Site url: https://www.momentum.co.za/momentum/personal/products/medical-aid/in-hospital-benefit
Pagecontext: org.apache.jasper.runtime.PageContextImpl@220a0d6d
NameValue
param.sharing.scope.{http://www.ibm.com/xmlns/prod/datatype/content}ibm.portal.sharing.scope.page
param.sharing.scope.{http://www.ibm.com/xmlns/prod/websphere/portal/v8.0/portal-contextual-portal}ibm.portal.sharing.scope.page
param.sharing.scope.{http://www.ibm.com/xmlns/prod/datatype/content/resource-collections}ibm.portal.sharing.scope.page
wcm.template.oidZ6_48GC1K80O0FH90QS83FHN530K6
flush.cache?01102021
param.sharing.scope.{http://www.ibm.com/xmlns/prod/websphere/portal/publicparams}path-infoibm.portal.sharing.scope.page
breadcrumb.enabledtrue
hero.imagehttps://retail.momentum.co.za/images/stock/major-medical-benefits-hero-2-1.jpg
param.template.pageZ6_48GC1K80O0FH90QS83FHN530K6
page.keywordsAffordable medical aid, Medical aid plans, Medical aid quotes, Medical aid South Africa, Medical aid, Student medical aid, Healthcare, Medical scheme, Cheap medical aid, momentum medical aid
param.sharing.scope.{http://www.ibm.com/xmlns/prod/websphere/portal/v7.0/portal-contextual-portal}ibm.portal.sharing.scope.page
hide.childrentrue
dynamic.sitemaptrue
param.sharing.scope.{http://ibm.connections.com/portlet}ibm.portal.sharing.scope.page
label.namepersonal
sitecontext:personal
ibm.template.oidZ6_48GC1K80O0FH90QS83FHN530K6
webchat.activetrue
menu.dividertrue
menu
Young mother and daughter at home, with daughter using a stethoscope to listen to her mother’s heartbeat.

In-hospital Benefit

This Major Medical Benefit includes cover for hospitalisation, as well as certain specialised procedures and treatment, and specialised scans. It gives you option-specific benefits that cover you if you’re hospitalised or need to have surgery.

  • 7 days’ supply of take-home medication on discharge.
  • Covers certain scans done in hospital.
  • Easy pre-authorisation done on the Momentum App.

What does the In-hospital Benefit cover?

Your hospital accounts and costs related to your stay in a hospital, as well as certain procedures performed both in- or out-of-hospital, are covered, subject to pre-authorisation.

The following is an overview of the cover provided across our 7 medical aid options.


Couple laughing
Cover
  • Hospital accounts are covered in full at the rate agreed with the hospital group.
  • Specialists are covered up to 100% of the Momentum Medical Scheme Rate.
  • No annual limit applies.

Hospital provider
oung man sitting on a bench outdoors, smiling while looking at his cell phone, reading up on Momentum’s Evolve medical aid option.
Cover
  • Hospital accounts are covered in full at the rate agreed with the hospital group.
  • Specialists are covered up to 100% of the Momentum Medical Scheme Rate. A R1 830 co-payment per authorisation applies, except for car accidents, maternity confinements, and emergency treatment. An additional co-payment may apply for specialised procedures.
  • No annual limit applies.

Hospital provider
An energetic family of 4 - a mother, father, and 2 young children jogging on a country path.
Cover
  • Hospital accounts are covered in full at the rate agreed with the hospital group.
  • Specialists are covered up to 100% of the Momentum Medical Scheme Rate. A R1 830 co-payment per authorisation applies, except for car accidents, maternity confinements, and emergency treatment. An additional co-payment may apply for specialised procedures.
  • No annual limit applies.

Hospital provider
Mother and father happily playing on the beach with their two children in the sand building a sandcastle, near the ocean.
Cover
  • Hospital accounts are covered in full at the rate agreed with the hospital group.
  • Specialists are covered up to 200% of the Momentum Medical Scheme Rate. Co-payments may apply for certain specialised procedures or treatment.
  • No annual limit applies.

