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 providers. When you choose to use Momentum Medical Scheme’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 Medical Scheme'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
It's the difference between Any provider (R2 767) and Any/Associated providers (R2 496) Any/State providers (R2 090) Associated/Any providers (R2 319) Associated providers (R2 106) Associated/State providers (R1 642). The actual amount you save depends on your medical aid option, the number of dependants on Momentum Medical Scheme, as well as your choice of providers.
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.
Primary Care Network
Active Primary Care Network
Ingwe and Ingwe Active Dental Network
Evolve Option providers
On the Evolve Option, members need to use Evolve Network hospitals for hospitalisation and State for chronic.
Summit Option providers
Members on the Summit Option may use any provider.
Important to know
When choosing Associated hospital provider
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 Medical Scheme 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
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.
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
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.