Momentum Health Medical Aid Comparison - 2013 Plans
Momentum Health strives to offer you good value for money by combining flexibility with comprehensive cover, because it is important to match your family’s needs. The Scheme’s unique Health Platform benefit provides a variety of free annual screening tests, while its provider choice model can save you up to 35% on your contribution. Members can also earn R5 400 per year through the Momentum Health Returns Programme.
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IN HOSPITAL BENEFIT |
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100% Scheme Rate |
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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*R1000 co-payment except for |
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Emergencies, MVA's and maternity |
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Associated Hospitals to be used |
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(Life and Mediclinics) |
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Annual Sub-limits :
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Psychiatric Treament |
R25,500 |
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Hospice Care (including |
R35,000 |
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rehab & step-down |
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facilities) |
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Oncology R280,000 |
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thereafter 20% co-pay |
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Internal Prostheses: |
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see detailed benefits |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 Chronic Disease Conditions |
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Subject to scheme formulary |
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Only from state hospitals |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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Does not apply |
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For more savings, please enquire |
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about the Health Saver |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 914 |
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Spouse/Adult dependant |
R 691 |
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Per Child (Max 3) |
R 323 |
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IN HOSPITAL BENEFIT |
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100% Scheme Rate |
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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*R1000 co-payment except for |
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Emergencies, MVA's and maternity |
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Associated Hospitals to be used |
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(Life and Mediclinics) |
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Annual Sub-limits :
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Psychiatric Treament |
R25,500 |
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Hospice Care (including |
R35,000 |
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rehab & step-down |
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facilities) |
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Oncology R280,000 |
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thereafter 20% co-pay |
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Internal Prostheses: |
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see detailed benefits |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 Chronic Disease Conditions |
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Subject to scheme formulary |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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Does not apply |
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For more savings, please enquire |
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about the Health Saver |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,196 |
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Spouse/Adult dependant |
R 943 |
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Per Child (Max 3) |
R 422 |
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IN HOSPITAL BENEFIT |
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200% Scheme rate |
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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*Co-payments apply for certain |
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procedures |
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Associated Hospitals to be used |
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(Life and Mediclinics) |
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Annual Sub-limits :
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Psychiatric Treament |
R26,000 |
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Hospice Care (including |
R35,000 |
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rehab & step-down |
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facilities) |
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Oncology R380,000 |
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thereafter 20% co-pay |
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Internal Prostheses: |
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see detailed benefits |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 Chronic Disease Conditions |
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Subject to scheme formulary |
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6 additional conditions limited to |
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R 7,000 per family |
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Only from state hospitals |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% Scheme Rate |
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Limits per annum: |
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Member |
R 1,512 |
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Member+Spouse |
R 2,700 |
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Member+Spouse+Child1 |
R 3,288 |
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Member+Spouse+Child2 |
R 3,876 |
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Member+Spouse+Child3 |
R 4,464 |
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Member+Child 1 |
R 2,100 |
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For more savings, please enquire |
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about the Health Saver |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,263 |
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Spouse/Adult dependant |
R 991 |
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Per Child (Max 3) |
R 490 |
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IN HOSPITAL BENEFIT |
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200% Scheme Rate |
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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*Co-payments apply for certain |
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procedures |
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Associated Hospitals to be used |
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(Life and Mediclinics) |
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Annual Sub-limits : |
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Psychiatric Treament |
R26,000 |
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Hospice Care (including |
R35,000 |
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rehab & step-down |
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facilities) |
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Oncology R380,000 |
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thereafter 20% co-pay |