Hospital provider
Happy mom and dad riding bicycles outdoors with their two children riding their bicycles ahead of their mother and father.
Cover
  • Hospital accounts are covered in full at the rate agreed with the hospital group.
  • Specialists are covered up to 200% of the Momentum Medical Scheme Rate. Co-payments may apply for certain specialised procedures or treatment.
  • No annual limit applies.

Hospital provider
An elderly woman and man, happily riding horses outdoors with mountains in the background.
Cover
  • Hospital accounts are covered in full at the rate agreed with the hospital group.
  • Specialists are covered up to 300% of the Momentum Medical Scheme Rate.
  • No annual limit applies.

Hospital provider
  • Any hospital.

For more information about hospitalisation and specialised procedures covered under this Major Medical Benefit, have a look at the focus page of your chosen medical aid option to see what you’re covered for.

Pre-authorisation for in-hospital benefits

You can get pre-authorisation once benefits have been verified and the Scheme Rules and protocols have been applied. If the hospital or your doctor obtains the authorisation on your behalf, you will need to verify with us if there are any co-payments or shortfalls because of not using a Designated Service Provider or resulting from benefit limits or protocols.

Important to know

Am I responsible for obtaining pre-authorisation?

You are responsible for obtaining pre-authorisation from Momentum Medical Scheme at least 48 hours before you and/or your dependants are admitted to a hospital or day clinic, receive specialised treatment covered under the Specialised Procedures/Treatment benefit, or have a specialised scan, such as MRI or CT scans.
What happens if I don't get a pre-authorisation for a procedure?

If authorisation is not obtained, a 30% co-payment will apply on all accounts related to the event and the Scheme will cover 70% of the negotiated tariff, provided authorisation would have been granted according to the Rules and protocols of the Scheme.
What happens in the case of an emergency?

In the case of an emergency, you, a family member, or a friend may obtain authorisation within 72 hours of admittance.
What happens if I don't use a network hospital?

  • Ingwe Option: Members who choose Ingwe Network hospitals and do not use this provider will have a co-payment of 30% on the hospital account. Members who choose State hospitals and do not use this provider will have a co-payment. This co-payment will be the difference in the cost between state facility charges and the amount charged by the provider they use.
  • Evolve Option and Fusion Options: Members who do not use Evolve or Fusion Network hospitals will have a 30% co-payment on their hospital account.
  • Custom, Incentive and Extender Options: Members who choose Associated hospitals and do not use them, will be liable for a 30% co-payment on their hospital account.

Want a quote?

You'll get a quote reflecting the medical aid contribution at the end of the process.

Need advice?

An accredited healthcare consultant will call you to discuss our medical aid options and benefits.

Other benefits

Chronic
Benefit

Day-to-day
Benefit

Health Platform
Benefit

Hello
Doctor

Contact Momentum Medical Scheme

Client service, claims and authorisations



Click here to contact us via WhatsApp.
Join an online help session.



Business hours are Monday to Friday from 08:00 to 17:00. Saturday and public holidays from 08:00 to 16:00. Closed on Sundays.

For local emergencies



Available 24 hours a day, 7 days a week, 365 days a year.

For international emergencies



Available 24 hours a day, 7 days a week, 365 days a year.

Momentum Medical Scheme Ethics and Fraud line




Available 24 hours a day, 7 days a week, 365 days a year.

We and our selected partners use cookies to enhance and personalise your experience on our website.Please see our cookie policy for more information.

To enhance your user experience on our site, learn more about our supported browsers

Your browser's cookies are disabled. Enable cookies to ensure our website functions correctly. View our Privacy Notice.

Tell us more!

We're always looking for ways to improve your online experience. Please take a moment to complete the
2-minute questionnaire.