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 R2149 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

    You will have a co-payment of R1 830 per authorisation, except for motor vehicle accidents, maternity confinements and emergency treatment. This co-payment applies even in the case of Prescribed Minimum Benefits, excluding emergencies If you chose Associated hospitals and do not use this provider, you will have a co-payment of 30% on the hospital account. An additional co-payment may also apply per authorisation to specialised scans, dental benefits and certain specialised procedures/treatment.

    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 050 co-payment per scan

    Medical rehabilitation, private nursing, Hospice and step-down facilities
    R61 000 per family

    Mental health
    – including psychiatry and psychology
    – drug and alcohol rehabilitation

    R43 000 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:
    Dental consultation (including sterile tray and gloves)

    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 available at Dis-Chem, Clicks or MediRite pharmacy clinics: 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)

    * If you chose Associated as your chronic provider, a 30% co-payment will apply if you do not use an Associated GP for GP consultations covered under the Health Platform Benefit

    ** Only covered if health assessment results indicate a total cholesterol of 6 mmol/l and above

    *** Only covered if health assessment results indicate blood sugar levels are 11 mmol/l and above

    Maternity programme

    Doula benefit (your gynaecologist must be an Associated Specialist)

    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 070 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 R541 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 R1687 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.

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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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