Extender
About this plan
🥇 Best suited for members with regular healthcare needs seeking comprehensive medical cover.
Principal Member
From
R7,939
per month
Adult Dependant
From
R6,021
per month
Child Dependant
From
R2,335
per month
What's covered
Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health
Waiting periods
- General
- 3 months
- Pre-existing conditions
- 12 months
Extender
Momentum Extender Medical Aid Plan (🇿🇦 2026*)
Overall, the Momentum Extender Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance for its Family Members. The Momentum Extender Medical Aid Plan starts from R7,939 ZAR.| 👤 Main Member Contribution | R7,939 ZAR - R11,472 ZAR |
| 👥 Adult Dependent Contribution | R6,021 ZAR - R9,240 ZAR |
| 💙 Child Dependent Contribution | R2,335 ZAR - R2,647 ZAR |
| 🔁 Gap Cover | ☑️ Yes |
| 🌎 International Cover | Up to R8 220 000 |
| 🏥 Hospital Cover | Unlimited |
| 💶 Prescribed Minimum Benefits (PMB) | ☑️ Yes |
| ➡️ Screening and Prevention | ☑️ Yes |
| 💳 Medical Savings Account | ☑️ Yes |
| 🍼 Maternity Benefits | ☑️ Yes |
Momentum Extender Review - 9 Key Point Quick Overview
- ☑️ Momentum Extender Plan Overview
- ☑️ Momentum Extender Plan Contributions
- ☑️ Extender Plan Benefits and Cover Comprehensive Breakdown
- ☑️ Momentum Extender Major Medical Benefits
- ☑️ Momentum Extender Health Platform Benefit
- ☑️ Custom Plan Exclusions and Waiting Periods
- ☑️ Momentum Extender Plan vs. Similar Plans from other Medical Schemes
- ☑️ Our Verdict on The Momentum Extender Plan
- ☑️ Momentum Extender Plan Frequently Asked Questions
Momentum Extender Plan Overview
The Momentum Extender medical aid plan is one of 6, starting from R7,939, and includes cover for chronic conditions, dentistry, optometry, in and out-of-hospital consultations, procedures, and much more.
Gap Cover is available on the Momentum Extender Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Momentum has a trust rating of 4.3.
Momentum Medical Scheme has a Momentum Multiply Rewards Program and also the following medical aid plans:
✅ Momentum Summit
✅ Momentum Ingwe
✅ Momentum Incentive
✅ Momentum Extender
✅ Momentum Evolve
✅ Momentum CustomMomentum Extender Plan Contributions
| 🏥 Hospital | 💊 Chronic | 👤 Main Member | 👥 2 Adults | 2️⃣ Main Member + 1 Child | 3️⃣ 2 x Adult + 1 Child | 4️⃣ 2 x Adults + 2 x Children | 5️⃣ 2 x Adults + 3 x Children |
| 📌 Associated | Any | R10,088 | R18,213 | R12,994 | R21,069 | R23,925 | R26,781 |
| 📌 Associated | Associated | R9,081 | R16,390 | R11,693 | R19,002 | R21,614 | R24,226 |
| 📌 Associated | State | R7,939 | R13,960 | R10,274 | R16,295 | R18,630 | R20,965 |
| 📍 Any | Any | R11,472 | R20,712 | R14,763 | R24,003 | R27,294 | R30,585 |
| 📍 Any | Associated | R10,079 | R18,196 | R12,978 | R21,095 | R23,994 | R26,893 |
| 📍 Any | State | R9,017 | R16,418 | R11,664 | R19,065 | R21,712 | R24,359 |
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Extender Plan Benefits and Cover Comprehensive Breakdown
Hospitalization and some specialized procedures and treatments are paid for under this benefit. A yearly cap on hospital stays is not in place, and the cover is unlimited for affiliated specialists and up to 200% of the Momentum Medical Plan Rate for all other specialists.Momentum Extender Major Medical Benefit
Furthermore, all hospital bills are paid at a predetermined rate. If your treatment has been approved in advance, the hospitalization benefit will pay for your hospital bill and any other fees paid during your stay in the hospital. The Major Medical Benefit covers specialized procedures/treatment if they are deemed medically necessary and have been pre-authorized, even if they do not necessitate hospitalization. If pre-authorization is not acquired, the Scheme will only pay 70% of the negotiated price (assuming authorization would have been given according to the regulations of the Scheme). Furthermore, the participant will be responsible for the remaining 30%. The main member, a member of their immediate family, or a close friend must get permission to stay longer than 72 hours if admitted due to an emergency. In addition, a 30% co-payment will be added to the hospital bill if they select Affiliated hospitals but do not end up using one of them.Momentum Extender Major Medical Benefits and Co-payments
- ☑️ Before utilizing your Major Medical Benefits, you must contact Momentum for pre-authorization.
