Includes hospital cover from a choice of providers, as well as a built-in 25% medical savings account for Day-to-day Benefits, and Extended Cover benefits once you reach the Threshold amount. There are also additional Chronic Benefits.
- Includes a range of benefits, such as preventative screening tests and specific check-ups.
- Use the voluntary HealthSaver+ for additional day-to-day expenses.
- Our maternity programme includes comprehensive benefits to take care of you during your pregnancy.
R6 589 per month
You can access any GP for your chronic scripts and any pharmacy for your chronic medication.
Save on your monthly contribution by choosing from our Associated GPs for your chronic script and Medipost courier pharmacy for your chronic medication.
You can choose to use State facilities for your chronic script, medication and treatment to obtain the maximum contribution saving.
Health Platform Benefit
Provides cover for a range of benefits, such as preventative screening tests, certain check-ups, and more.
See how much you can save
Calculate how much you can save as a single member.
Medical aid contribution savings
This is how much you can save on the Custom Option as a single member.
1. Select hospital provider
Your choice for planned procedures. In the event of an emergency, you can go to any hospital, regardless of your hospital choice.
2. Select chronic provider
Chronic medication is the treatment for certain life-threatening conditions that need ongoing treatment.
- Associated specialists are covered in full. Other specialists are covered up to 200% of the Momentum Medical Scheme Rate.
- Hospital accounts are covered in full at the rate agreed upon with the hospital group.
- Certain in-hospital dental and oral benefits covered from Major Medical Benefit.
- Co-payments may apply, depending on the procedure.
- Covered up to R500 000 per beneficiary per year, thereafter a 20% co-payment applies.
- Momentum Medical Scheme reference pricing applies to chemotherapy and adjuvant medication.
- No annual limit.
- You need to pay a co-payment of R2 770 per scan.
- Anti-retroviral treatment: No annual limit applies at a preferred provider.
- HIV-related hospital admissions: R87 900 per family at your chosen hospital provider.
- 25% of your contribution goes to a built-in Savings account, to cover your day-to-day expenses.
- Your Savings account is credited in advance for the year and any unused Savings balance at the end of the year will be carried forward to the following benefit year.
- If the Savings are not enough to cover annual day-to-day expenses, you will have a self-funding gap to pay out-of-pocket, up to the Threshold of R30 400 (principal member), R26 400 (adult dependant), R8 700 (per child, maximum 3 children).
- Although claims add up to the Threshold at 100% of the Momentum Medical Scheme Rate, you may claim a higher amount from Savings if the provider charges more than the Momentum Medical Scheme Rate. This will result in a bigger self-funding gap. You can use HealthSaver+ to fund your self-funding gap.
- Once the Threshold has been reached, claims will be paid from Extended Cover at the Momentum Medical Scheme Rate, subject to certain sub-limits. These day-to-day limits accumulate before and after the Threshold.
- If you choose Any or State as your chronic provider, we cover 100% of the Momentum Medical Scheme Rate.
- If you choose Associated provider for your chronic needs, we cover 100% of the Momentum Medical Scheme Rate for Associated GPs and 70% for non-Associated GPs.
- You are covered up to R5 030, subject to Savings or Extended Cover, to use on eye care per beneficiary.
- The maximum amount you can spend on a frame is R2 740.
- There is no limit for basic dentistry; covered at 100% of the Momentum Medical Scheme Rate from your available Day-to-day Benefits.
- Dental specialist accounts for extraction of impacted wisdom teeth in doctors’ rooms covered from Major Medical Benefit at 100% of the Momentum Medical Scheme Rate. You need to pay a R1 670 co-payment.
- Other specialised dentistry is paid from available Day-to-day Benefits, limited to R16 400 per beneficiary and R42 600 per family per year.
- Both in- and out-of-hospital dental specialist accounts accumulate towards the day-to-day limit.
- You are covered up to R21 100 per beneficiary, to use on prescribed medication, subject to Savings or Extended Cover.
- The maximum amount you can spend on prescribed medication is R40 000 per family.
- Over-the-counter medication is paid from Savings or HealthSaver+, if applicable.
Health Platform Benefit
- baby immunisations covered up to the age of 6,
- flu vaccines,
- pneumococcal vaccines, and
- tetanus-diphtheria injections.
- bone density scans,
- pap smears,
- dental consultations,
- general physical examinations,
- prostate specific antigens,
- health assessments,
- cholesterol tests,
- blood sugar tests, and
- HIV tests.
- a urine test,
- 2 pregnancy scans,
- certain antenatal pathology tests,
- 2 doula visits,
- 2 paediatrician visits in baby’s first year,
- online antenatal and postnatal classes,
- online video consultations with a lactation specialist, and
- 3 nurse home visits; first visit after returning from the hospital, as well as 2 and 6 weeks later.
This is only a summary of our benefits. Read the Extender Option brochure for more details. Momentum Medical Scheme rules apply.
An incentive programme that rewards you for taking ownership of your health. We aim to help you stay informed about your health status and reward you for staying healthy.
A voluntary savings account that works seamlessly with your medical aid. It pays for treatments and procedures not covered by
R40 per year
Get free expert health advice from qualified South African medical doctors through your phone or mobile device, 24/7/365.