Custom Option
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Our Custom medical aid option includes cover for hospitalisation in private hospitals. There is no overall annual limit for hospitalisation.
The Health Platform Benefit provides cover for a range of day-to-day benefits such as preventative screening tests, certain check-ups and more.
The Custom Option is the medical aid plan to choose if you are looking for:
- An affordable hospital plan.
- Customisable savings through HealthSaver+.
- Free preventative screening benefits.
Custom Option
From R2353 P/M
Terms and Conditions Apply
Custom Option
From R1808 P/M
Terms and Conditions Apply
Our Custom medical aid option includes cover for hospitalisation in private hospitals. There is no overall annual limit for hospitalisation.
The Health Platform Benefit provides cover for a range of day-to-day benefits such as preventative screening tests, certain check-ups and more.
The Custom Option is the medical aid plan to choose if you are looking for:
- An affordable hospital plan.
- Customisable savings through HealthSaver+.
- Free preventative screening benefits.
In-hospital Benefits
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.
Hospital Choice
Provider
Any or Associated hospitals
Hospitalisation
Consultations and visits
Associated specialists covered in full
Other specialists covered up to 100% of the Momentum Medical Scheme Rate
Oncology
R300 000 per beneficiary per year, thereafter a 20% copayment applies. Momentum Medical Scheme reference pricing may apply to chemotherapy and adjuvant medication
Organ transplants (recipient)
No annual limit applies
MRI and CT scans, magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET scans (in- and out-of-hospital)
No annual limit applies, subject to R3 200 co-payment per scan
Medical rehabilitation, private nursing, Hospice and step-down facilities
R64 000 per family
Mental health
– including psychiatry and psychology
– drug and alcohol rehabilitation
R45 300 per beneficiary
Take-home medication
7 days’ supply
Specialised Procedures/Treatment
Certain specialised procedures/treatment covered, when clinically appropriate, in- or out-of-hospital
Prescribed Minimum Benefits
(PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable.
Chronic Benefits
This benefit takes care of certain life-threatening conditions, such as diabetes and heart disease, that need ongoing treatment.
Network
Any, Associated or State
Benefit
26 conditions, according to the Chronic Disease List in the Prescribed Minimum Benefits
Prescribed Minimum Benefits
(PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable.
Day-to-day
If you would like cover for day-to-day expenses, you can make use of the Momentum HealthSaver+
Savings
You can add HealthSaver+ to supplement your day-to-day benefits.
+ You may choose to make use of additional products available from Momentum Metropolitan Holdings Limited (Momentum), to seamlessly enhance your medical aid. Momentum is not a medical scheme and is a separate entity to Momentum Medical Scheme.
The complementary products are not medical scheme benefits. You may be a member of Momentum Medical Scheme without taking any of the complementary products.
Health Platform Benefits
A unique benefit that encourages health awareness, enhances quality of life and gives peace of mind through preventative
care and early detection tests.
Benefit
Preventative care includes:
Baby immunisations, Flu vaccines, Tetanus diphtheria injection, Pneumococcal vaccine
Early detection tests include:
Preventative dental care
Pap smear consultation (nurse, GP or gynaecologist)
Pap smear (pathologist)
– Standard or LBC (Liquid based cytology) or – HPV PCR screening test
(If result indicates high risk, then a follow-up LBC is also covered)
Mammogram DEXA bone density scan (radiologist, GP* or specialist)
General physical examination (GP* consultation)
Prostate specific antigen (pathologist)
Health assessment: blood pressure test, cholesterol and blood sugar (finger prick tests), height, weight and waist circumference measurements
Cholesterol test (pathologist)**
Blood sugar test (pathologist)***
Glaucoma test HIV test (pathologist)
* On the Custom, Incentive and Extender Options, if you choose Associated as your chronic provider, a 30% co-payment will apply if you do not use an Associated GP for the Health Platform GP consultation benefits
** The cholesterol test is covered if health assessment results indicate a total cholesterol of 6 mmol/L and above
*** The blood sugar test is covered if health assessment results indicate blood sugar levels are 11 mmol/L and above
Maternity programme
Doula benefit
Antenatal visits (Midwives, GP* or gynaecologist)
Nurse home visits
Pathology tests: Blood group, full blood count, Rhesus factor, creatinine, glucose strip, haemoglobin estimation, Urinalysis, Urine tests (microscopic exams, antibiotic susceptibility and culture)
Urine tests (dipstick)
Scans
Paediatrician visits
Health line
24-hour emergency health advice.
Emergency evacuation
Emergency evacuation in South Africa by Netcare 911.
International emergency medical transport by preferred provider
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
For more information on this option, download the relevant document below.
See Our Medical Aid Options
Ingwe Option
From R589 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 R1847 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
Your journey to quality healthcare starts here.
Get a quote now
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View our Privacy Policy
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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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