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

This page has information on: Costs, Dentistry , Optometry Wellness and Preventative and Other benefits for Momentum Custom (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 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
• 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 (2025)

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

Monthly Costs (2026)

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

Dentistry benefits (2025):

(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
Main Member: Adult: Child: 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. Other Day-to-Day Funds:
Standard Dentistry:	Preventative care: R380 per person
Specialised Dentistry:	No benefit	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 R1,920 co-payment. Surgeon, dental and dental specialist accounts paid out-of-pocket Wisdom teeth: Paid by scheme, with: In chair: R1,920 co-payment 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:	No benefit

Optometry benefits (2025):

(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
Main Member: Adult: Child: 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. Other Day-to-Day Funds:
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.

Wellness/Preventative benefits (2025):

(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 Tetanus injection: As needed
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:

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. >R2,180 co-payment applies for each outpatient claim
Other:

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