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 R10 300

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 568

Spouse: R2 028

Per Child: R984 

 

ASSOCIATED PROVIDERS

Member: R3 588

Spouse: R2 856

Per Child: R1 356

 

ASSOCIATED HOSPITAL PROVIDERS & ANY CHRONIC PROVIDER

Member: R3 960

Spouse: R3 192

Per Child: R1 476 

 

ANY PROVIDER

Member: R4 476

Spouse: R3 636

Per Child: R1 740   

 

ANY PROVIDER & ASSOCIATED CHRONIC

Member: R3 900

Spouse: R3 132

Per Child: R1 536  

 

ANY PROVIDER & CHRONIC AT STATE

Member: R3 192

Spouse: R2 506 

Per Child: R1 260  

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 141

Adult: R1 583

Per Child: R769

 

ASSOCIATED PROVIDERS
Member: R2 988
Adult: R2 377
Per Child: R1 134

 

ASSOCIATED HOSPITAL PROVIDERS & ANY CHRONIC PROVIDER
Member: R3 301
Adult: R2 656
Per Child: R1 233

 

ANY PROVIDER
Member: R3 732
Adult: R3 032
Per Child: R1 454

 

ANY PROVIDER & ASSOCIATED CHRONIC
Member: R3 251
Adult: R2 609
Per Child: R1 278

 

ANY PROVIDER & CHRONIC AT STATE
Member: R2 658
Adult: R2 094
Per Child: R1 051

 

 

 


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