- ☑️ You must enroll in a health management program for certain conditions, such as cancer.
- ☑️ Momentum Medical Scheme will pay benefits according to the Scheme Rules and the Benefits Schedule.
- ☑️ The Scheme has established clinical protocols for the treatment of each condition.
- ☑️ The annual sub-limits specified below apply.
- ☑️ If you do not join in January, your sub-limits will be adjusted proportionally (i.e., according to the number of months remaining in the year).
| 📌 Providers | Any Hospitals Associated Hospitals |
| 📌 Overall Annual Limit on Custom | Unlimited |
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Momentum Extender Co-Payments
R2,000 per authorization, excluding motor vehicle accidents, pregnancy, and emergency treatment. An additional co-payment may be required for the following specialized procedures:- ☑️ On the Extender Option, your co-pay for these services, wherever they are rendered, will be R2,000.
- ☑️ If the procedure is done in a regular or a day hospital, you must also pay R5,500 per authorization for “Specialized Procedures.”
| ☑️ Arthroscopies, Back and neck surgery, Carpal tunnel release, Functional nasal and sinus procedures, Joint replacements, Laparoscopies | The co-payments above apply if the procedure is done in a day or acute hospital. |
| ☑️ Gastroscopies, Colonoscopies, Cystoscopies, Sigmoidoscopies, Nail surgery, Removing of extensive skin lesions | Done outside a hospital, day hospital, or a hospital if the appropriate co-payment is paid. |
| ☑️ Conservative back and neck treatment, Removal of minor skin lesions, Treatment of diseases of the conjunctiva, Treatment of headache, Treatment of adult influenza, Treatment of adult respiratory tract infections | The Scheme does not cover low-severity cases, but Momentum HealthSaver+ can pay for them if available. The Scheme pays for high-risk cases in an acute hospital with the abovementioned co-payments. |
Momentum Extender Hospitalization
- ☑️ All related specialists are covered under this benefit.
- ☑️ Up to 200% of the Momentum Medical Scheme Rate is paid for other specialists.
- ☑️ The hospital bill will be paid at the group’s agreed-upon rate.
Momentum Extender Chronic Benefit
The Chronic Benefit covers some life-threatening diseases requiring continued care. Any Affiliated or State may serve as your Chronic Benefit provider. There is no annual cap on chronic coverage for the 26 conditions listed on the Chronic Disease List, which is part of the Prescribed Minimum Benefits. In addition, an additional 36 conditions are subject to a yearly maximum per family (refer to the brochure for a list of these conditions). Chronic benefits are contingent upon enrollment in the Chronic Management Program and Scheme approval.| ☑️ High and Intensive Care | There is no annual limit on this benefit. |
| ✅ After-hour casualty visits | Subject to the day-to-day benefit. |
| 📌 Renal Dialysis | There is no annual limit. If you choose State as your chronic provider, you must undergo renal dialysis at State facilities. |
| 📍 Oncology | R500,000 per recipient per year and a 20% co-payment after that. Reference pricing from Momentum Medical Scheme is used for chemotherapy and other medications. The Custom Network of Oncologists is where you should get your oncology care and medicines. If you select State or Associated as your chronic provider, you must acquire your oncology medication through Medipost. |
| ❤️ Organ Transplants (Recipient) | There is no annual limit. |
| 💙 Organ Transplants (Doner) will only be covered if the recipient is an existing member of Momentum Health. | Cadaver costs are covered up to R28,700. Live donor costs are covered up to R59,000, including organ transportation. |
| ✳️ Maxillo-facial surgery and general anesthesia for children under 7 (this excludes implants). | Hospital account (covered in full at the rate negotiated with the hospital group) and anesthetist account (covered up to 200% of Momentum Medical Plan Rate) paid from Major Medical Benefit. Subject to a co-payment of R1,820 per authorization. The accounts for a dentist, dental specialist, and maxillofacial surgeon are paid from savings if available. |
| 🦷 Impacted Wisdom Teeth | Hospital account (covered in full at the rate negotiated with the hospital group) and anesthetist account (covered up to 200% of Momentum Medical Plan Rate) paid from Major Medical Benefit. Subject to R3,450 co-payment for day hospitals and R6,500 co-payment for acute hospitals per authorization. Major Medical Benefit pays up to 100% of Momentum Medical Scheme Rate for dentistry, dental specialist, and maxillofacial surgeon bills. |
