Medical aid
Momentum Medical Scheme
As one of the most trusted medical aid schemes in South Africa, we can help you find the most affordable medical aid option to suit your individual or family needs, with industry-leading benefits.
- Save up to R1 000 when you use Associated providers.
- Earn up to R3 000 a month in rewards+.
- View all our medical aid options to find the right plan.
Claims and authorisations
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Our medical aid plans
With Momentum Medical Scheme, you have access to a wide range of medical aid options and industry-leading benefits. Whether you’re a student looking for the most affordable medical aid, a young professional, or a breadwinner who needs extensive cover for your whole family in South Africa, we’ve got you covered.
Evolve
Covers hospitalisation from the Evolve Network of private hospitals (no overall annual limit) with 2 virtual doctors’ consultations. Additional day-to-day benefits are subject to HealthSaver+. Now includes a sports injury benefit that provides 2 physiotherapist or biokineticist visits up to R1 000 per beneficiary per year.
from R1 539 per month
Compare the cover and benefits of 2 or more Momentum Medical Scheme options side-by-side to find the most affordable option to suit your needs, then get an online medical aid quote, or call us on 0861 111 818 to discuss your medical aid and healthcare cover needs.
Why choose us?
- In-hospital Benefit
- Health Platform Benefit
- Day-to-day Benefit
- Chronic Benefit
Save up to R1 000
a month with
Provider Choice
Custom, Incentive, and Extender Options give you the flexibility to choose your healthcare providers – hospitals, doctors, and pharmacies. Save up to R1 000 on your monthly contributions when you choose to use Momentum Medical Scheme’s Associated providers.
MOMENTUM VALUE-ADDED BENEFITS
Convenient, innovative features, unique to Momentum
HealthReturns+
An incentive programme that rewards you for taking ownership of your health. We aim to help you stay informed about your health status and reward you for staying healthy.
Free
HealthSaver+
A voluntary medical savings account that works seamlessly with your medical aid. It pays for treatments and procedures not covered by
your option.
R40 per year
Hello Doctor+
Get free expert health advice from qualified South African medical doctors through your phone, tablet or computer, 24/7/365.
Free
GapCover+
Gap cover helps you avoid unexpected shortfalls for in-hospital expenses, that are not covered by your medical aid option.
from R203 per month
+ You may choose to make use of additional products available from Momentum Metropolitan Holdings Limited (Momentum), to seamlessly enhance your medical aid. Momentum is not a medical scheme and is a separate entity to Momentum Medical Scheme. The complementary products are not medical scheme benefits. You may be a member of Momentum Medical Scheme without taking any of the complementary products.
MOMENTUM MULTIPLY+ REWARDS PROGRAMME
Enjoy cashbacks and discounts
All members have access to Multiply+ Starter for free, which offers you discounts and cashbacks from a variety of partners. You can also upgrade to a Multiply+ Premier membership, which will reward you with additional cashbacks and discounts on Momentum products, at a range of partners and on the Multiply online shop.
More about medical aid
Learn how to get the best out of your medical aid in South Africa.
More information and contact us
How do medical schemes work?
The first important point to note is that the medical scheme belongs to you, the member.
All medical schemes in South Africa are non-profit organisations, governed by the Medical Schemes Act and regulated by the Council for Medical Schemes. The monthly contributions members pay to the scheme are pooled and used to pay for members’ healthcare expenses, in line with the scheme’s rules and the benefit option chosen.
What do medical schemes do with the contributions they receive from members?
Administration
Medical schemes contract with an administrator to handle all administrative processes on their behalf. These include the collection of contributions, the processing and payment of claims, the handling of any queries and member correspondence, etc. It can also include the marketing of the scheme. In turn the administrator receives a monthly fee from the scheme which gets disclosed to both the Council for Medical Schemes (the regulatory body that governs all South African schemes) as well as annually to members of the medical scheme. The administrator needs to ensure that the services contracted are performed in line with the Board of Trustees’ expectations.
Acquisition, marketing and distribution
The marketing and promotion of the scheme can be outsourced to the administrator, including paying financial advisers to help grow the scheme with new members. Commission is tightly regulated and may not exceed 3%, up to a maximum of R94.77 per month, per membership.
Contributions
Medical schemes receive their income purely from members’ contributions. This money needs to pay for all the claims they have to settle (known as healthcare costs) as well as all the contracted costs explained above (non-healthcare costs). Another important point to note is that schemes are not allowed to charge members different contributions based on their age, gender, health status or any other discriminatory factor. They may also not refuse any person membership and can, at most, apply certain waiting periods to minimise their risk.
Momentum Medical Scheme is committed to ensuring that the interests of our members are protected at all times.
This includes providing appropriate and adequate systems and processes to make sure we settle your claims timeously and providing a prompt response to any queries, complaints and disputes you may have. In order to affect this commitment, a Complaints and Disputes Policy and Procedure is in place. The full policy may be accessed here, the steps in summary are:
We urge you to follow the above process to ensure that your complaint is timeously and efficiently resolved by Momentum Medical Scheme, but an aggrieved Member has the right to lodge a complaint or an appeal with the Council for Medical Schemes against the decision of the Principal Officer or the Committee of the Board at any time prior to a request to convene a meeting of the Scheme’s Disputes Committee.
The Council for Medical Schemes(CMS) governs the medical schemes industry and therefore your complaint should be related to your medical aid. Any beneficiary who is aggrieved with the conduct of a medical scheme can submit a complaint. You can send your complaint in writing to the CMS via email at complaints@medicalschemes.co.za or via fax on (086) 673 2466. The CMS can also be reached telephonically on 0861 123 267 or you can visit medicalschemes.co.za for more information and for the necessary forms that will need to be completed.
Request Scheme Rules
Scheme Rules can be requested by Members of the Scheme. Log into your profile to submit a request.