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Provider Choice

Our cover options give you the flexibility to choose your healthcare providers - hospitals, doctors, and pharmacies. You can choose to make use of Any, Associated, or State provider. When you choose to use Momentum Health’s Associated providers, you can save up to R1 000 on your monthly contributions.

How does it work?

If you're a member of Custom, Incentive or Extender Option, you can pay lower monthly medical aid contributions, by using Momentum Health's Associated providers.

Associated providers includes private hospitals, general practitioners and pharmacies.

State healthcare facilities can also be used to receive your chronic benefits, which will reduce your monthly medical aid contributions.

Medical aid contribution savings

This is how much you can save on the Custom Option as a single member.

Select hospital provider

Select chronic provider

Monthly contribution

R2 521

Contribution savings

0%

Total savings

R0

It's the difference between Any provider (R2 521) and Any/Associated providers (R2 304) Any/State providers (R1 938) Associated/Any providers (R2 113) Associated providers (R1 944) Associated/State providers (R1 515). The actual amount you save depends on your medical aid option, the number of dependants on Momentum Health, as well as your choice of providers.

Associated providers

Custom, Incentive, and Extender Option providers

Associated GP Network Associated Hospitals Authorised Oncologists Pharmacy Network

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Ingwe Option providers

On the Ingwe Option, members can choose between Any, Ingwe Network and State hospitals as their hospital provider, and Ingwe Primary Care or Ingwe Active Primary Care Network Providers for their Chronic and Day-to-day benefits.

The option provides dentistry and optometry benefits from a list of providers. A specific list of tariff codes is covered for dentistry, pathology, and radiology.

Network Hospitals Primary Care Network Active Primary Care Network Pharmacy Network Optometry Network Ingwe and Ingwe Active Dental Network

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Impact Option providers

On the Impact Option, members need to use Impact Network hospitals for hospitalisation, and Impact Primary Care Network Providers for their Chronic and Day-to-day benefits.

Network Hospitals Primary Care Network Impact Dental Network Pharmacy Network Optometry Network

Summit Option providers

Members on the Summit Option may use any provider.

Important to know

When choosing Associated hospital provider

What happens if I don't use one of the Associated hospitals?

If you choose Associated hospitals as your preferred provider for Major Medical benefits and do not use one of the Associated hospitals, a 30% co-payment will apply on the hospital account. Momentum Health will be responsible for 70% of the negotiated tariff, provided authorisation would have been granted according to the rules of the Scheme.

When choosing Associated chronic provider

What happens if I don't use one of the Associated GP's?

If you choose Associated chronic provider, you'll have to obtain any chronic prescription from an Associated GP and chronic medication from Medipost, subject to an entry-level formulary. If you choose to obtain your chronic prescription from a non-Associated GP, the Scheme will pay 50% of the Momentum Health Rate for the consultation.

What happens if I don't obtain chronic medication from Medipost?

Similarly, if you choose to obtain your chronic medication from a pharmacy other than Medipost, the Scheme will pay only 50% of the formulary price. If you choose State as your chronic provider, you must choose one of the designated State healthcare facilities to obtain your chronic medication, subject to the State formulary.

When changing provider choice selected

When can I make changes to the choice of healthcare providers selected?

Changes to the choice of healthcare providers selected can only be exercised when option changes are done at the end of every year, to be effective from 1 January. Regardless of the choice of provider, the benefits available will remain the same.