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Overall, Momentum GapCover+ is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Momentum GapCover+ Plan starts from R219 ZAR. Momentum has a trust score of 3.9.
👥 The average number of members | 10,000+ |
🅰️ Number of Markets | 1 |
🅱️ Market Share | 6%> |
1️⃣ Number of plans offered | 1 |
📱Mobile App | ✅ Yes |
⚠️ Waiting Period | 3 – 12 months |
⛔ Exclusions | ✅ Yes |
Discover more about Momentum Medical Aid
🟥 Overall Annual Limit | R185,000 |
🟧 Medical Practitioner Costs | Covers shortfalls on medical practitioner costs up to 3 times the amount paid by the medical scheme. |
🟨 Allied Professionals | Covers shortfalls in in-hospital care provided by allied professionals up to 3 times the amount paid by the medical scheme. |
🟩 Co-Payments | Covers co-payments applied by the medical scheme for hospital admissions, procedures, and certain day clinic procedures/treatment. |
🟦 Oncology Co-Payments | Covers the 20% co-payment applied to oncology treatment after reaching the medical scheme limit. |
🟪 Robotic Procedure Shortfalls | Covers the shortfall of medical practitioners performing robotic-assisted surgery The benefit applies when the medical scheme does not cover the full cost of the procedure. Momentum GapCover covers up to 3 times the amount paid by the medical scheme. This benefit applies only if robotic-assisted surgery is required for the medical condition. |
🟥 Robotic Procedure Co-Payments | If you require robotic-assisted surgery and your medical scheme levies a co-payment, Momentum will cover you up to R12,000 per policy per year. |
🟧 Casualty Benefit | Covers casualty fees associated with admissions to the emergency room, at a registered hospital casualty facility, due to a medical emergency and an accident. Limited to 5 casualty visits and up to R22,000 per policy per calendar year. Three of these casualty ward visits may be used in an emergency only for a dependent that is 6 years old or less. The emergency-only benefit will be limited to R3,500 and accumulate to your 5 claim events and R22,000 annual benefit limit. |
🟨 Internal Prostheses Shortfall | Covers shortfalls on internal prosthesis costs, up to a maximum of R35,000 per policy per year. Stents and pacemakers are covered up to a sub-limit of R8,000 per claim event. |
🟩 Cancer Assist | Pays R5,000 for first-time diagnosis of minimum stage 2, local and malignant cancer; pays R20,000 for first-time diagnosis of minimum stage 2, regional and malignant cancer. |
🟦 Breast Reconstruction for non-affected breast | Covers costs incurred for cosmetic breast reconstruction for the non-affected breast due to a mastectomy, up to R15,000 per policy per year. |
🟪 Accident Assist | Covers R55,000 for death or permanent disability due to an accident, subject to one claim per insured per lifetime. |
🟥 Violent Crime Benefit | Increases the amount paid under the Accident Assist benefit to R110,000 if the claim event was due to a violent crime. |
🟧 Premium Waiver | Covers R36,000 upfront if you or a dependent who pays the monthly premium dies or becomes permanently disabled due to an accident while covered under this policy. |
🟨 Trauma and Bereavement Counselling | Covers up to R800 per session for any trauma or bereavement counseling fees, limited to R30,000 per policy per year. |
🟩 Baby Bump Benefit | Covers up to R2,000 upfront if you fall pregnant while covered on the policy to assist you with any unexpected costs. |
READ more about Medical Aid Choices
1️⃣ Age Group/Category | 💶 Monthly Premium |
2️⃣ <30 (Millennials) | R219 |
3️⃣ <42 | R355 |
4️⃣ 42> | R499 |
5️⃣ 65> | R628 |
The benefits of choosing Momentum GapCover+ include:
Finally, numerous existing members report a positive experience with Momentum GapCover+ and have not encountered any claims, cover, or service issues.
Momentum’s Gap Cover application process consists of the following steps:
After signing the contract and paying the premiums, your Gap Cover will become active, and you will be covered according to the terms of your chosen plan.
To submit a claim for Gap Cover with Momentum, follow these steps:
Once your claim has been processed, you will be notified of the outcome. Any payment owed to you or your healthcare provider will be made directly to you or your healthcare provider, depending on the circumstances of the claim.
Momentum GapCover+ has the following general exclusions:
and many more. A full list of exclusions will be provided by Momentum.
