Momentum Health Medical Aid Comparison - 2015 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  
  *R1000 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R28,500  
  Hospice Care (including R39,100  
   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 1,068  
  Spouse/Adult dependant R 807  
  Per Child (Max 3) R 378  
       
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1000 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R28,500  
  Hospice Care (including R39,100  
   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 1,443  
  Spouse/Adult dependant R 1,138  
  Per Child (Max 3) R 509  
       
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 R29,000  
  Hospice Care (including R39,100    
   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 7,800 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 1,668  
  Member+Spouse R 2,976  
  Member+Spouse+Child1 R 3,624  
  Member+Spouse+Child2 R 4,272  
  Member+Spouse+Child3 R 4,920  
  Member+Child 1 R 2,316  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,391  
  Spouse/Adult dependant R 1,091  
  Per Child (Max 3) R 539  
       
.
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 R29,000  
   Hospice Care (including R39,100  
    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 7, 800 per family  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 2,436  
  Member+Spouse R 4,404  
  Member+Spouse+Child1 R 5,316  
  Member+Spouse+Child2 R 6,228  
  Member+Spouse+Child3 R 7,140  
  Member+Child 1 R 3,348  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,032  
  Spouse/Adult dependant R 1,636  
  Per Child (Max 3) R 759  
       
       
       
       
       
       
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 R29,000   
    Hospice Care (including R40,300  
     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 7,800 per family  
  Only from state hospital  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 9,012  
  Member+Spouse R 15,792  
  Member+Spouse+Child1 R 18,564  
  Member+Spouse+Child2 R 21,336  
  Member+Spouse+Child3 R 24,108  
  Member+Child 1 R 11,784  
       
    For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 13,600  
  Spouse/Adult dependant R 11,700  
  Per Child (Max 3) R 4,000  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,005  
  Spouse/Adult dependant R 2,259  
  Per Child (Max 3) R 925  
       
       
       
       
       
       
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 R29,000    
   Hospice Care (including R40,300   
      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 7, 800 per family  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 11,088  
  Member+Spouse R 19,932  
  Member+Spouse+Child1 R 23,412  
  Member+Spouse+Child2 R 26,892  
  Member+Spouse+Child3 R 30,372  
  Member+Child 1 R 14,568  
       
   For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 13,600  
  Spouse/Adult dependant R 11,700  
  Per Child (Max 3) R 4,000  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,696  
  Spouse/Adult dependant R 2,949  
  Per Child (Max 3) R 1,160  
       
       
       
       
       
       
 
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,060,000 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 R1,400  
  per annum and/ or R850 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- R5,500  
  Principal Member    R 473  
       
  Spouse/Adult dependant R 473  
       
  Per Child R 255  
       
       
  Income p/m      R5,501- R7,400  
  Principal Member R 540  
  Spouse/Adult dependant R 540  
  Per Child R 260  
       
  Income p/m      R7,401- R9,900  
  Principal Member R 631  
  Spouse/Adult Dependant R 631  
  Per Child R 273  
       
  Income p/m    R9,900 +    
  Principal Member R 1,096  
  Spouse/Adult Dependant R 1,047  
  Per Child R 330  
       
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,060,000 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 R1,400  
  per annum and/ or R850 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- R5,500  
  Principal Member    R 591  
       
  Spouse/Adult dependant R 591  
       
  Per Child R 271  
       
       
  Income p/m      R5,501- R7,400  
  Principal Member R 753  
  Spouse/Adult dependant R 753  
  Spouse/Adult dependant R 282  
       
  Income p/m      R7,401- R9,900  
  Principal Member R 1,050  
  Principal Member R 1,018  
  Per Child R 309  
       
  Income p/m    R9,900 +    
  Principal Member R 1,488  
  Principal Member R 1,443  
  Principal Member R 438  
       
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,060,000 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 R1,400  
   per annum and / or R850 per event  
   with a 10% co-payment  
                    
     
     
  No Limit from Network Providers   
         
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
   Income p/m             R0- R5,500  
  Principal Member R 768  
  Spouse/Adult Dependant R 768  
  Per Child R 288  
       
   Income p/m      R5,501- R7,400  
   Principal Member R1,073  
   Spouse/Adult dependant R1,073  
   Spouse/Adult dependant R 324  
       
   Income p/m      R7,401- R9,900  
   Principal Member R1,468  
   Principal Member R1,404  
   Per Child R344  
       
   Income p/m    R9,900 +    
   Principal Member R1,880  
   Principal Member R1,838  
   Principal Member R 546  
       
       
       
       
.
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 R14,300  
  Hospice Care R 38,600  
  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 R60  
    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 1,569    
  Spouse /Adult                     R 1,492
 
  dependant  
  Per Child                            R 470
 
     
       
 

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.