Momentum Health Medical Aid Comparison - 2019 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 R48,700  
   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 1,515  
  Spouse/Adult dependant R 1,146  
  Per Child (Max 3) R 537  
       
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 R48,700  
   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 2,113  
  Spouse/Adult dependant R 1,667  
  Per Child (Max 3) R 745  
       
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 R36,100  
  Hospice Care (including     R51,000  
   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 9,800 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 2,412  
  Member+Spouse R 4,308  
  Member+Spouse+Child1 R 5,232  
  Member+Spouse+Child2 R 6,156  
  Member+Spouse+Child3 R 7,080  
  Member+Child 1 R 3,336  
  Member+Child 2 R 4,260  
  Member+Child 3 R 5,184  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,006  
  Spouse/Adult dependant R 1,583  
  Per Child (Max 3) R 769  
       
.
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 R36,100  
   Hospice Care (including R51,400  
    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 9,800 per family  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 3,612  
  Member+Spouse R 6,516  
  Member+Spouse+Child1 R 7,872  
  Member+Spouse+Child2 R 9,228  
  Member+Spouse+Child3 R 10,584  
  Member+Child 1 R 4,968  
  Member+Child 2 R 6,324  
  Member+Child 3 R 7,680  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,012  
  Spouse/Adult dependant R 2,423  
  Per Child (Max 3) R 1,126  
       
       
       
       
       
       
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 R36,100   
    Hospice Care (including R52,700  
     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 9,800 per family  
  Only from state hospital  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 13,740  
  Member+Spouse R 24,156  
  Member+Spouse+Child1 R 28,200  
  Member+Spouse+Child2 R 32,244  
  Member+Spouse+Child3 R 36,288  
  Member+Child 1 R 17,784  
  Member+Child 2 R 21,828  
  Member+Child 3 R 25,872  
       
    For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 20,800  
  Spouse/Adult dependant R 18,000  
  Per Child (Max 3) R 6,200  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 4,580  
  Spouse/Adult dependant R 3,473  
  Per Child (Max 3) R 1,347  
       
       
       
       
       
       
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 R36,100    
   Hospice Care (including R52,700   
      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 9,800 per family  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 17,052  
  Member+Spouse R 30,792  
  Member+Spouse+Child1 R 35,616  
  Member+Spouse+Child2 R 40,440  
  Member+Spouse+Child3 R 45,264  
  Member+Child 1 R 21,876  
  Member+Child 2 R 26,700  
  Member+Child 3 R 31,524  
       
   For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 20,800  
  Spouse/Adult dependant R 18,000  
  Per Child (Max 3) R 6,200  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 5,648  
  Spouse/Adult dependant R 4,579  
  Per Child (Max 3) R 1,608  
       
       
       
       
       
       
 
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall Annual Limit  
  *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 per year limited to  
  R1,000 per person and R2,000 per  
  family. Must be referred by a  
  Network GP  
     
  Conservative Dentistry:  
  No Limit from Network providers.  
   Pre authorisation    
   required if more than 4    
   fillings or extractions    
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Income p/m         R701- R6,800  
  Principal Member    R 835  
  Spouse/Adult dependant R 835  
  Per Child R 382  
       
       
  Income p/m      R6,801- R9,000  
  Principal Member R 1,062  
  Spouse/Adult dependant R 1,062  
  Per Child R 397  
       
  Income p/m      R9,001- R12,500  
  Principal Member R 1,479  
  Spouse/Adult Dependant R 1,479  
  Per Child R 435  
       
  Income p/m  R12,501 +    
  Principal Member R 2,094  
  Spouse/Adult Dependant R 2,094  
  Per Child R 617  
       
 
     
     
     
     
     
     
   
 
     
       
       
       
       
       
       
       
       
       
       
       
       
       
               
     
     
     
     
     
     
               
   
 
 
     
       
       
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
       
       
       
     
     
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
 
     
     
     
     
     
     
   
 
     
       
       
       
       
       
       
       
       
       
       
       
       
       
               
     
     
     
     
     
     
               
   
 
 
     
       
     
     
     
     
     
     
     
     
                    
     
     
     
     
     
     
         
       
       
       
     
     
               
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
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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.