Momentum Custom Network (for hospitals) State (for chronic):
prosthetic benefits (2024)

This page has information on: Costs and Prosthetics for Momentum Custom Network hospitals (and State provider for chronic) We also have information for: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Maternity, Cancer, Mental Health, Other/Extra Benefits and Wellness and Preventative Find all the open medical aid plans here. Compare any two plans side by side, instantly. Monthly Costs: Custom Associate (and State provider for chronic) 2024 prices Main member: Adult member: Child member: Total Cost pm: R2,149 R1,626 R762 Only pay for 3 children Savings (per year): No savings account option on this plan The scheme might still cover some or all day-to-day claims. See below, and see benefits. Children Rates: Under 21yrs Only pay for 3 children Note: Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list. All treatments and procedures are subject to authorisation and protocols All benefits are listed as an indication only. Please verify with your broker and scheme ♦️View all the other benefits for this plan:♦️ Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics You can also: ♦️Compare any two plans, side by side | ♦️View all the Momentum plans, with costs and brief summary . You'll get the printable guide as well as a weekly newsletter 🙂 Prosthetics benefits (2024): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Momentum: Custom Associate (and State provider for chronic) Overal Limit: Internal: R56,000 per person per event, maximum 2 events per year External, in-hospital: R26,600 per family Prosthetics required for PMB conditions are always paid paid in full by scheme, with no co-payment, if you follow the protocols. More info here Sub-limits: Intraocular lenses: R6,600 per person per event, maximum 2 events per year This is an additional limit to the prosthetic benefit Note: PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs here. DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit. Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product ♦️View all the other benefits for this plan:♦️ Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics You can also: ♦️Compare any two plans, side by side | ♦️View all the Momentum plans, with costs and brief summary .

Always consult with your broker before making final decisions regarding your healthcare cover.

Important!
• Unless specified, assume that all benefits are paid are paid at 100% scheme rate
• No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
• "Unlimited" benefits are still subject to authorisation, protocols and sublimits
• Assume that all benefits need to be pre-authorised