Evolve Option
From R1 424 per month
Our Evolve medical aid option is for digitally savvy individuals looking for affordable hospital cover and virtual GP visits, with the ability to manage their membership from their device in the comfort of their homes.
Covers hospitalisation from the Evolve Network of private hospitals (no overall annual limit) with 2 virtual doctors’ consultations.
- Hospitalisation from the Evolve Network of private hospitals.
- Access to 2 virtual consultations per beneficiary per year from the GP Virtual Consultation Network, which includes Hello Doctor.
- Preventative care with early detection tests.
Interested?
Send us your details to get a quote.
In-hospital Benefits
This benefit covers hospitalisation and some out-of-hospital procedures or treatments that can be safely performed in a doctor’s room, registered day hospital, or out-patient facility.
A co-payment of R1 740 applies per authorisation, except for motor vehicle accidents, maternity confinements, and emergency treatment. Additional co-payments may apply for certain procedures.
Our Health Platform Benefit covers a range of benefits such as preventative screening tests, certain check-ups and more.
Hospital choice
Provider
Major Medical Benefits are available at Evolve Network hospitals.
Certain procedures are only covered in day hospitals.
Hospitalisation
Benefit
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.
Oncology
Covered up to R200 000 per beneficiary per year, thereafter a 20% co-payment applies.
Momentum Medical Scheme reference pricing applies to chemotherapy and adjuvant (supplementary) medication.
You need to get your oncology treatment and medication from the Evolve Network of Oncologists.
Organ transplant and renal dialysis
Limited to Prescribed Minimum Benefits* at State facilities.
MRI and CT scans, magnetic resonance cholangiopancreatography, whole body radioisotope and PET scans
- No annual limit
- You will need to pay R2 900 per scan.
Medical rehabilitation, private nursing, Hospice, and step-down facilities
Limited to R52 600 per family per year.
Trauma benefit
Certain day-to-day claims that form part of your recovery following specific traumatic events
Take-home medication
7 days’ supply
Specialised procedures/treatment
Certain specialised procedures or treatments covered
Certain specialised procedures or treatments covered when clinically appropriate in- and 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.
This benefit takes care of certain life-threatening conditions, such as diabetes and heart disease, that need ongoing treatment.
Network
Provider
State facilities
Benefit
Cover
26 conditions under Prescribed Minimum Benefits* according to the Chronic Disease List.
*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.
You have cover for 2 virtual consultations from the GP Virtual Consultation Network, which includes Hello Doctor. If you need cover for other day-to-day expenses, like additional GP visits or prescribed medicine, you can choose to make use of the HealthSaver+.
Savings
Medical Savings Account
No built-in savings.
You can add HealthSaver+ to supplement your day-to-day benefits.
Benefit
GP visits
- 2 virtual consultations per beneficiary per year from the GP Virtual Consultation Network, which includes Hello Doctor. Consultations include scripting of medication where required. Medication is subject to HealthSaver+, if available.
- If you need cover for other day-to-day expenses, like additional GP visits or prescribed medicine, you can choose to make use of 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.
A unique benefit that encourages health awareness, enhances quality of life and gives peace of mind through preventative care and early detection tests.
Network provider
Available from:
any provider.
Benefit
- baby immunisations covered up to the age of 6,
- pneumococcal vaccines
- flu vaccines,
- tetanus-diphtheria injections, and more.
- mammograms,
- bone density scans,
- pap smears,
- dental consultations,
- general physical examinations,
- prostate specific antigens,
- health assessments,
- cholesterol tests,
- blood sugar tests, and
- HIV tests.
12 antenatal visits which include:
- a urine test
- certain antenatal pathology tests,
- 2 pregnancy scans,
- 2 doula visits,
- 2 nurse home visits after returning home from hospital, and
- 2 paediatrician visits in baby’s first year.
For the management of the following conditions:
- diabetes,
- hypertension,
- HIV/Aids,
- oncology,
- drug and alcohol rehabilitation,
- chronic renal failure,
- organ transplants, and
- cholesterol.
Ingwe
Option
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.
R482.00 per month
Terms & Conditions Apply.
Custom
Option
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.
R1 808.00 per month
Terms & Conditions Apply.
Want to learn more about Evolve?
For more information on this option, download the relevant document below.
