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, a leading maternity programme and health education and advice.
You do not need to pre-notify us before using Health Platform Benefits, except for dental consultations, pap smears, general physical examinations and HIV tests. Where pre-notification is required, you can pre-notify quickly and easily on the Momentum App, via the web chat facility or by logging on to momentummedicalscheme.co.za. You may also send us a WhatsApp or call us on 0860 11 78 59.
On the Ingwe Option, Health Platform Benefits are only available from your chosen Network provider, except for health assessments, maternity programme benefits and baby immunisations up to R2 800 in baby’s first year, which are available from any healthcare provider.
Benefit table
Preventative care
| What is the benefit? | Who is eligible? | How often? | On which option? |
| Baby immunisations (On Ingwe, baby immunisations are covered at private facilities in baby’s first year, limited to R2 800. Once the limit is reached, immunisations are available at the Department of Health baby clinics). No limit applies on any other option | Children up to age 6 | As required by the Department of Health | All options |
| Flu vaccines | Children between 6 months and 5 years Beneficiaries 60 and Older High-risk beneficiaries | As required by the Department of Health | All options |
| Tetanus diphtheria injection | All beneficiaries | As needed | All options |
| Pneumococcal vaccine | Beneficiaries 60 and older High-risk beneficiaries | Once a year | Evolve, Custom, Incentive, Extender and Summit |
Early detection tests
| What is the benefit? | Who is eligible? | How often? | On which option? |
| Dental consultation (including sterile tray and gloves) | All beneficiaries | Once a year | All options |
| Pap smear consultation (Nurse or GP) | Women 15 and older | Once a year | Ingwe |
| Pap smear consultation (Nurse, GP* or Gynaecologist) | Women 15 and older | Once a year | Evolve, Custom, Incentive, Extender and Summit |
Pap smear (pathologist):
| Women 15 and older Women 21 to 65 | Once a year Once every 3 years | All options |
| Mammogram | Women 38 and older | Once every 2 years | Evolve, Custom, Incentive, Extender and Summit |
| DEXA bone density scan (radiologist, GP* or specialist) | Beneficiaries 50 and older | Once every 3 years | Evolve, Custom, Incentive, Extender and Summit |
| General physical examination (GP* consultation) | Beneficiaries 21 to 29 Beneficiaries 30 to 59 Beneficiaries 60 to 69 Beneficiaries 70 and older | Once every 5 years Once every 3 years Once every 2 years Once a year | All options |
| Prostate specific antigen (pathologist) | Men 40 to 49 Men 50 to 59 Men 60 to 69 Men 70 and older | Once every 5 years Once every 3 years Once every 2 years Once a year | All options |
| Health assessment: Blood pressure test, Cholesterol and Blood sugar (finger prick tests), height, weight and waist circumference | All principal members and adult beneficiaries | Once a year | All options |
| Cholesterol test (pathologist)** | Principal members and adult beneficiaries | Once a year | All options |
| Blood sugar test (pathologist)*** | Principal members and adult beneficiaries | Once a year | All options |
| Glaucoma test | Beneficiaries 40 to 49 Beneficiaries 50 and older | Once every 2 years Once a year | Evolve, Custom, Incentive, Extender and Summit |
| HIV test (pathologist) | Beneficiaries 15 and older | Once every 5 years | All options |
* On the Custom, Incentive and Extender Options: if you choose Associated as your chronic provider, a 30% co-payment will apply if you do not use an Associated GP for the GP consultations ** The cholesterol test is covered if health assessment results indicate a total cholesterol of 6 mmol/L and above *** The blood sugar test is covered if health assessment results indicate blood sugar levels are 11 mmol/L and above |
Maternity programme
(you need to register on the programme between 8 and 20 weeks of pregnancy)
| What is the benefit? | Who is eligible? | How often? | On which option? |
| Doula benefit | Women registered on the programme | 2 visits per pregnancy | Evolve, Custom, Incentive, Extender and Summit |
| Antenatal visits (Midwives, GP* or gynaecologist) | 7 visits | Ingwe | |
| 12 visits | Evolve, Custom, Incentive, Extender and Summit | ||
| Online or face-to-face antenatal and postnatal classes | 18-month online subscription with BellyBabies or face-to-face classes covered up to R410 per pregnancy at any provider | Incentive, Extender and Summit | |
| Online video consultation with lactation specialist, offered through BellyBabies | Initial consultation | Incentive | |
| Initial consultation plus follow-up | Extender and Summit | ||
| Nurse home visit | Day after return from hospital | All options | |
| 2 weeks after initial visit | Evolve, Custom, Incentive, Extender and Summit | ||
| 6 weeks after initial visit | Incentive, Extender and Summit | ||
| Urine tests (dipstick) | Included in antenatal visits | All options | |
| Pathology tests | How often? | On which option? | |
| Antiglobin, platelet count and Rubella antibody | 1 test | Incentive, Extender and Summit | |
| Blood group, full blood count and Rhesus factor | 1 test | All options | |
| Creatinine | 1 test | Evolve, Custom, Incentive, Extender and Summit | |
| Glucose strip | 1 test | Evolve and Custom | |
| 2 tests | Incentive, Extender and Summit | ||
| Haemaglobin estimation | 1 test | Ingwe, Evolve and Custom | |
| 2 tests | Incentive, Extender and Summit | ||
| Urinalysis | 7 tests | Ingwe | |
| 12 tests | Evolve, Custom, Incentive, Extender and Summit | ||
| Urine (microscopic exams, antibiotic susceptibility and culture) | As indicated | All options | |
| Scans | 2 pregnancy scans | Ingwe | |
| 2 pregnancy scans. We cover 3D and 4D scans up to the rate that we pay for 2D scans | Evolve, Custom, Incentive, Extender and Summit | ||
| Paediatrician visits | Babies up to 12 months registered on the programme | 1 visit in baby’s first year | Ingwe |
| 2 visits in baby’s first year | Evolve, Custom, Incentive, Extender and Summit |
Health Line
| What is the benefit? | Who is eligible? | How often? | On which option? |
| 24-hour emergency health advice | All beneficiaries | As needed | All options |