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Summit Option

Created for families who require extensive in-hospital cover, Day-to-day and Chronic Benefits, from a provider of their choice.

  • Unlimited hospital cover.
  • Extensive day-to-day and chronic cover from any provider.
  • The Health Platform Benefit provides a range of preventative screening tests.

From
R14 903 per month

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An overview of the Summit Option

What does the Summit
Option cover?

This benefit covers hospitalisation as well as some out-of-hospital procedures that can be safely performed in a doctor's room or day hospital.

Hospital choice

Providers
Available at any hospital.

Hospitalisation

Benefit
  • Associated specialists are covered in full. Other specialists are covered up to 300% of the Momentum Medical Scheme Rate.
  • Hospital accounts are covered in full at the rate agreed upon with the hospital group.
High and intensive care
No annual limit.
Specialised dentistry
The In-hospital Benefit covers certain in-hospital dental and oral benefits.
Maternity
No annual limit on maternity confinement and neonatal intensive care.
Renal dialysis and oncology
No annual limit.
Organ transplant
No annual limit.
MRI and CT scans, magnetic resonance cholangiopancreatography, whole-body radioisotope and PET scans
  • No annual limit.
  • You need to pay a co-payment of R2 900 per scan.
Medical rehabilitation, private nursing, Hospice, and step-down facilities
R72 000 per family.
Trauma benefit
Certain day-to-day claims form part of your recovery following specific traumatic events.
Health management programmes for conditions such as chronic renal disease, organ transplants, mental health, HIV/Aids and oncology.
Your doctor needs to register you on the appropriate health management programme.
Immune deficiency related to HIV
  • Anti-retroviral treatment - HIV related admissions.
  • No annual limit applies at any provider R92 600 per family at any hospital.
Emergency medical transport in South Africa by Netcare 911
No annual limit applies.
International emergency medical transport by preferred provider
R9 010 000 per beneficiary per 90-day journey. This benefit includes R15 500 for emergency optometry, R15 500 for emergency dentistry and R765 000 terrorism cover. A R2 180 co-payment applies per emergency out-patient claim.
Take-home medication
7 days’ supply.

Specialised procedures/treatment

Certain specialised procedures/treatments
Certain specialised procedures/treatments are covered, when clinically appropriate, in- and out-of-hospital.
*Prescribed Minimum Benefits (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable.
This benefit takes care of certain life-threatening conditions, such as diabetes and heart disease, that need ongoing treatment.

Network provider

Available from:
Any provider.

Benefit

Cover
  • 26 conditions under Prescribed Minimum Benefits* according to the Chronic Disease List with no annual limit.
  • 36 additional conditions – accumulate to the overall day-to-day limit of R33 000 per beneficiary per year (this is a combined limit incorporating both day-to-day cover and cover for the 36 additional conditions)
*Prescribed Minimum Benefits (PMB) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable.
This benefit covers everyday medical expenses, such as doctor visits and prescribed medication. On this option, you get R33 000 to cover day-to-day expenses per beneficiary every year.

Network provider

Available from:
Any provider.

Savings

Medical Savings Account
There are no savings built into this option, but you can add HealthSaver+.

Benefit

General practitioners
Subject to an overall annual day-to-day limit of R33 000 per beneficiary.
Eye care
  • You get R5 800 to use on eye care per beneficiary.
  • The maximum amount you can spend on a frame is R2 950.
  • Subject to an overall annual day-to-day limit of R33 000 per beneficiary.
Dentistry
  • Basic dentistry is subject to an overall annual day-to-day limit of R33 000 per beneficiary.
  • Specialised dentistry is paid from available day-to-day benefits, limited to R19 800 per beneficiary and R47 700 per family per year.
  • Both in and out-of-hospital specialist accounts accumulate towards the day-to-day limit.
  • Dental specialist accounts for extraction of impacted wisdom teeth in doctors’ rooms covered from Major Medical Benefit at 100% of the Momentum Medical Scheme Rate.
Medicine
  • Prescribed medication is covered up to R25 700 per beneficiary and R42 300 per family per year.
  • Subject to an overall annual day-to-day limit of R33 000 per beneficiary.
  • Over-the-counter medication is paid out-of-pocket or from HealthSaver+ if available.
Mental health
  • We cover up to R28 300 per family every year.
  • Subject to an overall annual day-to-day limit of R33 000 per beneficiary.
Specialist visits
Subject to overall annual day-to-day limit of R33 000 per beneficiary.
+ 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.
A unique benefit that encourages health awareness, enhances quality of life, and gives peace of mind through preventative care and early detection tests.

Network provider

Available from:
Any provider.

Benefit

Preventative care includes:
  • baby immunisations covered up to the age of 6,
  • flu vaccines,
  • pneumococcal vaccines, and
  • tetanus-diphtheria injections.
Early detection tests include:
  • mammograms,
  • bone density scans,
  • pap smears,
  • dental consultations,
  • general physical examinations,
  • prostate specific antigen tests,
  • health assessments,
  • cholesterol tests,
  • blood sugar tests, and
  • HIV tests.
Maternity programme
Our comprehensive maternity programme is aimed at providing members with the support and quality care they need during their pregnancy and after delivery. The benefits include:
  • 12 antenatal visits, including urine tests (dipstick),
  • 2 pregnancy scans,
  • certain antenatal pathology tests,
  • 2 doula visits,
  • 2 paediatrician visits in the baby’s first year,
  • online antenatal and postnatal classes,
  • online video consultations with a lactation specialist, and
  • 3 nurse home visits after returning from the hospital, as well as 2 and 6 weeks later.
Health line
24-hour emergency health advice.

This is only a summary of our benefits. Read the Summit Option brochure for more details. Momentum Medical Scheme’s Rules apply.

Compare medical aid options

Compare the cover and benefits of 2 Momentum medical aid options side-by-side to find the most budget-friendly option to suit your needs.

Compare options

Want to know more?

For more information relating to this option, download the relevant document below.

Summit Option brochure

ADDED BENEFITS

Convenient, innovative
features, unique to our
medical aid.

+ 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.

Young fit couple in gym gear sitting on the street, smiling, and looking at the young man’s fitness watch that’s tracking health activity for Momentum Multiply points.

MOMENTUM MULTIPLY+ REWARDS PROGRAMME

Enjoy exclusive rewards

Multiply encourages and rewards members for making healthier choices! Multiply Inspire is available to you for free. You can upgrade to Multiply Inspire Plus and earn up to R1 000 per beneficiary per month.

Learn more

Want a quote?

You'll get a quote reflecting the medical aid contribution at the end of the process.

Get an online quote

Need advice?

An accredited healthcare consultant will call you to discuss our medical aid options and benefits.

Request a call back

Contact Momentum Medical Scheme


0860 117 859

WhatsApp us
Join an online help session.

+27 31 573 4008

[email protected]

[email protected]
Business hours are Monday to Friday from 08:00 to 17:00. Saturdays from 08:00 to 16:00.
Closed on Sundays and public holidays.

082 911

Available 24 hours a day, 7 days a week, 365 days a year.

+27 11 541 1263

Available 24 hours a day, 7 days a week, 365 days a year.

0800 000 438

[email protected]

Available 24 hours a day, 7 days a week, 365 days a year.
Other Momentum contacts

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