Momentum - Incentive Option Medical Aid Plan

Momentum - Incentive Option

The Momentum Incentive Option provides unlimited private hospitalization and average day-to-day cover. You can choose providers and a savings of 10% of contributions is allocated for day-to-day expenses.

In Hospital Benefits

Overall Annual Limit

Unlimited at 200% (Momentum's Rate)

Provider

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

GP's & Specialists

Hospital accounts covered at negotiated rate,
Specialised procedures covered
Oncology R400 000 per beneficiary (80% after)
Organ Transplants: unlimited for recipient
Dialysis unlimited
Internal Prosthesis has limits per procedure

Chronic

26 PMB's and 6 non-PMB's with a limit of R 10 700

Out of Hospital Benefits

Saving / Day to Day / OHEB

Savings according to provider choice

Fixed at 10% of contribution:

ASSOCIATED HOSPITAL PROVIDERS & CHRONIC AT STATE

Member: R2 664

Spouse: R2 112

Per Child: R1 020

 

ASSOCIATED PROVIDERS

Member: R3 732

Spouse: R2 976

Per Child: R1 416

 

ASSOCIATED HOSPITAL PROVIDERS & ANY CHRONIC PROVIDER

Member: R4 140

Spouse: R3 324

Per Child: R1 548

 

ANY PROVIDER

Member: R4 680

Spouse: R3 804

Per Child: R1 824

 

ANY PROVIDER & ASSOCIATED CHRONIC

Member: R4 068

Spouse: R3 264

Per Child: R1 596

 

ANY PROVIDER & CHRONIC AT STATE

Member: R3 312

Spouse: R2 616

Per Child: R1 308

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 and 2 pediatrician visits in the 1st year. Must register for benefit.

Contributions

Contributions

ASSOCIATED HOSPITAL PROVIDERS & CHRONIC AT STATE

Member: R2 224

Adult: R1 756

Per Child: R853

 

ASSOCIATED PROVIDERS
Member: R3 113
Adult: R2 477
Per Child: R1 182

 

ASSOCIATED HOSPITAL PROVIDERS & ANY CHRONIC PROVIDER
Member: R3 449
Adult: R2 774
Per Child: R1 289

 

ANY PROVIDER
Member: R3 899
Adult: R3 168
Per Child: R1 520

 

ANY PROVIDER & ASSOCIATED CHRONIC
Member: R3 388
Adult: R2 718
Per Child: R1 331

 

ANY PROVIDER & CHRONIC AT STATE
Member: R2 763
Adult: R2 178
Per Child: R1 093

 

 

 


Finding it difficult to make sense of all this? Not to worry, you can:

Finding it difficult to make sense of all this? Not to worry, you can:

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