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An elderly woman and man, happily riding horses outdoors with mountains in the background.

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

R13 573 per month

An overview of the Summit Option

In-hospital Benefit

Cover for hospitalisation at any private hospital with no overall annual limit.

Day-to-day and Chronic Benefit

Extensive Day-to-day and Chronic Benefits from any provider.

Health Platform Benefit

Provides cover for various benefits, such as preventative screening tests, certain check-ups and more.

What does the Summit
Option cover?

In-hospital Benefit

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

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 770 per scan.
Medical rehabilitation, private nursing, Hospice and step-down facilities
R68 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 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: R87 900 per family at your chosen hospital provider.

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 070 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.

Chronic Benefit

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 R31 300 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.

Day-to-day Benefit

This benefit covers everyday medical expenses, such as doctor visits and prescribed medication. On this option, you get R31 300 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 R31 300 per beneficiary.
Eye care
  • You get R5 190 to use on eye care per beneficiary.
  • The maximum amount you can spend on a frame is R2 800.
  • Subject to an overall annual day-to-day limit of R31 300 per beneficiary.
Dentistry
  • Basic dentistry is subject to an overall annual day-to-day limit of R31 300 per beneficiary.
  • Specialised dentistry is paid from available day-to-day benefits, limited to R18 800 per beneficiary and R45 300 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 R24 400 per beneficiary and R40 200 per family per year.
  • Subject to an overall annual day-to-day limit of R31 300 per beneficiary.
  • Over-the-counter medication is paid out-of-pocket or from HealthSaver+ if available.
Mental health
  • We cover up to R26 900 per family every year.
  • Subject to an overall annual day-to-day limit of R31 300 per beneficiary.
Specialist visits
Subject to overall annual day-to-day limit of R31 300 per beneficiary.
+ 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,
  • 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 antigens,
  • health assessments,
  • cholesterol tests,
  • blood sugar tests, and
  • HIV tests.
Maternity programme
12 antenatal visits which include:
  • a urine test,
  • 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; first visit after returning from the hospital, as well as 2 and 6 weeks later.

This is only a summary of our benefits. Read the Summit 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.

Want to know more?

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

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 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 or mobile device, 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 R236 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.

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 Momentum Medical Scheme members on the Evolve, Custom, Incentive, Extender, and Summit Options for free. You can upgrade to Multiply Inspire Plus and earn up to R1 500 per adult dependant, in HealthReturns.

Multiply Engage is available to Momentum Medical Scheme members on the Ingwe Option and Momentum Health4Me members for free. For multiplied benefits and rewards, you can upgrade to Multiply Engage Plus.

Want a quote?

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

Need advice?

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

Contact Momentum Medical Scheme

Client service, claims and authorisations



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