Momentum - Custom Option Medical Aid Plan

Momentum - Custom Option

The Momentum Custom Option hospital plan offers cover for unlimited hospitalization at a provider of your choice. Major medical benefits require a co-payment of R1 300, except for maternity confinements, car accidents and emergency treatments. This is a flexible option that allows members to add savings through the health saver.

In Hospital Benefits

Overall Annual Limit

Unlimited at 100% (Momentum's Rate)

Provider

Associated hospitals / Any hospital (depends on plan - see contributions)

GP's & Specialists

R1 500 co-payment per admission applies, specialised procedures covered
Oncology R300 000 per beneficiary (80% after)
Organ recipient Unlimited
Dialysis Unlimited
Internal Prosthesis: R46 600 with sub limits

Chronic

26 PMBs

Out of Hospital Benefits

Saving / Day to Day / OHEB

Members may add the Health Saver if they want Savings (optional)
R100 minimum

Pooled Day to Day Benefit

Not applicable

Threshhold / Safety Net

Not applicable

Self-Payment Gap Before Threshold

Not applicable

Above Threshold Limits

Not applicable

Maternity Care

12 antenatal visits, 2 scans, 2 Pediatrician visits in the 1st year
Must register for benefit

Contributions

Contributions

ASSOCIATED HOSPITAL PROVIDERS & CHRONIC AT STATE

Member: R1 642

Adult: R1 242

Per Child: R582

 

ASSOCIATED PROVIDERS

Member: R2 106

Adult: R1 633

Per Child: R744

 

ASSOCIATED HOSPITAL PROVIDERS & ANY CHRONIC PROVIDER

Member: R2 319

Adult: R1 830

Per Child: R818

 

ANY PROVIDER
Member: R2 767
Adult: R2 221
Per Child: R988

 

ANY HOSPITAL CHRONIC AT ASSOCIATED

Member: R2 496

Adult: R1 950

Per Child: R907

 

ANY HOSPITAL CHRONIC AT STATE

Member: R2 090

Adult: R1 577

Per Child: R766

 

 

 


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