Home » Medical Aid »

Momentum Extender Medical Aid Plan

Overall, the Momentum Extender Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance to up to 5 Family Members. The Momentum Extender Medical Aid Plan starts from R6,589 ZAR.

👤 Main Member Contribution	R5,544 ZAR
👥 Adult Dependent Contribution	R4,997 ZAR
💙 Child Dependent Contribution	R1,937 ZAR
🔁 Gap Cover	☑️ Yes
🌎 International Cover	Up to R8 million
🏥 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
☑️ Custom 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 R6,589, 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 Custom

Momentum 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	R8,315	R15,012	R10,668	R17,365	R19,718	R22,071
📌 Associated	Associated	R7,537	R13,604	R9,705	R15,772	R17,940	R20,108
📌 Associated	State	R6,589	R11,586	R8,526	R13,523	R15,460	R17,397
📍 Any	Any	R9,456	R17,072	R12,168	R19,784	R22,496	R25,208
📍 Any	Associated	R8,365	R15,102	R10,772	R17,509	R19,916	R22,323
📍 Any	State	R7,485	R13,629	R9,682	R15,826	R18,023	R20,220

You might like the 5 Best Medical Aids under R200

Custom 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

POLL: 5 Best Hospital Plans for Unemployed

Momentum Extender Co-Payments

R1,740 per authorization, excluding motor vehicle accidents, pregnancy, and emergency treatment. An additional co-payment may be required for the following specialized procedures:

On the Custom Option, your co-pay for these services, wherever they are rendered, will be R1,740.
If the procedure is done in a regular or a day hospital, you must also pay R3,480 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 of R11,800 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 R24,700. Live donor costs are covered up to R50,000, 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 R1,590 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 R3,150 co-payment for day hospitals and R5,850 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 R2,630 per scan.
📉 Medical and Surgical Appliances, for instance, support stockings, back braces, etc.	Covers up to R7,950 per family per year.
🦵 Internal Prostheses	Cochlear implants: R210,00 per recipient, maximum of 1 procedure per year Intraocular lenses: R8,220 per recipient per event, maximum 2 events per year Other internal prostheses: R79,400 per recipient per event, with a maximum of two yearly events.
🦾 External Prostheses	There is up to R27,600 available per family.
🧠 Mental Health, including psychiatry, psychology, drug, and alcohol rehabilitation	Covers up to R43,600 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 R64,000 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 R83,300 per family.

Note: If the State cannot provide you with the necessary chronic medication, you may acquire it through Ingwe Primary Care Network providers, subject to a Network formulary and Scheme approval.

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 accrue 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:

Main Member – R27,500
Adult Dependent – R23,900
Child Dependent – R7,900

🔎 Provider	Any or connected. Members who have chosen Associated as their chronic care provider must see a Doctor affiliated with Associated.
📌 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 R22,700 per family.
🪥 Basic Dentistry	Unlimited within the provisions of General Rule.
🦷 Specialized Dentistry	R15,500 for each recipient and R40,400 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 an R1,590 co-payment and pre-authorization.
🩺 External Medical Devices: (Including hearing aids, glucometers, blood pressure monitors, wheelchairs, etc.)	R28,100 per household Sub-limit of R8,480 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 R4,770 per beneficiary. There is a sub-limit of R2,600 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 R2,630 per scan and prior authorization.
💊 Prescribed medication	There is a limit of R20,000 per beneficiary. There is a limit of R37,900 per family.
🅰️ Over-the-Counter Medication	Subject to medical savings if funds are available. Does not accumulate to the annual threshold.

Benefits are contingent on the availability of Savings, and claims are paid at cost with no sub-limits.

POLL: 5 Best Medical Insurance Plans

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

These benefits are limited to PMBs and are covered at State Facilities

Read more about the 10 Best Medical Aids in South Africa

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 Annexure D 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	🥈 Sasolmed Comprehensive	🥉 Platinum Health PlatFreedom
👤 Main Member Contribution	R6,589 ZAR	R
👥 Adult Dependent Contribution	R4,997 ZAR		R
👶 Child Dependent Contribution	R1,937 ZAR		R
🔁 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.

You might also like the Momentum Summit

You might also like the Momentum Ingwe

You might also like the Momentum Incentive

You might also like the Momentum Evolve

Momentum Extender Plan Frequently Asked Questions

What is Momentum Extender Plan?

The Momentum Medical Aid Extender Plan is a medical aid plan offered by Momentum Health that provides comprehensive coverage for a range of healthcare services.

What coverage can I expect from the Momentum Extender Plan?

The plan offers coverage for hospitalization in private hospitals and chronic treatments. Members have the flexibility to choose between accessing any doctor and pharmacy or a list of associated doctors and Medipost courier pharmacies, which can result in monthly contribution savings.

What is the cost for the Momentum Extender Plan?

The starting price for the Momentum Extender Medical Aid Plan is R6589 ZAR.

Does Momentum Extender Plan offer medical emergency assistance?

Up to five family members can receive 24/7 medical emergency assistance with the Momentum Extender Medical Aid Plan.

Does the Momentum Extender Plan come with a medical savings account?

Yes, a medical savings account is one of the features of this plan.

Adriaan Schoeman

Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.