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 9 800

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 412
Spouse: R1 896
Per Child: R924
ASSOCIATED PROVIDERS
Member: R3 324
Spouse: R2 640
Per Child: R1 260
ASSOCIATED HOSPITAL PROVIDERS & ANY CHRONIC PROVIDER
Member: R3 612
Spouse: R2 904
Per Child: R1 356
ANY PROVIDER
Member: R4 092
Spouse: R3 324
Per Child: R1 596
ANY PROVIDER & ASSOCIATED CHRONIC
Member: R3 612
Spouse: R2 904
Per Child: R1 416
ANY PROVIDER & CHRONIC AT STATE
Member: R2 952
Spouse: R2 328
Per Child: R1 164

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 006
Adult: R1 583
Per Child: R769

 

ASSOCIATED PROVIDERS
Member: R2770
Adult: R2 203
Per Child: R1 052

 

ASSOCIATED HOSPITAL PROVIDERS & ANY CHRONIC PROVIDER
Member: R3 012
Adult: R2 423
Per Child: R1 126

 

ANY PROVIDER
Member: R3 406
Adult: R2 767
Per Child: R1 327

 

ANY PROVIDER & ASSOCIATED CHRONIC
Member: R3 014
Adult: R2 419
Per Child: R1 184

 

ANY PROVIDER & CHRONIC AT STATE
Member: R2 464
Adult: R1 942
Per Child: R974

 

 

 


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