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Medical Aid Options

The Custom Option provides cover for hospitalisation at
private hospitals. There is no overall annual limit for hospitalisation.

You can choose to have access to any hospital or you can choose to save on
your monthly contribution by selecting to use a specific list of private hospitals.

A co-payment of R1 920 per authorisation applies to Major Medical Benefits including for non- emergency Prescribed Minimum Benefits, except for motor vehicle accidents, maternity confinements, emergency treatment and when you involuntarily use a non-designated Service Provider.

Connect Network hospitals, Ingwe Network hospitals or Any hospital

R7 660 000 per beneficiary per 90-day journey. This benefit includes R15 500 for emergency optometry, R15 500 for emergency dentistry and R765 000 terrorism cover
A R2 180 co-payment applies per emergency out-patient claim

Not applicable. You can choose to add the HealthSaver+

3 virtual doctor consultations per beneficiary per year from the GP Virtual Consultation Network, which includes Hello Doctor. Consultations include scripting of medication where required

Subject to HealthSaver+ if available

1 eye test and 1 pair of clear standard or bi-focal lenses with standard frame as per formulary per beneficiary every 2 years. Spectacles will only be granted if your refraction measurement is more than 0.5

Subject to HealthSaver+ if available

Examinations, fillings and x-rays as per the list of tariff codes. One dental consultation is covered per year per beneficiary. You need to call us for pre-authorisation if you have more than 4 fillings or 4 extractions

Anaesthetist and 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 R1 920 co-payment and pre-authorisation
Other specialised dentistry: Subject to HealthSaver+ if available

Subject to HealthSaver+ if available

2 visits per family per year, limited to R1 350 per visit and up to a maximum of R2 700 per family per year. Covered at 100% of Momentum Medical Scheme Rate. Subject to referral and pre-authorisation. Psychologists and psychiatrists are limited to Prescribed Minimum Benefits at State facilities

Subject to HealthSaver+ if available

Ingwe Primary Care Network, Ingwe Active Network or State facilities, unless otherwise indicated