Ingwe Option

This benefit covers hospitalisation as well as some out-of-hospital procedures or treatments that can be safely performed in a doctor's room, registered day hospital, or out-patient facility.

Major Medical Benefits are available at Any, Ingwe Networkget_app or State hospitals.

Hospitalisation

• Specialists are covered up to 100% of the Momentum Medical Scheme Rate. Hospital accounts are covered in full at the rate agreed upon with the hospital group.
• No annual limit applies to maternity confinements.
• Caesarean section: Only emergency caesareans are covered.
• No annual limit applies to neonatal intensive care.
• Organ transplant limited to Prescribed Minimum Benefits* at State facilities.
• MRI and CT scans, magnetic resonance cholangiopancreatography, whole body radioisotope and PET scans limited to Prescribed Minimum Benefits* at State facilities.
• Medical rehabilitation, and step-down facilities limited to
  R14 200 per beneficiary every year.
• 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 moreopen_in_new

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

Chronic Benefits are available at Ingwe Primary Care Networkget_app or Ingwe Active Networkget_app.

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

*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 moreopen_in_new

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

Day-to-day Benefits are available at Ingwe Primary Care Networkget_app or Ingwe Activeget_app providers.

Savings
There is no savings built into this option, but you can add on HealthSaver⁺ to supplement your day-to-day benefits.

General practitioners
You have unlimited GP visits. From the 11^th visit onwards, you need pre-authorisation from the Scheme for it to be covered.

Eye care
You get 1 eye test, 1 pair of clear standard or bi-focal lenses with a standard frame, per beneficiary every 2 years.

Dentistry
You get 1 dentistry consultation per beneficiary every year, plus extractions, fillings and x-rays. Specialised dentistry such as braces is not covered by the Scheme.

Medicine
Prescribed medication is subject to a list of medicineopen_in_new referred to as the prescribed formulary.

Mental health
Limited to Prescribed Minimum Benefits* at State facilities.

Specialist visits
You get 2 visits per family every year, limited to R1 150 per visit and up to a maximum of R2 300 per family per year. Covered at 100% of the Momentum Medical Scheme Rate.

⁺ You may choose to make use of additional products available from Momentum Metropolitan Holdings Limited (Momentum), to seamlessly enhance your medical aid. Momentum is not a medical scheme and is a separate entity to Momentum Medical Scheme. The complementary products are not medical scheme benefits. You may be a member of Momentum Medical Scheme without taking any of the complementary products.

*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 moreopen_in_new

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

The Health Platform Benefits are available at Ingwe Primary Care Networkget_app or Ingwe Active get_app providers.

Preventative care
Includes baby immunisations covered in private facilities for baby’s first year up to R2 500, 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 7 antenatal visits which include a urine test and two pregnancy scans, as well as a nurse home visit after returning home from hospital.

Health management programmes
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.