Momentum Health Medical Aid Comparison - 2016 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 30% on your contribution. Members can also earn R1 800 per year through the Momentum Compliance incentive™

 
Momentum Health Custom Option 1
Custom Option 2
Incentive Option 1
Incentive Option 2
Extender Option 1
Extender Option 2
  Ingwe Option 1 Ingwe Option 2 Ingwe Option 3
  Access Option    
 
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1100 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R30,200  
  Hospice Care (including R41,400  
   rehab & step-down    
    facilities)    
       
       
  Oncology R300,000    
   thereafter 20% co-pay    
  Internal Prostheses:    
    see detailed benefits    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
   Only from state hospitals  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Does not apply   
       
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,152  
  Spouse/Adult dependant R 871  
  Per Child (Max 3) R 408  
       
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1100 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R30,200  
  Hospice Care (including R41,400  
   rehab & step-down    
    facilities)    
       
       
  Oncology R300,000    
   thereafter 20% co-pay    
  Internal Prostheses:    
     see detailed benefits    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Does not apply   
       
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,557  
  Spouse/Adult dependant R 1,228  
  Per Child (Max 3) R 549  
       
MOMENTUM INCENTIVE OPTION
  IN HOSPITAL BENEFIT  
  200% Scheme rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *Co-payments apply for certain  
  procedures  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R30,700  
  Hospice Care (including R41,400    
   rehab & step-down    
    facilities)    
       
       
  Oncology R400,000    
    thereafter 20% co-pay    
  Internal Prostheses:    
      see detailed benefits    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
  6 additional conditions limited to  
  R 8,300 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 1,824  
  Member+Spouse R 3,264  
  Member+Spouse+Child1 R 3,972  
  Member+Spouse+Child2 R 4,680  
  Member+Spouse+Child3 R 5,388  
  Member+Child 1 R 2,532  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,524  
  Spouse/Adult dependant R 1,196  
  Per Child (Max 3) R 591  
       
.
MOMENTUM INCENTIVE OPTION
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *Co-payments apply for certain  
  procedures  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :  
       
   Psychiatric Treament R30,700  
   Hospice Care (including R41,400  
    rehab & step-down    
     facilities)    
       
   Oncology R400,000    
    thereafter 20% co-pay    
  Internal Prostheses:    
    see detailed benefits    
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
  6 additional conditions limited to  
  R 8, 300 per family  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 2,676  
  Member+Spouse R 4,824  
  Member+Spouse+Child1 R 5,820  
  Member+Spouse+Child2 R 6,816  
  Member+Spouse+Child3 R 7,812  
  Member+Child 1 R 3,672  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,228  
  Spouse/Adult dependant R 1,792  
  Per Child (Max 3) R 832  
       
       
       
       
       
       
MOMENTUM EXTENDER OPTION
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *Co-payments apply for certain  
  procedures  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :  
       
    Psychiatric Treament R30,700   
    Hospice Care (including R42,700  
     rehab & step-down    
      facilities)    
       
   Oncology R500,000    
     thereafter 20% co-pay    
  Internal Prostheses:    
     see detailed benefits    
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
  36 additional conditions limited to  
  R 8,300 per family  
  Only from state hospital  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 9,912  
  Member+Spouse R 17,364  
  Member+Spouse+Child1 R 20,412  
  Member+Spouse+Child2 R 23,460  
  Member+Spouse+Child3 R 26,508  
  Member+Child 1 R 12,960  
       
    For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 14,900  
  Spouse/Adult dependant R 12,900  
  Per Child (Max 3) R 4,400  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,303  
  Spouse/Adult dependant R 2,483  
  Per Child (Max 3) R 1,107  
       
       
       
       
       
       
MOMENTUM EXTENDER OPTION
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *Co-payments apply for certain  
  procedures  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :  
       
   Psychiatric Treament R30,700    
   Hospice Care (including R42,700   
      rehab & step-down    
       facilities)    
       
    Oncology R500,000    
     thereafter 20% co-pay    
   Internal Prostheses:    
      see detailed benefits    
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
  36 additional conditions limited to  
  R 8, 300 per family  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 12,180  
  Member+Spouse R 21,900  
  Member+Spouse+Child1 R 25,728  
  Member+Spouse+Child2 R 29,556  
  Member+Spouse+Child3 R 33,384  
  Member+Child 1 R 16,008  
       
   For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 14,900  
  Spouse/Adult dependant R 12,900  
  Per Child (Max 3) R 4,400  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 4,061  
  Spouse/Adult dependant R 3,241  
  Per Child (Max 3) R 1,275  
       
