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Momentum Custom State (for chronic):
dentistry, optometry and wellness (2024)

This page has information on: Costs, Dentistry , Optometry Wellness and Preventative and Other benefits for Momentum Custom (State provider for chronic)

We also have information on: In-hospital, Out of Hospital, Medicine, Maternity, Cancer, Mental Health and Prosthetics benefits.

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Monthly Costs:

Custom (State for chronic) 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R2,737
  • R2,066
  • R1003
  • 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
.



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Dentistry benefits (2024):

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

Momentum: Custom (State for chronic)
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:
  • 1 consult per person paid by scheme
Specialised Dentistry:
  • No benefit
In-Hospital Dentistry:
  • Maxillo-facial surgery and general anaesthesia for children under 7yrs: Hospital and anaesthetist accounts paid by scheme, with R1,830 co-payment. Surgeon, dental and dental specialist accounts paid out-of-pocket
  • Wisdom teeth: Paid by scheme, with:
    In chair: R1,830 co-payment
    Day hospital: R3,300 co-payment
    Overnight hospital: R6,150 co-payment
  • Procedures due to trauma: Covered
 PMBs are always covered by the scheme, and cannot have sublimits or co-payments imposed. These include fracture of face bones, orbit and/or jaw. You can see a full list of maxillo facial PMB benefits here.
Orthodontics:
  • No benefit
Note:
  • PMBs: Prescribed Minimum Benfits. To read more about PMBs click 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
.
.
.

Optometry benefits (2024):

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

Momentum: Custom (State for chronic)
Assume scheme pays all these costs, unless otherwise stated
Optometry:
  • No benefit
Note:
  • This section does not apply to opthamology 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.
♦️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
.
.
.

Wellness/Preventative benefits (2024):

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

Momentum: Custom (State 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 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
.
.
.

Other benefits for 2024:

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

Custom (State for chronic)
International Insurance:
  • R7.66 million international emergency cover. Includes R15,500 for emergency optometry, R15,500 for emergency dentistry and R765,000 terrorism cover.
    • R1,850 co-payment applies for each outpatient claim
Other:
♦️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
.

    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

Also see these:




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