Momentum medicine benefits: 2017

By Staff Writer -

Below is a full list of how each Momentum plan pays for Mental health benefits.

Click here to compare out-of-hospital benefits across all schemes, or use the menu bar above for more options. Or go to the Momentum home page.

Ingwe options

Custom options

Momentum Custom (Any provider for chronic) 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. Chronic benefits at any provider. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,059 R1,653 R735
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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Momentum Custom Associate (and any provider for chronic) 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Chronic benefits at any provider. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from any provider
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,742 R1,374 R614
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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Momentum Custom (Network for chronic) 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. Chronic benefits at Network provider. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from Network provider
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,899 R1,483 R689
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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Momentum Custom Associate (and Network provider for chronic) 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Chronic benefits at Network provider. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from Network provider
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,573 R1,219 R556
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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Momentum Custom (State for chronic) 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. Chronic benefits at State facilities. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from State provider
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,610 R1,215 R590
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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Momentum Custom Associate (and State provider for chronic) 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. State hospitals. Chronic benefits at State facilities. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from State provider
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,266 R957 R448
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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Incentive options

Momentum Incentive (Any provider for chronic) 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. Chronic benefits at any provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme
  • non-PMBs chronic: additional 6 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,794 R2,270 R389
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R3,288 R3,288 R2,724

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Incentive Network hospital (and any provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits at any provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme
  • non-PMBs chronic: additional 6 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,529 R2,034 R826
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R3,035 R3,035 R2,441

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Incentive (Network provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Chronic benefits at Network provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from Network provider
  • non-PMBs chronic: additional 6 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,506 R2,010 R1,089
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R3,007 R3,007 R2,412

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Incentive Network hospital (and Network provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits at Network provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from Network provider
  • non-PMBs chronic: additional 6 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,323 R1,848 R949
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R2,788 R2,788 R2,218

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Incentive (State provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Chronic benefits at State facilities. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from State provider
  • non-PMBs chronic: additional 6 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,088 R1,646 R984
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R2,506 R2,506 R1,975

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Incentive Network hospital (and State provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits at State facilities. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme, from State provider
  • non-PMBs chronic: additional 6 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,700 R1,333 R883
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R2,040 R2,040 R1,600

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Extender options

Momentum Extender (Any provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Chronic benefits from any provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
1. Chronic:
  • PMB chronic: paid by scheme
  • non-PMBs chronic: additional 36 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R5,308 R4,235 R1,665
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
Main: Adult: Child:
(S) Savings: R15,924 R12,705 R4,995
(SP) Self Payment: R1,176 R2,095 R105
Threshold (S+SP): R17,100 R14,800 R5,100
Above Threshold: No limit No limit No limit

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, R15,100 per person and R28,400 per family
3. Over-the-counter:
  • Paid from day-to-day benefit
    • , but does not accumulate to threshold
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Extender Network hospital (and any provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits from any provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
1. Chronic:
  • PMB chronic: paid by scheme
  • non-PMBs chronic: additional 36 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R4,671 R3,728 R1,465
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
Main: Adult: Child:
(S) Savings: R14,013 R11,184 R4,395
(SP) Self Payment: R3,087 R3,616 R705
Threshold (S+SP): R17,100 R14,800 R5,100
Above Threshold: No limit No limit No limit

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, R15,100 per person and R28,400 per family
3. Over-the-counter:
  • Paid from day-to-day benefit
    • , but does not accumulate to threshold
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Extender (Network provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Chronic benefits from Network provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
1. Chronic:
  • PMB chronic: paid by scheme, from Network provider
  • non-PMBs chronic: additional 36 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R4,776 R3,813 R1,495
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
Main: Adult: Child:
(S) Savings: R14,328 R11,439 R4,485
(SP) Self Payment: R2,772 R3,361 R615
Threshold (S+SP): R17,100 R14,800 R5,100
Above Threshold: No limit No limit No limit

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, R15,100 per person and R28,400 per family
3. Over-the-counter:
  • Paid from day-to-day benefit
    • , but does not accumulate to threshold
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Extender Network hospital (and Network provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits from Network provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
1. Chronic:
  • PMB chronic: paid by scheme, from Network provider
  • non-PMBs chronic: additional 36 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R4,304 R3,433 R1,352
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
Main: Adult: Child:
(S) Savings: R12,912 R10,299 R4,056
(SP) Self Payment: R4,188 R4,501 R1,044
Threshold (S+SP): R17,100 R14,800 R5,100
Above Threshold: No limit No limit No limit

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, R15,100 per person and R28,400 per family
3. Over-the-counter:
  • Paid from day-to-day benefit
    • , but does not accumulate to threshold
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Extender (State provider for chronic) 2017: Medicine Benefits
In brief: 00% scheme rate. Chronic benefits from State provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
1. Chronic:
  • PMB chronic: paid by scheme, from State provider
  • non-PMBs chronic: additional 36 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R4,309 R3,507 R1,323
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
Main: Adult: Child:
(S) Savings: R12,927 R10,521 R3,969
(SP) Self Payment: R4,173 R4,279 R1,131
Threshold (S+SP): R17,100 R14,800 R5,100
Above Threshold: No limit No limit No limit

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, R15,100 per person and R28,400 per family
3. Over-the-counter:
  • Paid from day-to-day benefit
    • , but does not accumulate to threshold
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Momentum Extender Network hospital (and State provider for chronic) 2017: Medicine Benefits
In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits from State provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
1. Chronic:
  • PMB chronic: paid by scheme, from State provider
  • non-PMBs chronic: additional 36 conditions covered, R8,800 per family
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R3,732 R2,805 R1,149
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid.
Main: Adult: Child:
(S) Savings: R11,196 R8,415 R3,447
(SP) Self Payment: R5,904 R6,385 R1,653
Threshold (S+SP): R17,100 R14,800 R5,100
Above Threshold: No limit No limit No limit

Compare with these plans:

2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, R15,100 per person and R28,400 per family
3. Over-the-counter:
  • Paid from day-to-day benefit
    • , but does not accumulate to threshold
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Other plans

Momentum Access 2017: Medicine Benefits
In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
1. Chronic:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,842 R1,842 R552
Children: Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Acute (presrcibed) medication:
  • Some medication covered
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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Momentum Summit 2017: Medicine Benefits
In brief: 300% scheme rate. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
1. Chronic:
  • PMB chronic: paid by scheme
  • non-PMBs: Additional 36 conditions covered, from day-to-day benefit
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R7,637 R6,108 R1,754
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R22,300 R22,300 R22,300

Compare with these plans:

2. Acute (presrcibed) medication:
  • R17,400 per person and R28,500 per family from day-to-day benefit
3. Over-the-counter:
  • No benefit
4. On Discharge:
  • 7 days supply
5. Birth Control:
  • No benefit
6. Notes:

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