Choosing an entry level medical aid
Starting out? We’ve got a medical aid plan just for you!
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:
- Affordable access to entry-level cover
- Hospitalisation cover from Any hospital, the Ingwe Network of private hospitals, or State hospitals.
- Your contribution is based on your income and family composition.
Medical aid resources
Helpful guides and articles to help you understand your cover and make informed choices.
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Bloom Ingwe medical aid benefits
A co-payment applies per hospital authorisation. Day-to-day cover can be added through HealthSaver+, a separate Momentum product.
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 R2 000 per authorisation applies to Major Medical Benefits, including for nonemergency Prescribed Minimum Benefits, except for motor vehicle accidents, maternity confinements, emergency treatment, and when you involuntarily use a non-designated Service Provider.
Hospital Choice
Any or Associated hospitals
Hospitalisation
Consultations and visits
Associated specialists covered in full
Other specialists covered up to 100% of Momentum Medical Scheme Rate
Hospital accounts are covered in full at the rate agreed upon with the hospital group
No overall annual limit applies
Oncology
R300 000 per beneficiary per year, thereafter a 20% co-payment applies. Momentum Medical Scheme Reference Pricing will 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 850 co-payment per scan and pre-authorisation
Medical rehabilitation, private nursing, Hospice and step-down facilities
R67 000 per family (combined limit), subject to case management
Mental health
– incl. psychiatry and psychology
– drug and alcohol rehabilitation
R47 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
Medical management including doctor, pharmacy, blood tests, x-rays, etc Any (Any GP and any pharmacy), Associated** (Selected preferred GPs and Medipost Courier pharmacy for chronic medication), or State facilities
Network
Any: Basic formulary
Associated: Core formulary
State: State formulary
Benefit
26 conditions – no annual limit applies
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
This benefit provides for day-to-day medical expenses, such as GP visits and prescribed medication.
Savings
You have the choice of adding more day-to-day cover through the HealthSaver+
+ 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
The Health Platform Benefit encourages health awareness, enhances quality of life and gives peace of mind through preventative care, early detection and a leading maternity programme.
Benefit
Preventative care includes:
Baby immunisations (On Ingwe Option, baby immunisations are covered in private facilities for baby’s first year, limited to R3 100. Once the limit is reached, immunisations are available at the Department of Health baby clinics
Flu vaccines
Tetanus diphtheria injection
Pneumococcal vaccine
Early detection tests include:
Health assessment: Blood pressure test, Cholesterol and Blood sugar (finger prick tests), height, weight and waist circumference All principal members and adult beneficiaries Once a year
Preventative dental care covered up to R500 per beneficiary at any dental provider
Pap smear consultation (nurse, GP* or gynaecologist)
Pap smear (pathologist)
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
FIT (Faecal immunochemical testing) test
DEXA bone density scan (radiologist, GP* or specialist)
General physical examination (GP* consultation)
Prostate specific antigen (pathologist)
Cholesterol test (pathologist)**
Blood sugar test (pathologist)***
Glaucoma test
HIV test (pathologist)
Maternity programme
Doula benefit
Antenatal visits (Midwives, GP* or gynaecologist)
Nurse home visit
Urine tests (dipstick)
Pathology tests – Blood group, full blood count and Rhesus factor, Creatinine, Glucose strip, Haemoglobin estimation, Urinalysis, Urine tests (microscopic exams, antibiotic susceptibility and culture)
Scans
Paediatrician visits
Health line
24-hour emergency health advice
For more information on this option, download the relevant document below.
See Our Medical Aid Options
Ingwe Option
From R699 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 R2083 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
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