applicable.

Mental health
Subject to Savings. If no savings available, paid out-of-pocket or from HealthSaver if applicable.

Specialist visits
Subject to Savings. If no savings available, paid out-of-pocket or from HealthSaver if applicable.

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, various pathology tests, as well as online antenatal and postnatal classes, online video consultations with a lactation specialist, 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 R8 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 Features

Convenient and innovative features unique to Momentum

Take advantage of these extra features at no additional cost.

HealthReturns+

An incentive programme that rewards you for taking ownership of your health. Our aim is to help you stay informed about your health status and reward you for staying healthy.

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.

+ These extra features are complementary products available from Momentum, a part 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.

Additional products

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 cover your medical aid contributions.

GapCover+

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


from


R278 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


R240 per month

+ These additional products are complementary and available from Momentum, a part 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.

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

Earn up to R3 000 per month in extra savings

Get rewarded for living a healthy lifestyle. Complete the Health and Fitness assessment to earn up to R3 000 per family, per month in HealthReturns.


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.

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Contact Momentum Health

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For international emergencies



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