| 🍼 Maternity confinements | No annual limit. |
| 👶 Neonatal Intensive Care | No annual limit. |
| 📈 MRI, PET, and CT scans | No annual limit exists, but this benefit is subject to a co-payment of R3,500 per scan. |
| 📉 Medical and Surgical Appliances, for instance, support stockings, back braces, etc. | Covers up to R9,230 per family per year. |
| 🦵 Internal Prostheses | Cochlear implants: R245,00 per recipient, maximum of 1 procedure per year Intraocular lenses: R9,540 per recipient per event, maximum 2 events per year Other internal prostheses: R92,200 per recipient per event, with a maximum of two yearly events. |
| 🦾 External Prostheses | There is up to R32,000 available per family. |
| 🧠 Mental Health, including psychiatry, psychology, drug, and alcohol rehabilitation | Covers up to R50,600 per beneficiary yearly. There is a 21-day sub-limit that applies to drug and alcohol rehabilitation. |
| 💊 Take-Home Medication | The patient receives a 7-day supply upon discharge. |
| 💉 Trauma Benefit | Covers certain day-to-day expenses incurred because of specified traumatic incidents, including near-drowning, poisoning, severe allergic reactions, and external and internal brain traumas. According to the authorization, treatment relating to the event is covered. |
| ⚕️ Alternatives to Hospitalization, such as step-down facilities | There is a limit of R75,000 per family. |
| 🚩 Immune Deficiency – HIV | Members can use a network provider of their choosing. |
| 📌 Anti-retroviral Treatments | There is no annual limit on this benefit. |
| 📍 HIV-related hospital admissions | There is a limit of R96,800 per family. |
| 🛺 International emergency medical transport by preferred provider | R8 220 000 per beneficiary per 90-day journey. This benefit includes R15 500 for emergency optometry, R15 500 for emergency dentistry and R765 000 terrorism cover. A R2 280 co-payment applies per emergency out-patient claim |
Momentum Extender Day-to-day Benefit
This benefit covers routine medical expenses, such as doctor’s visits and prescription medication. In addition, 25% of your gift can be used to support operational costs. If this component is insufficient to cover your annual living expenditures, you will have a self-funding gap up to the Threshold (a predetermined sum dependent on the size of your family). Once you reach this threshold, the Scheme will pay your claims from Extended Cover. You may consult any general practitioner if you have chosen any State as your chronic care provider. However, if you have chosen Associated as your chronic care provider, you must consult an Associated general practitioner. In this case, claims will only acc rue at 70% of the Momentum Medical Scheme Rate to Threshold. A 30% co-payment will apply after Extended Cover has been activated. The threshold levels are as follows per member:- ☑️ R36 900 for the principal member
- ☑️ R32 000 per adult dependent
- ☑️ R10 600 per child (applies up to a maximum of three children)
| 🔎 Provider, cover and limit. | Any or connected. Members who have chosen Associated as their chronic care provider must see a Doctor affiliated with Associated. 26 conditions covered according to Chronic Disease List in Prescribed Minimum Benefits – no annual limit applies. 36 additional conditions. |
| 📌 Healthcare Alternatives: Acupuncture, Homeopathy, Naturopathy, Herbology, Audiology, Occupational and Speech therapy, Chiropractors, Dieticians, Biokinetics, Orthoptists, Osteopathy, Audiometry, Chiropody, Physiotherapy, and Podiatry | Unlimited within the provisions of General Rule. |
| 🧠 Mental Health (Psychology and Psychiatry) | There is a limit of R50,600 per family. |
| 🪥 Basic Dentistry | Unlimited within the provisions of General Rule. |
| 🦷 Specialized Dentistry | R20,700 for each recipient and R49,800 per household Both in-hospital and out-of-hospital accounts for dental specialists accrue towards the limit. In doctors’ offices, a dental specialist is responsible for extracting impacted wisdom teeth where the Major Medical Benefit is covered at 100% of the Momentum Medical Scheme Rate. Subject to overall annual day-to-day limit of R34 500 per beneficiary. |
| 🩺 External Medical Devices: (Including hearing aids, glucometers, blood pressure monitors, wheelchairs, etc.) | R40,100 per household Sub-limit of R23,200 per family for hearing aids. Subject to prior approval |
