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    Specialist Benefits

    A maximum of 2 visits, limited to R1 290 per visit and up to R2 580 per member/family per year is applied

    Members may consult any specialist, subject to a Network GP referral and pre-authorisation

    The specialist may refer the member for pathology and radiology according to the applicable Health4Me pathology and radiology lists

    Shortfalls will be payable by the member

    Waiting periods may apply

    If you need to see a specialist, you must first visit your Network GP, who will give you a referral letter. You will need to call us on 0860 10 29 03 to get authorisation. The maximum amount we will pay per visit is R1 220, with a maximum for the year of R2 440 for you and your family, if they are also covered. This amount is for the visit and any medication that the specialist prescribes. The specialist may also send you for basic blood tests and black-and-white x-rays.

    Example: Let’s say the specialist charges you R1 300 for a visit. The specialist will send the account for R1 300 to Momentum
    for payment. Momentum will pay the specialist R1 220, and your benefit left for the year will reduce from R2 440 to R1 220.
    You will have to pay the additional R80 for the visit from your own pocket.

    Specialist benefit disciplines covered

    Please note that this benefit is only available on the Health4Me Gold option.

    To download a copy of the Specialist benefit information click on the download button below.

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    Momentum Health4Me is not a medical scheme product, and is not a substitute for medical scheme membership. The information provided on this website does not constitute advice in terms of the Financial Advisory and Intermediary Services Act. Momentum is a division of Momentum Metropolitan Life Limited, an authorised financial services provider (FSP 6406) and a wholly owned subsidiary of Momentum Metropolitan Holdings Limited.

    Bloom Gap Cover is not a medical Scheme. Products that are offered are not the same as that of a medical scheme.

    © Bloom Financial Services 2023. Bloom Financial Services (Pty) Ltd is an authorised financial services provider (FSP 50140). Bloom Gap is underwritten by Infiniti Insurance Limited a licensed non-life insurer and an authorised financial services provider (FSP No.35914)

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