       
       
       
       
       
 
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,120,000 per family per annum  
  *7 days Take Home Medicine  
     
     
  Annual Sub-limits :
 
     
   Psychiatric Treament PMB  
   Hospice Care n/a  
   Oncology PMB  
       
       
       
       
       
       
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Ingwe Primary Care network  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Primary Care Network    
       
  GP's:   
  No Limit from Ingwe Primary Care  
  Network  
     
     
  Specialists:  
  2 visit per family limited to R1,480  
  per annum and/ or R900 per event  
    with 10% co-payment              
     
  Conservative Dentistry:  
  No Limit from Ingwe Primary Care  
   Network    
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Income p/m             R0- R5,800  
  Principal Member    R 510  
       
  Spouse/Adult dependant R 510  
       
  Per Child R 275  
       
       
  Income p/m      R5,801- R7,800  
  Principal Member R 583  
  Spouse/Adult dependant R 583  
  Per Child R 281  
       
  Income p/m      R7,801- R10,400  
  Principal Member R 681  
  Spouse/Adult Dependant R 681  
  Per Child R 295  
       
  Income p/m  R10,401 +    
  Principal Member R 1,138  
  Spouse/Adult Dependant R 1,138  
  Per Child R 356  
       
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,120,000 per family per annum  
  *7 days Take Home Medicine  
     
     
  Annual Sub-limits :
 
     
    Psychiatric Treament PMB  
    Hospice Care n/a  
    Oncology PMB  
       
       
       
       
       
       
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Ingwe Primary Care network  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Primary Care Network    
       
  GP's:   
  No Limit from Ingwe Primary Care  
  Network Providers   
     
     
  Specialists:  
  2 visit per family limited to R1,480  
  per annum and/ or R900 per event  
   with 10% co-payment               
     
  Conservative Dentistry:  
  No Limit from Network Providers   
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Income p/m             R0- R5,800  
  Principal Member    R 638  
       
  Spouse/Adult dependant R 638  
       
  Per Child R 292  
       
       
  Income p/m      R5,801- R7,800  
  Principal Member R 812  
  Spouse/Adult dependant R 812  
  Spouse/Adult dependant R 304  
       
  Income p/m      R7,801- R10,400  
  Principal Member R 1,133  
  Principal Member R 1,098  
  Per Child R 333  
       
  Income p/m   R10,400 +    
  Principal Member R 1,606  
  Principal Member R 1,557  
  Principal Member R 473  
       
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,120,000 per family per annum  
  *7 days Take Home Medicine  
     
     
  Annual Sub-limits :
 
     
     Psychiatric Treament PMB  
     Hospice Care n/a  
     Oncology PMB  
       
       
       
       
       
       
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  IngwePrimary Care Network  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Primary Care Network    
   No limit from Ingwe Primary Care  
   Network  
     
     
     
   2 visits per family limited to R1,480  
   per annum and / or R900 per event  
   with a 10% co-payment  
                    
     
     
  No Limit from Network Providers   
         
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
   Income p/m             R0- R5,800  
  Principal Member R 829  
  Spouse/Adult Dependant R 829  
  Per Child R 311  
       
   Income p/m      R5,801- R7,800  
   Principal Member R1,158  
   Spouse/Adult dependant R1,158  
   Spouse/Adult dependant R 350  
       
   Income p/m      R7,801- R10,400  
   Principal Member R1,584  
   Principal Member R1,515  
   Per Child R371  
       
   Income p/m  R10,401 +    
   Principal Member R2,029  
   Principal Member R1,983  
   Principal Member R 589  
       
       
       
       
.
MOMENTIM ACCESS OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
   *7 days take home medicine  
  Access Network hospitals to be used  
     
     
     
   
 
  Annual Sub-limits per person:  
  Psychiatric Treatment R15,200  
  Hospice Care R 40,900  
  Oncology PMB  
       
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Access Primary Care Network  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% NHRPL rate  
  Access Primary Care Network  
  GP's: 10 visits per person per  
    annum, thereafter R65  
    co-payment  
       
  Specialists: 3 visits per person limited  
    to 5 visits per family per  
    annum  
     
  Conservative Dentistry:  
    No Limit from
 
    Network Providers.  
       
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
     
  Principal Member                 R 1,693    
  Spouse /Adult                     R 1,610
 
  dependant  
  Per Child                            R 507
 
     
       
 

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 the Momentum Health Medical Aids.