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Created On: 24/10/2024
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Underwriting Summary Individuals Compulsory group Super group Group size 1 member 2 to 9 principal members 10 or more principal members Underwriting Individual medical unde...
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Concession business for January 2025 take-on The Medical Schemes Act allows for employer groups to switch between medical schemes on 1 January of every year without any waiting periods. This is referred to as Concession Business. The following...
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Specialised procedure and treatment This document provides a guideline of the procedures and treatment covered on the various benefit options and paid from the Major Medical Benefit, irrespective of whether the procedure and treatment is perfor...
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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 Biopsies ...
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The Major Medical Benefit includes cover for hospitalisation, as well as certain specialised procedures/ treatment and specialised scans. Overview of the cover provided in hospital across the six options Option
Cover
Limit...
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Third party injuries are incidents where a third party was responsible for the injury and therefore maybe liable for medical expenses, such as a motor vehicle accident (MVA). Any amount recovered from a third party or from the Road Accident Fund f...
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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 s...
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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...