| 🧪 General Practitioner consultations | 100% of the Momentum Medical Scheme Rate, regardless of the provider’s location. 100% of the Momentum Medical Scheme Rate for Affiliated GPs and 70% of the Momentum Medical Scheme Rate for non-Associated GPs are paid to Associated providers. |
| 👩⚕️ Specialist consultations | Covered up to 100% of the Momentum Medical Scheme Rate. |
| 👓 Optical and Optometry | There is an overall limit of R6,100 per beneficiary. There is a sub-limit of R3,080 for frames. |
| 📌 Pathology | Unlimited within the provisions of General Rule. |
| 📍 Radiology | Unlimited within the provisions of General Rule. |
| ✳️ MRI, PET, and CT scans | Covered by Major Medical Coverage, subject to a co-payment of R3,500 per scan and prior authorization. |
| 💊 Prescribed medication | There is a limit of R26,900 per beneficiary. There is a limit of R44,200 per family. |
| 🅰️ Over-the-Counter Medication | Subject to medical savings if funds are available. Does not accumulate to the annual threshold. |
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Momentum Extender Health Platform Benefit
Health Platform benefits are covered by the Scheme up to a maximum Rand amount per benefit, provided you inform the scheme before using the benefits.Preventative Care
| 🔎 Benefit | ➡️ Eligibility | 📉 Frequency |
| 🍼 Baby immunizations | Children up to 6 | According to the Department of Health (DOH). |
| 💉 Flu Vaccines | Children 6 months – 5 Years Beneficiaries 60 and older High-risk beneficiaries | Once yearly |
| ☑️ Tetanus diphtheria Injection | All beneficiaries | As required |
| 📌 Pneumococcal Vaccine | Beneficiaries 60 and older High-risk beneficiaries | Once yearly |
Early Detection Testing
| 🔎 Benefit | ☑️ Eligibility | ➡️ Frequency |
| 🦷 Dental Consultations | All | Once yearly |
| 📌 Pap Smear and GP consult | Women 15> | Once yearly |
| 📍 Mammogram | Women 38> | Once yearly |
| 🦵 DEXA Bone Density Scan | Beneficiaries 50> | Once every 2 years |
| ✔️ GP Consultation for General Physical Exams | Beneficiaries 21 – 29 Beneficiaries 30 – 59 Beneficiaries 60 – 69 Beneficiaries 70> | Once every 5 years Once every 3 years Once every 2 years Once yearly |
| ✳️ Prostate Specific Antigen | Male Beneficiaries 40 – 49 Male Beneficiaries 50 – 59 Male Beneficiaries 60 – 69 Male Beneficiaries 70> | Once every 5 years Once every 3 years Once every 2 years Once yearly |
| 🩺 Health Assessment, including blood pressure testing, cholesterol, blood sugar, height, weight, and waist circumference measurements | Principal members and their adult dependents | Once yearly |
| 🧪 Cholesterol Testing, only if the health assessment shows a level of 6mmol/L> | Principal members and their adult dependents | Once yearly |
| 🍬 Blood Sugar Tests, only if the health assessment shows a level of 11 mmol/L> | Principal members and their adult dependents | Once yearly |
| 👁️ Glaucoma test | Beneficiaries 40 – 49 Beneficiaries 50> | Once every 2 years Once yearly |
| ✅ HIV Testing | Beneficiaries 15> | Once every 5 years |
Health Management Programs
| 🔎 Benefit | ☑️ Eligibility | 📉 Frequency |
| 📈 Cholesterol | All beneficiaries who are registered in the program. | As Required |
| 📉 Chronic Renal Failure | All beneficiaries who are registered in the program. | As Required |
| 🍬 Diabetes | All beneficiaries who are registered in the program. | As Required |
| 💊 Drug and Alcohol Rehabilitation | All beneficiaries who are registered in the program. | As Required |
| 📌 HIV/AIDS | All beneficiaries who are registered in the program. | As Required |
| 📍 Hypertension (Cardio Care) | All beneficiaries who are registered in the program. | As Required |
| 🧠 Mental Health | All beneficiaries who are registered in the program. | As Required |
| ➡️ Oncology | All beneficiaries who are registered in the program. | As Required |
| ❤️ Organ Transplants | All beneficiaries who are registered in the program. | As Required |
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Custom Plan Exclusions and Waiting Periods
Exclusions
Momentum members must note that while limitations and exclusions exist, they are still entitled to Prescribed Minimum Benefits (PMBs). Furthermore, the following items are not covered by Momentum but could be claimed from a positive Medical Savings Account:- ☑️ Costs during waiting periods or for conditions not disclosed during application.
