Momentum Health Medical Aid Comparison - 2018 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  
  *R1,300 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R33,900  
  Hospice Care (including R46,400  
   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 1,366  
  Spouse/Adult dependant R 1,033  
  Per Child (Max 3) R 484  
       
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1,300 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R33,900  
  Hospice Care (including R46,400  
   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 1,885  
  Spouse/Adult dependant R 1,487  
  Per Child (Max 3) R 665  
       
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 R34,400  
  Hospice Care (including     R46,400  
   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 9,300 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 2,196  
  Member+Spouse R 3,924  
  Member+Spouse+Child1 R 4,776  
  Member+Spouse+Child2 R 5,628  
  Member+Spouse+Child3 R 6,480  
  Member+Child 1 R 3,048  
  Member+Child 2 R 3,900  
  Member+Child 3 R 4,752  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,834  
  Spouse/Adult dependant R 1,439  
  Per Child (Max 3) R 711  
       
.
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 R34,400  
   Hospice Care (including R46,400  
    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 9, 300 per family  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 3,288  
  Member+Spouse R 5,928  
  Member+Spouse+Child1 R 7,152  
  Member+Spouse+Child2 R 8,376  
  Member+Spouse+Child3 R 9,600  
  Member+Child 1 R 4,512  
  Member+Child 2 R 5,736  
  Member+Child 3 R 6,960  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,737  
  Spouse/Adult dependant R 2,202  
  Per Child (Max 3) R 1,022  
       
       
       
       
       
       
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 R34,400   
    Hospice Care (including R47,900  
     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  
  6 additional conditions limited to  
  R 9,300 per family  
  Only from state hospital  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 12,384  
  Member+Spouse R 21,696  
  Member+Spouse+Child1 R 25,416  
  Member+Spouse+Child2 R 29,136  
  Member+Spouse+Child3 R 32,856  
  Member+Child 1 R 16,104  
  Member+Child 2 R 19,136  
  Member+Child 3 R 23,544  
       
    For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 18,700  
  Spouse/Adult dependant R 16,200  
  Per Child (Max 3) R 5,600  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 4,129  
  Spouse/Adult dependant R 3,104  
  Per Child (Max 3) R 1,239  
       
       
       
       
       
       
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 R34,400    
   Hospice Care (including R47,900   
      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  
  6 additional conditions limited to  
  R 9,300 per family  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 15,336  
  Member+Spouse R 27,576  
  Member+Spouse+Child1 R 32,184  
  Member+Spouse+Child2 R 36,792  
  Member+Spouse+Child3 R 41,400  
  Member+Child 1 R 19,944  
  Member+Child 2 R 24,552  
  Member+Child 3 R 29,160  
       
   For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 18,700  
  Spouse/Adult dependant R 16,200  
  Per Child (Max 3) R 5,600  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 5,113  
  Spouse/Adult dependant R 4,081  
  Per Child (Max 3) R 1,535  
       
       
       
       
       
       
 
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,260,000 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- R6,300  
  Principal Member    R 759  
  Spouse/Adult dependant R 759  
  Per Child R 347  
       
       
  Income p/m      R6,301- R8,500  
  Principal Member R 965  
  Spouse/Adult dependant R 965  
  Per Child R 361  
       
  Income p/m      R8,501- R11,700  
  Principal Member R 1334  
  Spouse/Adult Dependant R 1334  
  Per Child R 395  
       
  Income p/m  R11,701 +    
  Principal Member R 1,903  
  Spouse/Adult Dependant R 1,903  
  Per Child R 561  
       
 
     
     
     
     
     
     
   
 
     
       
       
       
       
       
       
       
       
       
       
       
       
       
               
     
     
     
     
     
     
               
   
 
 
     
       
       
     
     
     
     
     
     
     
     
     
     
     
     
     
     
       
       
       
     
     
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
 
     
     
     
     
     
     
   
 
     
       
       
       
       
       
       
       
       
       
       
       
       
       
               
     
     
     
     
     
     
               
   
 
 
     
       
     
     
     
     
     
     
     
     
                    
     
     
     
     
     
         
       
       
       
     
     
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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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.