Waiting periods for Momentum GapCover:
Finally, Compulsory groups with over 20 members have no waiting periods, all are waived.
Happy Members.
Our family transitioned to Momentum GapCover+ at the beginning of 2017. As with any new gap cover, there were some uncertainties regarding what to expect. However, the product has been effective for our needs, from selecting the appropriate plan to completing the transition process. – Bill Shelton
Excellent.
We have never encountered any difficulties with claims, cover, or service. – Solly Ndluli
Highly Satisfied.
Although I faced some minor issues with Momentum GapCover in the past, some of which were due to my lack of understanding, I am highly satisfied with the outcome of my significant shortfall claim for my wife’s cesarean delivery and all other related maternity claims. – Belinda Haas
🔎 Gap Cover Provider | 🥇 Momentum | 🥈 Ambledown | 🥉 Elixi |
🟥 Waiting Periods | 3 – 12 months | 3 – 12 months | 3 – 12 months |
🟧 Number of Plans | 1 | 7 | 8 |
🟨 Travel Cover Extender | None | None | None |
🟩 Average Price | R219 | R203 | R242 – R788 |
🟦 Exclusions | ✅ Yes | ✅ Yes | ✅ Yes |
🟪 Oncology Benefit | ☑️ Yes | ☑️ Yes | ☑️ Yes |
🟥 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 Out-of-Hospital Cover | ☑️ Yes | ☑️ Yes | ☑️ Yes |
🟨 Maternity Benefit | ✅ Yes | None | ✅ Yes |
🟩 Scopes and Scans | ☑️ Yes | ☑️ Yes | ☑️ Yes |
🟦 Co-payment Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟪 Emergency Room | ☑️ Yes | ☑️ Yes | ☑️ Yes |
🟥 Accidental Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 Trauma Counseling | ☑️ Yes | None | ☑️ Yes |
🟨 Premium Waiver | ✅ Yes | ✅ Yes | ✅ Yes |
🟩 Non-DSP Co-Payment | ☑️ Yes | None | None |
🟦 Prostheses | ✅ Yes | None | ✅ Yes |
🟪 Accidental Death/ Permanent Disability | ☑️ Yes | ☑️ Yes | ☑️ Yes |
Sharpen your knowledge with a better understanding of Best Affordable Medical Aid in SA
✅ Pros | ❎ Cons |
Comprehensive cover for medical gap expenses | Waiting periods apply for certain medical conditions |
Flexibility to choose from four plan options | No cover for certain medical procedures such as cosmetic surgery |
Waiver of waiting periods for certain group members | Premiums increase annually |
Momentum GapCover+ is a comprehensive gap cover product offered by Momentum. It is designed to provide individuals and families with additional financial protection for medical expenses not covered by their medical aid scheme.
One of the standout features of this product is the option to choose from four different plans, each offering a different level of coverage at varying prices to suit different needs and budgets. This allows individuals to tailor their gap cover to their specific circumstances and requirements.
Momentum GapCover+ covers various medical expenses, including specialist fees, in-hospital procedures, and out-of-hospital treatments. It also covers cancer and maternity-related expenses, including cesarean sections and postnatal care.
However, it is important to note that, like most gap cover products, Momentum GapCover+ does have some limitations and exclusions.
Momentum GapCover+ is a health insurance plan offered by Momentum Health Insurance that covers the gap between what your medical scheme covers and the actual cost of private healthcare.
You can apply for Momentum GapCover+ by visiting the Momentum Health Insurance website or contacting their customer service center.
The benefits of Momentum GapCover+ include covering the shortfall between your medical scheme’s cover and the actual cost of private healthcare, covering co-payments and deductibles, and offering a range of additional benefits, such as coverage for oncology and organ transplants.
Yes, Momentum GapCover+ is available for seniors, but the premiums may be higher due to increased health risks associated with aging.
Momentum GapCover+ may cover pre-existing conditions after a waiting period, which varies depending on the condition.
The waiting periods for Momentum GapCover+ vary depending on the condition, but they typically range from 3 to 12 months.
Momentum GapCover+ is designed to complement your medical scheme cover by covering the gap between what your medical scheme covers and the actual cost of private healthcare. As a result, it may be more affordable than taking out a comprehensive health insurance plan.
The premiums for Momentum GapCover+ vary depending on your age, health status, and other factors, starting from R219.
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