Day-to-day Benefit

On the Ingwe Option, you get your day-to-day services from Ingwe Primary Care Networkget_app or Ingwe Active Networkget_app providers. You have unlimited GP visits (from the 11^th visit onwards, you need to obtain pre-authorisation), basic eye care and dentistry, prescribed medicine, specialist visits. You also get 3 virtual doctor consultations per beneficiary per year from the GP Virtual Consultationsget_app and much more.

The Fusion Option brings you hospitalisation cover with no overall annual limit at the Fusion Network of private hospitals. Hospitalisation is available from the Fusion Network of private hospitals. Preventative care with early detection tests.

On the Evolve Option, you get 2 virtual consultations per beneficiary per year from the GP Virtual Consultation Networkget_app, which includes Hello Doctor. Additional day-to-day healthcare expenses like further GP visits, optometry, dentistry, and specialists can be funded from Momentum's voluntary HealthSaver⁺ account.

On the Custom Option, your day-to-day healthcare expenses like GP visits, optometry, dentistry, and specialists can be funded from Momentum's voluntary HealthSaver⁺ account. Or you can pay for these expenses out of your own pocket.

On the Incentive Option, 10% of your total contribution goes to a Medical Savings account. This is advanced upfront for the year and any unused funds at the end of the year will be carried forward to the following year. Once your medical savings have been depleted, you will pay out-of-pocket for day-to-day expenses like GP visits and dentistry. Alternatively, you can use Momentum’s voluntary HealthSaver⁺ account to save and pay for these expenses.

On the Extender Option, 25% of your total contribution goes to a Medical Savings account to cover day-to-day healthcare expenses like GP visits, dentistry, and specialists. This is advanced upfront for the year and any unused funds at the end of the year will be carried forward to the following year.

Once medical savings have been depleted, you will fall into the self-funding gap which means that you will have out-of-pocket expenses up until the Threshold, determined by your family size. Alternatively, you can use Momentum’s voluntary HealthSaver⁺ account to save and pay for these expenses. You must still submit your claims in this period so that we know when you move when you reach the Threshold.

On the Summit Option, day-to-day claims are paid at 100% of the Momentum Medical Scheme Rate, subject to certain sub-limits. The overall day-to-day limit is R30 400 per beneficiary for 2024. Any expenses over this amount you will need to pay for. Alternatively, you can use Momentum’s voluntary HealthSaver⁺ account to save and pay for these expenses.