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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 perf...
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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 Biopsie...
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The Major Medical Benefit includes cover for hospitalisation, as well as certain specialised procedures or treatment and specialised scans. Overview of the cover provided in hospital across the six options Option
Cover
L...
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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...
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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 m...
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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 to th...
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Physical rehabilitation Certain illnesses, injuries, accidents or surgical procedures can leave you with physical challenges or disabilities. Physical rehabilitation is a therapeutic programme designed to assist you in regaining your strengt...