Benefits 2026

Chronic Benefit structure The Chronic Benefit covers certain life-threatening conditions that need ongoing treatment and includes cover for the 26 Chronic Disease List conditions, which form part of the Prescribed Minimum Benefits. Chronic be...

Medical aid plays an important role in providing healthcare cover and peace of mind to consumers. There are several practical ways for members to optimally use their benefits, thereby keeping their out-of-pocket expenses to the minimum. Preve...

The following dental benefits are available on Momentum Medical Scheme: Ingwe Option Preventative dental care Covered up to R500 per beneficiary at dentists, dental therapists and oral hygienists Basic dentistry, such as extraction...

The following exclusions apply to Momentum Medical Scheme benefits.  General exclusions mentioned in this paragraph are not affected by any specific exclusions. Unless otherwise decided by the Scheme (and with the express exception of medicin...

The Trauma Benefit covers certain day-to-day care and treatment following a hospital admission for specific traumatic events. This benefit is available on the Evolve, Incentive, Extender and Summit Options and appropriate treatment related t...

MRI and CT scans, magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET scans are subject to pre-authorisation. Even if you have authorisation for an in-hospital admission, a separate pre-authorisation will be requi...

What is a doula? A doula provides non-clinical support and care to a woman (and her partner) during childbirth and the postpartum (after delivery) period. What are the criteria for using the benefit? There are three criteria that need to be...

You need to obtain pre-authorisation from Momentum Medical Scheme for:  Hospitalisation  Day hospital admissions  Specialised procedures/treatment  MRI, CT, Magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET...

Momentum Medical Scheme has contracted with Netcare 911 to provide our members with emergency medical transport benefits within the borders of South Africa. Netcare 911 is available 24 hours a day, seven days a week to assist our members in th...

Introduction This benefit provides for day-to-day medical expenses, such as doctors’ visits and prescribed medication.  On the Ingwe Option , members who choose Connect Network hospitals need to use State facilities, while members who cho...

Health Platform Benefits are available to all Momentum Medical Scheme members and are paid for by the Scheme. These benefits encourage health awareness, enhance quality of life and give peace of mind through preventative care, early detection,...

Anorectal -  Treatment of haemorrhoids, fissure, fistula Covered for complicated cases that cannot be treated as an out-patient or where the out-patient treatment options failed and treatment is required in a medical facility Biopsie...

This document provides an overview of the Momentum Medical Scheme International Emergency Travel benefit. Who is covered? Beneficiaries on the Evolve, Custom, Incentive, Extender and Summit Options are covered per 90-day leisure journey as f...

Clinical criteria for registration on the chronic benefit  Prescribed Minimum Benefit Chronic Disease List (CDL)  conditions Further information or tests required Addison’s disease Diagnosis by a specialist physician, p...

This document provides an overview of the vaccines and immunisations (subject to availability) that Momentum Medical Scheme members are covered for as part of their Health Platform benefits. Vaccines and immunisations covered under the He...