Note: We are updating 2024 benefits as they are released. Some plans show old benefits until schemes release new plans.

Momentum Ingwe D State:
in-and-out of hospital benefits (2024)


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Monthly Costs:

Ingwe State D 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R1,259
  • R1,259
  • R544
  • Pay for all 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
  • Pay for all children
Income band:
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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In-hospital Procedures for 2024:

Momentum: Ingwe State D
Assume scheme pays all these costs, unless otherwise stated
non-Network Specialists:
  • 100% scheme rate
network Specialists:
  • 100% scheme rate
non-Network GPs:
  • 100% scheme rate
network GPs:
  • 100% scheme rate
Hospital Choice:
  • State
Day Hospitals:
Penalty for using other hospital:
  • If you don't use State facilities, you will pay the difference between what the private and State facilities charge
Other Co-payments:
  • n/a
Specialised Radiology:
  • PMBs only and only in State facilities
Supplementary Services: (Physio, etc)
  • 100% scheme rate
Transplants:
  • PMBs only and only in State facilities
Dialysis:
  • PMBs only and only in State facilities
Exclusions:
Alternatives to hospitals:
  • Medical rehabilitation and step-down facilities: R15,900 per family
  • Private nursing and hospice: No benefit, unless PMB
Casualty:
  • 1 consult per person and 2 per family
  • R105 co-payment.
  • This benefit is shared with out-of-network GP consults and after-hours consults
Other:
  • High and Intensive Care: 10 days
  • HIV related admissions: R39,000 per family
Note:
  • 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
♦️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
.
.
.

Out-of-hospital Procedures for 2024:

Momentum: Ingwe State D
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
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.
PMBs out of hospital:
  • All medical aids must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
  • This can include consults with specialists, blood or other tests, radiology and medicine
  • The benefit is paid by the scheme, and not out of your savings account
  • If you have no day-to-day funds, you still have cover for PMBs
  • Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
  • See our Guide to PMBs for more information.
General info:
  • Services must be obtained from the Ingwe Primary Care Network
GP consultations:
  • Primary Care Network: Unlimited
  • Virtual consults::
  • 3 per person
  • Non-network: 1 consult per person and 2 per family with R105 co-payment. This benefit is shared with ER and after-hours consults
  • Consults include medicine where required
Childcare:
  • Paediatrician: 2 consults, 0-12 months
  • Immunisations: R2,800, covered for 1st year only
Specialists consultations:
  • 2 consults per family
  • R1,290 per consult and R2,580 per family
  • Psychologists and psychiatrists: PMBs only, at State facilities
Pathology:
  • Some specific pathology covered by scheme
General radiology:
  • Some specific x-rays covered by scheme
Specialised radiology:
  • MRI and CT scans, (MRCP), whole body radioisotope and PET scans: PMBs only , at State facilities
Supplementary Services: (Physio, etc)
  • Physiotherapy: included in specialist benefit, see above
  • Otherwise, PMBs only and only in State facilities
General Appliances:
  • In-hospital: R6,400 per family
  • Out-of-hospital: No benefit
1.1. Hearing Aids:
  • No benefit
1.2. Wheelchairs:
  • No benefit
Note:
  • PMBs: Prescribed Minimum Benefits. 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
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

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Medication Benefit for 2024:

Momentum: Ingwe State D
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
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.
Chronic:
  • Use State facilities for your chronic script, medication and treatment
Acute (presrcibed) medication:
  • Some prescribed medication covered by scheme
Over-the-counter:
  • No benefit
Birth Control:
  • No benefit
On Discharge:
  • 7 days supply
Biological:
  • PMBs only
Note:
  • Schemes have very strict rules about where you can get your medicine to get full benefit. We do not list the requirements here, so confirm with your scheme before you collect your medicine.
  • Formulary: A pre-defined list of approved medicines. Each plan has a different list, and might not pay for non-listed medicine. Confirm with your scheme whether your required medicine is covered by them.
  • 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
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.


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