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Internal Prostheses: |
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see detailed benefits |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 Chronic Disease Conditions |
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Subject to scheme formulary |
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6 additional conditions limited to |
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R 7, 000 per family |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% Scheme Rate |
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Limits per annum: |
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Member |
R 2,028 |
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Member+Spouse |
R 3,660 |
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Member+Spouse+Child1 |
R 4,416 |
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Member+Spouse+Child2 |
R 5,172 |
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Member+Spouse+Child3 |
R5,928 |
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Member+Child 1 |
R2,784 |
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For more savings, please enquire |
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about the Health Saver |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,692 |
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Spouse/Adult dependant |
R 1,362 |
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Per Child (Max 3) |
R 632 |
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IN HOSPITAL BENEFIT |
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200% Scheme Rate |
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No Overall Annual Limit |
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| |
*7 days Take Home Medicine |
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| |
*Co-payments apply for certain |
|
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procedures |
|
| |
Associated Hospitals to be used |
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(Life and Mediclinics) |
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Annual Sub-limits : |
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Psychiatric Treament |
R26,000 |
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Hospice Care (including |
R36,000 |
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rehab & step-down |
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facilities) |
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Oncology R480,000 |
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thereafter 20% co-pay |
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Internal Prostheses: |
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see detailed benefits |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 Chronic Disease Conditions |
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Subject to scheme formulary |
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36 additional conditions limited to |
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R 7,000 per family |
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Only from state hospital |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% Scheme Rate |
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Limits per annum: |
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Member |
R 7,728 |
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Member+Spouse |
R 13,428 |
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Member+Spouse+Child1 |
R 15,852 |
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Member+Spouse+Child2 |
R 18,276 |
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Member+Spouse+Child3 |
R 20,700 |
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Member+Child 1 |
R 10,152 |
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For more savings, please enquire |
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about the Health Saver |
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ANNUAL THRESHOLD BENEFIT |
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Principal Member |
R 12,000 |
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Spouse/Adult dependant |
R 10,500 |
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Per Child (Max 3) |
R 3,300 |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 2,577 |
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Spouse/Adult dependant |
R 1,899 |
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Per Child (Max 3) |
R 809 |
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IN HOSPITAL BENEFIT |
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200% Scheme Rate |
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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| |
*Co-payments apply for certain |
|
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procedures |
|
| |
Associated Hospitals to be used |
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| |
(Life and Mediclinics) |
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Annual Sub-limits : |
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Psychiatric Treament |
R26,000 |
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Hospice Care (including |
R36,000 |
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rehab & step-down |
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facilities) |
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Oncology R480,000 |
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thereafter 20% co-pay |
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Internal Prostheses: |
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see detailed benefits |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 Chronic Disease Conditions |
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Subject to scheme formulary |
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36 additional conditions limited to |
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R 7, 000 per family |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% Scheme Rate |
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Limits per annum: |
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Member |
R 9,228 |
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Member+Spouse |
R 16,596 |
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Member+Spouse+Child1 |
R 19,488 |
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Member+Spouse+Child2 |
R 22,380 |
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Member+Spouse+Child3 |
R 25,272 |
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Member+Child 1 |
R 12,120 |
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For more savings, please enquire |
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about the Health Saver |
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ANNUAL THRESHOLD BENEFIT |
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Principal Member |
R 12,000 |
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Spouse/Adult dependant |
R 10,500 |
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Per Child (Max 3) |
R 3,300 |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 3,077 |
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Spouse/Adult dependant |
R 2,456 |
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Per Child (Max 3) |
R 965 |
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MOMENTUM INGWE OPTION
|
| STATE HOSPITALS |
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IN HOSPITAL BENEFIT |
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100% Scheme Rate |
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R950,000 per family per annum |
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*7 days Take Home Medicine |
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Annual Sub-limits :
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Psychiatric Treament |
PMB |
