Momentum Health Medical Aid Comparison - 2013 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 35% on your contribution. Members can also earn R5 400 per year through the Momentum Health Returns Programme.

 
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 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 R25,500  
  Hospice Care (including R35,000  
   rehab & step-down    
    facilities)    
       
       
  Oncology R280,000    
   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 914  
  Spouse/Adult dependant R 691  
  Per Child (Max 3) R 323  
       
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 R25,500  
  Hospice Care (including R35,000   
   rehab & step-down    
    facilities)    
       
       
  Oncology R280,000    
   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 1,196  
  Spouse/Adult dependant R 943  
  Per Child (Max 3) R 422  
       
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 R26,000  
  Hospice Care (including R35,000    
   rehab & step-down    
    facilities)    
       
       
  Oncology R380,000    
    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 7,000 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 1,512  
  Member+Spouse R 2,700  
  Member+Spouse+Child1 R 3,288  
  Member+Spouse+Child2 R 3,876  
  Member+Spouse+Child3 R 4,464  
  Member+Child 1 R 2,100  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,263  
  Spouse/Adult dependant R 991  
  Per Child (Max 3) R 490  
       
.
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 R26,000  
   Hospice Care (including R35,000  
    rehab & step-down    
     facilities)    
       
   Oncology R380,000    
    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, 000 per family  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 2,028  
  Member+Spouse R 3,660  
  Member+Spouse+Child1 R 4,416  
  Member+Spouse+Child2 R 5,172  
  Member+Spouse+Child3 R5,928  
  Member+Child 1 R2,784  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,692  
  Spouse/Adult dependant R 1,362  
  Per Child (Max 3) R 632  
       
       
       
       
       
       
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 R26,000   
    Hospice Care (including R36,000  
     rehab & step-down    
      facilities)    
       
   Oncology R480,000    
     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 7,000 per family  
  Only from state hospital  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 7,728  
  Member+Spouse R 13,428  
  Member+Spouse+Child1 R 15,852  
  Member+Spouse+Child2 R 18,276  
  Member+Spouse+Child3 R 20,700  
  Member+Child 1 R 10,152  
       
    For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 12,000  
  Spouse/Adult dependant R 10,500  
  Per Child (Max 3) R 3,300  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,577  
  Spouse/Adult dependant R 1,899  
  Per Child (Max 3) R 809  
       
       
       
       
       
       
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 R26,000    
   Hospice Care (including R36,000   
      rehab & step-down    
       facilities)    
       
    Oncology R480,000    
     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, 000 per family  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 9,228  
  Member+Spouse R 16,596  
  Member+Spouse+Child1 R 19,488  
  Member+Spouse+Child2 R 22,380  
  Member+Spouse+Child3 R 25,272  
  Member+Child 1 R 12,120  
       
   For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 12,000  
  Spouse/Adult dependant R 10,500  
  Per Child (Max 3) R 3,300  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,077  
  Spouse/Adult dependant R 2,456  
  Per Child (Max 3) R 965  
       
       
       
       
       
       
 
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R950,000 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 R1,250  
  per annum and/ or R750 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- R4,900  
  Principal Member    R 397  
       
  Spouse/Adult dependant R 397  
       
  Per Child R 216  
       
       
  Income p/m      R4,901- R6,600  
  Principal Member R 450  
  Spouse/Adult dependant R 450  
  Per Child R 217  
       
  Income p/m      R6,601- R8,900  
  Principal Member R 526  
  Spouse/Adult Dependant R 526  
  Per Child R 228  
       
  Income p/m    R8,900 +    
  Principal Member R 912  
  Spouse/Adult Dependant R 872  
  Per Child R 275  
       
MOMENTUM INGWE OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R950,000 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 R1,250  
  per annum and/ or R750 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- R4,900  
  Principal Member    R 496  
       
  Spouse/Adult dependant R 496  
       
  Per Child R 237  
       
       
  Income p/m      R4,901- R6,600  
  Principal Member R 641  
  Spouse/Adult dependant R 641  
  Per Child R 235  
       
  Income p/m      R6,601- R8,900  
  Principal Member R 899  
  Spouse/Adult Dependant R 854  
  Per Child R 270  
       
  Income p/m    R8,900 +    
  Principal Member R 1,239  
  Spouse/Adult Dependant R 1,178  
  Per Child R 372  
       
MOMENTUM ACCESS OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
     
     
  Annual Sub-limits :
 
     
     Psychiatric Treament R12 800  
     Hospice Care R34 500  
     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% Scheme Rate  
  Access Primary Care    
   Network    
  GP's:   
  10 visits per person per annum  
  thereafter R60  co-payment  
   applies.   
     
  Specialists:  
  3 visits per person limited to  
  5 visits per family per annum  
                    
  Conservative Dentistry:  
  No Limit from Ingwe Primary Care Network   
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
       
  Principal Member R 1,306  
  Spouse/Adult Dependant R 1,242  
  Per Child R 391  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
.

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 Momentum Health.