Momentum Health Medical Aid Comparison - 2017 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 Network Option
   
 
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1200 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R32,100  
  Hospice Care (including R44,000  
   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 1,266  
  Spouse/Adult dependant R 957  
  Per Child (Max 3) R 448  
       
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1200 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R32,100  
  Hospice Care (including R44,000  
   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 1,742  
  Spouse/Adult dependant R 1,374  
  Per Child (Max 3) R 614  
       
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 R32,100  
  Hospice Care (including     R44,000  
   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 2,040  
  Member+Spouse R 3,636  
  Member+Spouse+Child1 R 4,428  
  Member+Spouse+Child2 R 5,220  
  Member+Spouse+Child3 R 6,012  
  Member+Child 1 R 2,832  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,700  
  Spouse/Adult dependant R 1,333  
  Per Child (Max 3) R 659  
       
.
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 R32,100  
   Hospice Care (including R44,000  
    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 3,036  
  Member+Spouse R 5,472  
  Member+Spouse+Child1 R 6,600  
  Member+Spouse+Child2 R 7,728  
  Member+Spouse+Child3 R 8,856  
  Member+Child 1 R 4,164  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,529  
  Spouse/Adult dependant R 2,034  
  Per Child (Max 3) R 944  
       
       
       
       
       
       
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 R32,100   
    Hospice Care (including R44,000  
     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 11,196  
  Member+Spouse R 19,608  
  Member+Spouse+Child1 R 23,052  
  Member+Spouse+Child2 R 26,496  
  Member+Spouse+Child3 R 29,940  
  Member+Child 1 R 14,640  
       
    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 3,732  
  Spouse/Adult dependant R 2,805  
  Per Child (Max 3) R 1,149  
       
       
       
       
       
       
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 R32,100    
   Hospice Care (including R44,000   
      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 14,016  
  Member+Spouse R 25,200  
  Member+Spouse+Child1 R 29,592  
  Member+Spouse+Child2 R 33,984  
  Member+Spouse+Child3 R 38,376  
  Member+Child 1 R 18,408  
       
   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 4,671  
  Spouse/Adult dependant R 3,728  
  Per Child (Max 3) R 1,465  
       
       
       
       
       
       
 
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,190,000 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. Pre authorisation required  
   from 11th visit. 1 out of Network visit  
   per person and max 2 visits per family  
   per year with a R100 co payment  
     
  Specialists:  
  2 visit per family with a R100  
   co-payment. Must be referred by a  
   Network GP  
     
  Conservative Dentistry:  
  No Limit from Ingwe Primary Care  
   Network. Pre authorisation    
   required if more than 4    
   fillings or extractions    
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Income p/m             R0- R6,100  
  Principal Member    R 701  
  Spouse/Adult dependant R 701  
  Per Child R 321  
       
       
  Income p/m      R6,101- R8,200  
  Principal Member R 892  
  Spouse/Adult dependant R 892  
  Per Child R 334  
       
  Income p/m      R8,201- R11,000  
  Principal Member R 1241  
  Spouse/Adult Dependant R 1241  
  Per Child R 365  
       
  Income p/m  R11,001 +    
  Principal Member R 1,758  
  Spouse/Adult Dependant R 1,758  
  Per Child R 518  
       
 
     
     
     
     
     
     
   
 
     
       
       
       
       
       
       
       
       
       
       
       
       
       
               
     
     
     
     
     
     
               
   
 
 
     
       
       
     
     
     
     
     
     
     
     
     
     
     
     
     
     
       
       
       
     
     
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
 
     
     
     
     
     
     
   
 
     
       
       
       
       
       
       
       
       
       
       
       
       
       
               
     
     
     
     
     
     
               
   
 
 
     
       
     
     
     
     
     
     
     
     
                    
     
     
     
     
     
         
       
       
       
     
     
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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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 the Momentum Health Medical Aids.