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Hospice Care |
n/a |
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Oncology |
PMB |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 PMB Chronic Disease Conditions |
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Subject to scheme formulary |
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Ingwe Primary Care network |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% Scheme Rate |
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Primary Care Network |
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GP's: |
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No Limit from Ingwe Primary Care |
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Network |
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Specialists: |
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2 visit per family limited to R1,250 |
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per annum and/ or R750 per event |
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with 10% co-payment |
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Conservative Dentistry: |
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No Limit from Ingwe Primary Care |
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Network |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Income p/m R0- |
R4,900 |
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Principal Member |
R 397 |
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Spouse/Adult dependant |
R 397 |
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Per Child |
R 216 |
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Income p/m R4,901- |
R6,600 |
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Principal Member |
R 450 |
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Spouse/Adult dependant |
R 450 |
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Per Child |
R 217 |
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Income p/m R6,601- |
R8,900 |
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Principal Member |
R 526 |
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Spouse/Adult Dependant |
R 526 |
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Per Child |
R 228 |
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Income p/m R8,900 + |
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Principal Member |
R 912 |
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Spouse/Adult Dependant |
R 872 |
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Per Child |
R 275 |
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MOMENTUM INGWE OPTION
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| INGWE NETWORK HOSPITALS |
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IN HOSPITAL BENEFIT |
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100% Scheme Rate |
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R950,000 per family per annum |
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*7 days Take Home Medicine |
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Annual Sub-limits :
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Psychiatric Treament |
PMB |
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Hospice Care |
n/a |
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Oncology |
PMB |
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CHRONIC MEDICATION BENEFIT |
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100% Scheme Rate |
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27 PMB Chronic Disease Conditions |
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Subject to scheme formulary |
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Ingwe Primary Care network |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% Scheme Rate |
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Primary Care Network |
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GP's: |
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No Limit from |
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Ingwe Primary Care Network |
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Specialists: |
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2 visit per family limited to R1,250 |
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per annum and/ or R750 per event |
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with 10% co-payment |
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Conservative Dentistry: |
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No Limit from Ingwe Primary Care Network |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Income p/m R0- |
R4,900 |
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Principal Member |
R 496 |
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Spouse/Adult dependant |
R 496 |
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Per Child |
R 237 |
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Income p/m R4,901- |
R6,600 |
|
| |
Principal Member |
R 641 |
|
| |
Spouse/Adult dependant |
R 641 |
|
| |
Per Child |
R 235 |
|
| |
|
|
|
| |
Income p/m R6,601- |
R8,900 |
|
| |
Principal Member |
R 899 |
|
| |
Spouse/Adult Dependant |
R 854 |
|
| |
Per Child |
R 270 |
|
| |
|
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|
| |
Income p/m R8,900 + |
|
|
| |
Principal Member |
R 1,239 |
|
| |
Spouse/Adult Dependant |
R 1,178 |
|
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Per Child |
R 372 |
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MOMENTUM ACCESS OPTION
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| ACCESS NETWORK HOSPITALS |
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IN HOSPITAL BENEFIT |
|
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100% Scheme Rate |
|
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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Annual Sub-limits :
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Psychiatric Treament |
R12 800 |
|
| |
Hospice Care |
R34 500 |
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Oncology |
PMB |
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CHRONIC MEDICATION BENEFIT |
|
| |
100% Scheme Rate |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Subject to scheme formulary |
|
| |
Access Primary Care Network |
|
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% Scheme Rate |
|
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Access Primary Care |
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Network |
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GP's: |
|
| |
10 visits per person per annum |
|
| |
thereafter R60 co-payment |
|
| |
applies. |
|
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Specialists: |
|
| |
3 visits per person limited to |
|
| |
5 visits per family per annum |
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Conservative Dentistry: |
|
| |
No Limit from Ingwe Primary Care Network |
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ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
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MONTHLY CONTRIBUTIONS |
|
| |
|
|
|
| |
Principal Member |
R 1,306 |
|
| |
Spouse/Adult Dependant |
R 1,242 |
|
| |
Per Child |
R 391 |
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| . |
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For more detailed information on any of the above Momentum Health plans, just click on the name of the relevant plan in the tables above. If you already know what you want, why not make use of our site to download the relevant Medical Aid Application form and then fax it back to us on 021 712 6626. Alternatively, if you would like us to confirm some of the finer details and/or pricing, just fill in our Medical Aid Quote Request form and we will get back to you promptly.
Finally, we invite you to contact us on +27 21 712-8866 at any point in your decision making process for further information on Momentum Health.
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