Momentum Incentive State (for chronic):
dentistry, optometry and wellness (2025)

This page has information on: Costs, Dentistry, Optometry, Wellness and Preventative and Other benefits for Momentum Incentive (State provider for chronic) View all the Momentum plans, with costs and brief summary.

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Terminology:

  • PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
  • DSPs: Designated Service Providers. Where stipulated, you must use 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.
  • All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Monthly Costs (2026)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Momentum:Incentive (State provider for chronic) (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R4,179
  • R3,292
  • R1652
  • Only pay for 3 children
Savings:
  • R5,016
  • R3,948
  • R1,980
Children Rates:
  • Under 21yrs
  • Only pay for 3 children

Dentistry benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Momentum: Incentive (State provider for chronic)
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings:
  • R4,560
  • R3,588
  • R1,800
Other Day-to-Day Funds:
Standard Dentistry:
  • One dental consult per year.
  • Otherwise, from day-to-day benefit
Specialised Dentistry:
  • Wisdom teeth, in chair: R1,750 co-payment .
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
In-Hospital Dentistry:
  • Maxillo-facial surgery and general anaesthesia for children under 7yrs: Hospital and anaesthetist accounts paid by scheme, with R1,750 co-payment. Surgeon, dental and dental specialist accounts paid from day-to-day benefit
  • Wisdom teeth: Paid by scheme with:
    Day hospital: R3,450 co-payment
    Overnight hospital: R6,500 co-payment
  • Procedures due to trauma: Covered
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Orthodontics:
  • From day-to-day benefit

Optometry benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Momentum: Incentive (State provider for chronic)
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings:
  • R4,560
  • R3,588
  • R1,800
Other Day-to-Day Funds:
Optometry:
  • From day-to-day benefit
  • Refractive Surgery: day-to-day benefit
Note:
  • This section does not apply to ophthalmology benefits, which fall under "in-hospital" benefits. Some of those are PMBs, and are paid for in full by your scheme. You can read more about PMBs here.

Wellness/Preventative benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Momentum: Incentive (State provider for chronic)
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • Covered for children under 5yrs and adults 60yrs+
Pneumonia vaccines:
  • Covered for 60yrs+
Biometric Screening:
  • Covered
Child Immunisation:
  • Covered, up to age 6
Pap Smear:
  • Covered for 15yrs+
Mammogram:
  • Covered for 38yrs+, every 2 years
PAS Test:
  • Covered for 40yrs+, every 1-5 years depending on age
HIV Test:
  • Covered for 15yrs+, every 5 years
Other:
  • Bone density scan: 50yrs+, every 3 years
  • Glaucoma test: 40yrs+, every 1-2 yrs, depending on age
View other benefits for this plan:
In-hospital | 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.

Find all other open medical aid plans here.

Other benefits for 2025:

Incentive (State provider for chronic)
International Insurance:
  • R8 million international emergency cover. Includes R15,500 for emergency optometry, R15,500 for emergency dentistry and R765,000 terrorism cover.
  • >R2,180 co-payment applies for each outpatient claim
Other:
    .

    Important!
  • Unless specified, assume that all benefits 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.

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