- ☑️ Costs exceeding the annual maximum for the specific category as set out in Annexure B of the Scheme Rules.
- ☑️ Injuries sustained during participation in a riot, civil commotion, war, invasion, terrorist activity, or rebellion.
- ☑️ Professional speed contests or trials.
- ☑️ Treatment by a health care provider not registered with a recognized professional body constituted in terms of an Act of Parliament.
- ☑️Holidays for recuperative purposes, including headache and stress relief clinics.
- ☑️ Treatment for which efficacy and safety cannot be proved.
- ☑️ Operations, medicine, treatments, and procedures for cosmetic purposes unrelated to illness, accident, or disease.
- ☑️ Obesity
- ☑️ Costs for attempted suicide that exceed Prescribed Minimum Benefits limits.
- ☑️ Certain cosmetic surgeries, such as breast reduction, breast augmentation, gynecomastia, otoplasty, and blepharoplasty.
- ☑️ Medication not registered by the Medicine Control Council.
- ☑️ Services rendered by institutions not registered in terms of any law (except for State facilities/hospitals).
- ☑️ Gum guards and gold are used in dentures.
- ☑️ Frail care
- ☑️ All traveling expenses except the benefits covered by Emergency rescue and international cover.
- ☑️ Costs deemed medically unnecessary or inappropriate by the Medical Assessor.
- ☑️ Missed appointments.
- ☑️ Circumcision unless clinically indicated, and any contraceptive measures or devices.
- ☑️ Reversal of vasectomies or tubal ligation (sterilization).
- ☑️ Injuries resulting from narcotism or alcohol abuse (except for the Prescribed Minimum Benefits).
- ☑️ Infertility treatment covered by Prescribed Minimum Benefits will be covered in State facilities subject to paragraph 4 of AnnexureD of the Scheme Rules.
- ☑️ Cost of injury and related costs resulting from scuba diving to depths below 40 meters and cave diving.
Waiting Periods
Depending on pre-existing or existing conditions, the following might apply when you register for medical cover with the Momentum Extender Plan:- ☑️ A 3-month general waiting period in respect of all benefits.
- ☑️ A 12-month exclusion in respect of a pre-existing condition.
- ☑️ A late-joiner contribution penalty.
Medical Aid Comparisons : Momentum Extender Plan vs. Similar Plans from other Medical Schemes
| 🔍 Medical Aid Plan | 🥇 Momentum Extender Plan (2026) | 🥈 Sasolmed Comprehensive (2026) | 🥉 Platinum Health PlatFreedom (2026) |
| 👤 Main Member Contribution | R7,939 ZAR – R11,472 ZAR | Contribution payable as a percentage of monthly benefitvalue/control amount, or pension, subject to a minimum of R3 985 per month and a maximum of R29 560 per month. | R2,449 - R5,016 |
| 👥 Adult Dependent Contribution | R6,021 ZAR – R9,240 ZAR | (Adult dependant contribution rates are payable for child dependants from the age of 23, unless they are permanently disabled) | R1,922 - R1,922 |
| 👶 Child Dependent Contribution | R2,335 ZAR – R2,647 ZAR | (Child dependant contribution rates are payable for child dependants until the age of 23 and for permanently disabled children, irrespective of their age) | R657 - R1,179 |
| 🔁 Gap Cover | ☑️ Yes | ☑️ Yes | None |
| 💶 Prescribed Minimum Benefits (PMB) | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 💻 Screening and Prevention | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 💳 Medical Savings Account | ☑️ Yes | None | None |
| 🍼 Maternity Benefits | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| ⚕️ Chronic Conditions | ☑️ Yes | ☑️ Yes | ☑️ Yes |
Our Verdict on The Momentum Extender Plan
In conclusion, the Momentum Extender Option provides a comprehensive medical aid plan with various benefits.
This plan includes hospitalization coverage in private hospitals and chronic treatment options with the choice to either access any doctor and pharmacy or select a list of Associated doctors and Medipost courier pharmacies to save on monthly contributions.
The plan also offers a Health Platform Benefit, covering a range of preventative screening tests and check-ups. Additionally, 25% of the contribution is available in a Personal Medical Savings account to cover day-to-day expenses. Finally, the Extended Cover benefit provides further cover for day-to-day benefits once the threshold amount is reached.
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