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Medical Aid Options

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    We’ve partnered with Momentum to offer our members affordable medical aid solutions for the South African market. There are three medical aid cover plans available and each plan provides a wide range of in-and-out of hospital benefits.

    Ingwe
    Option
    Evolve
    Option
    Custom
    Option
    In-hospital Benefit
    Hospitalisation
    Hospital accounts are covered in full at the rate agreed upon with the hospital group. No overall annual
    limit applies. Specialists who treat you in hospital are covered up to 100% of the Momentum Medical
    Scheme Rate.
    Associated specialists are covered in full. Other specialists are covered up to 100% of the Momentum
    Medical Scheme Rate. Hospital accounts are covered in full at the rate agreed upon with the hospital
    group. Certain procedures are covered in day facilities only.
    A co-payment of R1 740 applies and co-payments may also apply for certain specialised procedures and
    treatment.
    Associated specialists are covered in full. Other specialists are covered up to 100% of the Momentum
    Medical Scheme Rate. Hospital accounts are covered in full at the rate agreed upon with the hospital
    group. No overall annual limit applies. A co-payment of R1 740 applies per admission and co-payments may
    also apply for certain specialised procedures and treatment.
    Hospital provider
    Any, Ingwe Network, or State Evolve Network Any, or Associated
    Health Platform Benefit
    Emergency Cover
    Emergency evacuation in South Africa by Netcare 911. International emergency cover is not available on
    this option.
    Emergency evacuation in South Africa by Netcare 911. International emergency cover by ISOS, covered up
    to R5 million per 90-day journey.
    Emergency evacuation in South Africa by Netcare 911. International emergency cover by ISOS, covered up
    to R7.66 million per 90-day journey.
    Preventative and early detection tests
    We cover certain tests and vaccines and a free health assessment once a year. We cover certain tests and vaccines and a free health assessment once a year. We cover certain tests and vaccines and a free health assessment once a year.
    Maternity programme detection tests
    Women registered on our maternity programme get 7 antenatal visits which include a urine test and 2
    pregnancy scans, and 1 visit to the paediatrician during the baby’s first year, as well as a home visit
    from a nurse on the day after child-birth.
    Women registered on our maternity programme get 2 doula visits, 12 antenatal visits which include a
    urine test, 2 pregnancy scans, certain pathology tests, and 2 visits to the paediatrician during the
    baby’s first year. You also get a home visit from a nurse on the day after childbirth, and again after 2
    weeks.
    Women registered on our maternity programme get 2 doula visits, 12 antenatal visits which include a
    urine test, two pregnancy scans, certain pathology tests, and two visits to the paediatrician during the
    baby’s first year. You also get a home visit from a nurse on the day after childbirth, and again after
    two weeks.
    Day-to-day Benefit
    Savings
    There is no savings built into this option, but you can add HealthSaver+ There is no savings built into this option, but you can add HealthSaver+ There is no savings built into this option, but you can add HealthSaver+
    General practitioners
    You have unlimited GP visits. From the 11th visit onwards, you need pre-authorisation from the Scheme
    for it to be covered. You also get 3 virtual consultations with a doctor on the GP Virtual Consultation
    Network, which includes Hello Doctor.
    2 Virtual consultations from a doctor on the GP Virtual Consultation Network, which includes Hello
    Doctoropen_in_new. If you need more GP visits, you can use HealthSaver+ if available. Sports injury
    treatment: 2 Physiotherapist or Biokineticist consultations per beneficiary, up to a limit of R1 000 per
    year, subject to authorisation.
    GP visits are not covered. You will pay out of your pocket or you can use HealthSaver+ funds, if
    available.
    Eye care
    You get 1 eye test, 1 pair of clear standard or bi-focal lenses with standard frame, per beneficiary
    every 2 years. Spectacles will only be granted if your refraction measurement is more than 0.5.
    Not covered. You will pay out-of-pocket or use HealthSaver+ funds, if available. Not covered. You will pay out of your pocket or you can use HealthSaver+ funds, if available.
    Dentistry
    You get 1 basic dentistry consultation per beneficiary every year, plus extractions, fillings, and
    x-rays. Specialised dentistry, such as braces, is not covered by the Scheme.
    Not covered. You will pay out-of-pocket or use HealthSaver+ funds, if available. Basic dentistry: You can use HealthSaver+open_in_new funds, if available. Dental specialist accounts for
    extraction of impacted wisdom teeth in doctors’ rooms: Covered from Major Medical Benefit at 100% of the
    Momentum Medical Scheme Rate, subject to HealthSaver+ funds, if available..
    Medicine
    Any prescribed medication from the list of medicine, referred to as the prescribed formulary. Prescribed and over-the-counter medication not covered. You will pay out of your pocket or you can use
    HealthSaver+ funds, if available.
    GP visits are not covered. You will pay out of your pocket or you can use HealthSaver+ funds, if
    available.
    Mental health
    Limited to Prescribed Minimum Benefits* at State facilities. Not covered. You will pay out of your pocket or can use HealthSaver+, if available. Not covered. You will pay out of your pocket or you can use HealthSaver+ funds, if available.
    Specialist visits
    2 visits per family per year, limited to R1 220 per visit and up to a maximum of R2 440 per family per
    year. Covered at 100% of the Momentum Medical Scheme Rate. Subject to referral by your Ingwe Primary
    Care Network or Ingwe Active Network provider and pre-authorisation. Psychologists and psychiatrists are
    limited to Prescribed Minimum Benefits* at State facilities
    Not covered. You will pay out of your pocket or can use HealthSaver+, if available. Not covered. You will pay out of your pocket or can use HealthSaver+ funds, if available.
    Day-to-day provider
    Ingwe Primary Care Network or Ingwe Active Network Any provider, subject to HealthSaver+ funds,
    if available.
    Any provider, subject to HealthSaver+ funds,
    if available.
    Chronic Benefit
    Chronic cover
    We cover 26 chronic conditions according to the Chronic Disease List in the Prescribed Minimum
    Benefits*. No annual limit applies.
    We cover 26 chronic conditions according to the Chronic Disease List in the Prescribed Minimum
    Benefits*. No annual limit applies.
    We cover 26 chronic conditions according to the Chronic Disease List in the Prescribed Minimum
    Benefits*. No annual limit applies.
    Chronic provider
    Ingwe Primary Care Network or Ingwe Active Network State Any associated or state
    Hello Doctor
    Expert advice from real doctors
    We give you a free subscription to Hello Doctor, where you can seek advice from a doctor, anytime,
    anywhere. Available 365/24/7.
    We give you a free subscription to Hello Doctor, where you can seek advice from a doctor, anytime,
    anywhere. Available 365/24/7.
    We give you a free subscription to Hello Doctor, where you can seek advice from a doctor, anytime,
    anywhere. Available 365/24/7.

    See Our Medical Aid Options

    Ingwe Option

    From R482 P/M

    It’s an affordable, entry-level medical aid plan, but you can still enjoy hospital cover, day-to-day and chronic illness benefits when you use the network providers.

    Terms and Conditions Apply

    Evolve Option

    From R1424 P/M

    For digitally savvy individuals who are looking for affordable hospital cover and virtual GP visits, with the ability to manage their membership from their device in the comfort of their own home.

    Terms and Conditions Apply

    Custom Option

    From R1808 P/M

    The Custom Option is the medical aid plan to choose if you are looking for
    an affordable hospital plan with customisable savings through HealthSaver+ and free preventative screening benefits.

    Terms and Conditions Apply

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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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