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Young man sitting on a bench outdoors, smiling while looking at his cell phone, reading up on Momentum’s Evolve medical aid option.

Evolve Option

The Evolve Option is for digitally savvy individuals looking for affordable hospital cover and virtual GP visits, who can manage their membership from their devices in the comfort of their homes.

  • Hospitalisation from the Evolve Network of private hospitals.
  • Access to 2 virtual consultations per beneficiary per year from the GP Virtual Consultation Network, which includes Hello Doctor+.
  • Preventative care with early detection tests.
from

R1 687 per month

Get an online quote Call me for a quote

How does Evolve work?

In-hospital Benefit

Evolve Network

The Evolve Option provides cover for hospitalisation at the Evolve Network of private hospitals with no overall annual limit.


Day-to-day Benefit

GP Virtual Consultation Network

Covers 2 virtual consultations per beneficiary per year from the GP Virtual Consultation Network, which includes Hello Doctor+. If you need more day-to-day cover, you can use the HealthSaver+.

Chronic treatment

State facilities

You must use State facilities for chronic treatment, including scripts and medication.



Health Platform Benefit

Free health screening cover

It covers a range of benefits, such as preventative screening tests, specific check-ups, and more.


Sports injury benefit


2 Physiotherapist or Biokineticist consultations per beneficiary, up to a limit of R1 060 per year, subject to pre-authorisation.

What does the Evolve
Option cover?

In-hospital Benefit
This benefit covers hospitalisation as well as some out-of-hospital procedures or treatments that can be safely performed in a doctor's room, registered day hospital, or out-patient facility. A co-payment of R1 830 applies per authorisation, except for motor vehicle accidents, maternity confinements, and emergency treatment. Additional co-payments may apply for certain procedures.

Our Health Platform Benefit provides cover for a range of benefits such as preventative screening tests, certain check-ups and more.

Hospital choice

Provider

Hospitalisation

Benefit
  • Associated specialists are covered in full. Other specialists are covered up to 100% of the Momentum Medical Scheme Rate.
  • Hospital accounts are covered in full at the rate agreed upon with the hospital group.
Oncology
  • Covered up to R200 000 per beneficiary per year, thereafter a 20% co-payment applies.
  • Momentum Medical Scheme reference pricing applies to chemotherapy and adjuvant (supplementary) medication.
  • You need to get your oncology treatment and medication from the Evolve Network of Oncologists.
Organ transplant and renal dialysis
Limited to Prescribed Minimum Benefits* at State facilities.
MRI and CT scans, magnetic resonance cholangiopancreatography, whole body radioisotope and PET scans
  • No annual limit
  • You will need to pay R3 050 per scan.
Medical rehabilitation, private nursing, Hospice, and step-down facilities
Limited to R55 000 per family per year.
Trauma benefit
Certain day-to-day claims that form part of your recovery following specific traumatic events
Health management programmes for conditions such as 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: No annual limit applies at a preferred provider.
  • HIV-related hospital admissions: R45 900 per family at Evolve Network hospitals.
Emergency medical transport in South Africa by Netcare 911
No annual limit applies.
International emergency medical transport by preferred provider
R5 000 000 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 070 co-payment applies per emergency out-patient claim.
Take-home medication
7 days’ supply.

Specialised procedures/treatment

Certain specialised procedures or treatments covered
Certain specialised procedures or treatments 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.

Chronic Benefit
This benefit takes care of certain life-threatening conditions, such as diabetes and heart disease, that need ongoing treatment.

Network provider

Provider
State facilities

Benefit

Cover
26 conditions under Prescribed Minimum Benefits* according to the Chronic Disease List.
*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.

Day-to-day Benefit
You have cover for 2 virtual consultations from the GP Virtual Consultation Network, which includes Hello Doctor. If you need cover for other day-to-day expenses, like additional GP visits or prescribed medicine, you can choose to make use of the HealthSaver+.

Savings

Medical Savings Account
  • No built-in savings.
  • You can add HealthSaver+ to supplement your day-to-day benefits.

Benefit

GP visits
  • 2 virtual consultations per beneficiary per year from the GP Virtual Consultation Network, which includes Hello Doctor+. Consultations include scripting of medication where required. Medication is subject to HealthSaver+, if available.
  • If you need cover for other day-to-day expenses, like additional GP visits or prescribed medicine, you can choose to make use of the HealthSaver+.
+ 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.

Health Platform Benefit
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,
  • pneumococcal vaccines
  • flu vaccines,
  • tetanus-diphtheria injections, and more.
Early detection tests include:
  • mammograms,
  • bone density scans,
  • pap smears,
  • dental consultations,
  • general physical examinations,
  • prostate specific antigens,
  • health assessments,
  • cholesterol tests,
  • blood sugar tests, and
  • HIV tests.
Maternity programme
12 antenatal visits which include:
  • a urine test
  • certain antenatal pathology tests,
  • 2 pregnancy scans,
  • 2 doula visits,
  • 2 nurse home visits; first visit after returning from the hospital, as well as 2 weeks later, and
  • 2 paediatricians visits in baby’s first year.

This is only a summary of our benefits. Read the Evolve Option brochure for more details. Momentum Medical Scheme rules apply.

Compare medical aid options

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.

Compare options

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

Learn more

HealthSaver+

A voluntary savings account that works seamlessly with your medical aid. It pays for treatments and procedures not covered by your option. 




R40 per year

Learn more

Hello Doctor+

Get free expert health advice from qualified South African medical doctors through your phone or mobile device, 24/7/365




Free

Learn more

GapCover+

Gap cover helps you avoid unexpected shortfalls for in-hospital expenses, that are not covered by your medical aid option.




from R236 per month

Learn more

+ 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.

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 500 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

Client service, claims and authorisations

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. Saturday and public holidays from 08:00 to 16:00. Closed on Sundays.

For local emergencies

082 911

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

For international emergencies


+27 11 541 1263

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

Momentum Medical Scheme Ethics and Fraud line

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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