Get the most out of medical aid benefits
Practical tips and advice on how to maximise your health benefits and minimise unforeseen out-of-pocket expenses.
1. Use the preventative screening tests
Make use of the preventative screening tests on the Health Platform Benefit to help prevent the development of conditions that could involve costly treatment. For example, taking your children for an annual flu vaccine can prevent them from getting flu, thus decreasing the chances of repeat infections that may require additional consultations and medication.
2. Use network pharmacies
Make use of the Scheme's pharmacy network, as they are contracted with the Scheme and won’t ask for additional administration or dispensing fees on medication.
3. Choose generic over original medication
Ask your doctor or pharmacist to prescribe or dispense generic medication where possible.
4. Compare provider rates
Speak to your doctor to check if you can negotiate the rates charged in line with what your medical aid option covers.
If you’re on the Ingwe Option, make sure you use healthcare providers on the network to ensure that the provider charges according to the rates covered on your option.
If you’re admitted to a hospital, make use of Associated specialists to get peace of mind that the specialist will charge at the rate covered on your medical aid option.
Log in to momentum.co.za to view the providers in your area. You are also welcome to contact our call centre via the web chat facility on momentummedicalscheme.co.za, email us at [email protected], send us a WhatsApp message on 0860 117 859 or call us on 0860 117 859.
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5. Get a quote from the doctor
Ask for quotes from providers, such as dentists, before undergoing high-cost treatments. Sometimes providers offer payment arrangements.
Remember to contact us to request pre-authorisation before undergoing procedures in hospital or day hospital. In doing so, you will be able to find out whether there will be any upfront co-payments and potential shortfalls in claims reimbursement.
6. Register your chronic condition
If you are diagnosed with a chronic condition, contact us to see whether it will be covered from the Chronic Benefit on your option. It is important to register the condition on our health management programme, for your claims to be reimbursed from this benefit and not be paid from your savings, or as an out-of-pocket expense.
+ 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.