Members on Momentum Medical Scheme’s Custom, Incentive and Extender Options pay lower monthly contributions if they are willing to make use of the Scheme’s Associated providers.
Associated providers include a network of private hospitals as well as a network of GPs and pharmacies for chronic prescriptions and medication. Members can also choose to use State facilities for their chronic script, medication and treatment for the maximum saving in monthly contributions.
Example of a single member on the Custom Option:
| In-hospital provider | Chronic provider | Contribution for principal member | Saving through provider choice |
| Any | Any | R4 047 | 0% |
| Any | Associated | R3 596 | R451 (11%) |
| Any | State | R2 997 | R1 050 (26%) |
| Associated | Any | R3 393 | R654 (16%) |
| Associated | Associated | R3 033 | R1 014 (25%) |
| Associated | State | R2 353 | R1 694 (42%) |
The total saving between the Custom Any hospital with Any chronic provider Option vs the
Custom Associated hospitals with State chronic provider Option = R1 694 (R4 047 – R2 353),
or 42%.
The actual savings will differ, depending on the choice of option, family composition and choice of provider.
Distribution of members who have chosen Associated providers
Regardless of the choice of provider, the benefits available remain the same.
If members choose Associated hospitals as their preferred provider for Major Medical Benefits, and do not use this provider, they would be liable for a co-payment of 30%.
If members choose Associated chronic provider, they must obtain their chronic prescriptions from an Associated GP and chronic medication from Medipost, subject to a formulary. If members choose to obtain their chronic prescription from a non-Associated GP, the Scheme will pay 50% of the Momentum Medical Scheme Rate for the consultation. Similarly, if members choose to obtain their chronic medication from a pharmacy other than Medipost, the Scheme will pay only 50% of the formulary price.
If members choose State as their chronic provider, they must choose one of the designated State facilities to obtain their chronic medication, subject to the State formulary.
Members can change their choice of providers once a year when they exercise their option change, effective from 1 January of the following year.
Momentum Medical Scheme’s 2025 benefit and contribution amendments have been submitted to the Council for Medical Schemes and are subject to approval by the Regulator.
Disclaimer: +Momentum Medical Scheme members may choose to make use of additional products available from Momentum Group Limited and its subsidiaries as well as Momentum Multiply (herein collectively referred to as Momentum). Momentum is not a medical scheme and is a separate entity to Momentum Medical Scheme. Momentum products are not medical scheme benefits. You may be a member of Momentum Medical Scheme without taking any of the products offered by Momentum.