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Momentum Ingwe Medical Aid Plan

Overall, the Momentum Ingwe 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 Ingwe Medical Aid Plan starts from R541 ZAR.

👤 Main Member Contribution	R541 – R3,760
👥 Adult Dependent Contribution	R541 – R3,760
💙 Child Dependent Contribution	R466 – R1,091
🔁 Gap Cover	☑️ Yes
🏥 Hospital Cover	Unlimited
💶 Prescribed Minimum Benefits (PMB)	☑️ Yes
📉 Screening and Prevention	☑️ Yes
💳 Medical Savings Account	None
🍼 Maternity Benefits	☑️ Yes
🏠 Home Care	☑️ Yes

Momentum Ingwe Plan Review – 7 Key Point Quick Overview

☑️ Momentum Ingwe Plan Overview
☑️ Momentum Ingwe Plan Contributions
☑️ Ingwe Plan Benefits and Cover Comprehensive Breakdown
☑️ Ingwe Plan Exclusions and Waiting Periods
☑️ Momentum Ingwe Plan vs. Similar Plans from other Medical Schemes
☑️ Our Verdict on The Ingwe Plan
☑️ Momentum Ingwe Plan Frequently Asked Questions

Momentum Ingwe Plan Overview

The Momentum Ingwe medical aid plan is one of 6, starting from R541, 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 Ingwe 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 Ingwe Plan Contributions

🔎 Monthly Income	🏥 Hospital Provider	⚕️ Chronic Network	💙 Day-To-Day Network	👤 Main Member Only	👥 Two Adults	2️⃣ One Adult + One Child	3️⃣ Two Adults + One Child	4️⃣ Two Adults + Two Children	5️⃣ Two Adults + Three Children
✅ <R775	State	Ingwe Primary Care	Ingwe Primary Care Network	R541	R1082	R1007	R1548	R2014	R2480
✅ <R775	Ingwe Network	Ingwe Primary Care	Ingwe Primary Care Network	R541	R1082	R1029	R1570	R2058	R2546
✅ <R775	Any	Ingwe Active Network	Ingwe Active network	R541	R1082	R1082	R1623	R2164	R2705
☑️ R776 – R7,750	State	Ingwe Primary Care	Ingwe Primary Care Network	R942	R1,884	R1450	R2392	R2900	R3408
☑️ R776 – R7,750	Ingwe Network	Ingwe Primary Care	Ingwe Primary Care Network	R1184	R2368	R1726	R2910	R3452	R3994
☑️ R776 – R7,750	Any	Ingwe Active Network	Ingwe Active network	R1538	R3076	R2148	R3686	R4296	R4906
✅ R7,751 – R10,250	State	Ingwe Primary Care	Ingwe Primary Care Network	R1078	R2156	R1599	R2677	R3198	R3719
✅ R7,751 – R10,250	Ingwe Network	Ingwe Primary Care	Ingwe Primary Care Network	R1507	R3014	R2071	R3578	R4142	R4706
✅ R7,751 – R10,250	Any	Ingwe Active Network	Ingwe Active network	R2151	R4302	R2801	R4952	R5602	R6252
☑️ R10,251 – R14,600	State	Ingwe Primary Care	Ingwe Primary Care Network	R1259	R2518	R1803	R3062	R3606	R4150
☑️ R10,251 – R14,600	Ingwe Network	Ingwe Primary Care	Ingwe Primary Care Network	R2069	R4138	R2678	R4747	R5336	R5965
☑️ R10,251 – R14,600	Any	Ingwe Active Network	Ingwe Active network	R2930	R5860	R3613	R6543	R7226	R7909
✅ R14,601>	State	Ingwe Primary Care	Ingwe Primary Care Network	R2174	R4348	R2827	R5001	R5654	R6307
✅ R14,601>	Ingwe Network	Ingwe Active Network	Ingwe Primary Care Network	R2970	R5940	R3845	R6815	R7690	R8565
✅ R14,601>	Any	Ingwe Active Network	Ingwe Active network	R3760	R7520	R4851	R8611	R9702	R10793

Ingwe Plan Benefits and Cover Comprehensive Breakdown

Major Medical Benefits

Depending on your chosen provider, this benefit provides coverage for hospitalization and certain specialized procedures/treatments. Furthermore, you can receive this benefit at any hospital, private hospitals in the Ingwe Network, or State hospitals, and up to 100% of the Momentum Medical Scheme Rate will be covered. The hospitalization benefit covers hospital accounts and related costs incurred during the hospital stay, from admission to discharge, if the treatment has been approved. The benefit for specialized procedures/treatments is included in the Major Medical Benefit and may not require hospitalization. However, it is covered, assuming it is clinically appropriate and authorized.

Hospitalization

Specialists are reimbursed up to 100% of the Momentum Medical Scheme Rate. In addition, hospital accounts are fully covered at the agreed-upon rate with the hospital group.

🔎 High and Intensive Care	Limited to 10 days per admission.
📌 Renal Dialysis and Oncology	Only PMBs are covered at State Hospitals.
❤️ Organ Transplants	Only PMBs are covered at State Hospitals.
🍼 Maternity confinements	No annual limit.
👶 Neonatal Intensive Care	No annual limit.
🦾 Medical and Surgical Appliances, for instance, support stockings, back braces, etc.	Covers up to R6,100 per family per year.
📍 Internal Prostheses	Only PMBs are covered at State Hospitals.
✔️ External Prostheses	Only PMBs are covered at State Hospitals.
🩺 MRI and CT scans	Only PMBs are covered at State Hospitals.
🧠 Mental Health, including psychiatry, psychology, drug, and alcohol rehabilitation	Only PMBs are covered at State Hospitals. 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.
🚑 Alternatives to Hospitalization, such as step-down facilities	There is a limit of R15,100 per beneficiary.
💉 Immune Deficiency – HIV	This can be done at any network provider of the member’s choosing.
📈 Anti-retroviral Treatments	There is a limit of R36,500 per family.
📉 HIV-related hospital admissions	There is a limit of R37,000 per family.

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Specialized Procedures and Treatment

Specific specialized procedures/treatments are covered in and out-of-hospital (when clinically appropriate).

Chronic Benefit

The Chronic Benefit covers certain life-threatening conditions requiring ongoing treatment. On the Ingwe Option, chronic benefits are offered through the Ingwe Primary Care Network or the Ingwe Active Network. The Chronic Disease List, part of the Prescribed Minimum Benefits, specifies coverage for 26 chronic conditions. Furthermore, all chronic benefits are subject to approval and registration.

Day-to-day Benefit

This benefit covers routine medical expenses, such as doctor’s visits and prescription medication. In addition, on the Ingwe Option, the Ingwe Primary Care Network or Ingwe Active Network provides day-to-day benefits. Additionally, you are covered for three virtual consultations per year through the Virtual GP Consultation Network, which consists of Hello Doctor.

🔎 Allied Health Professionals such as Homeopaths, Naturopaths, Chiropractors, etc.	Only PMBs are covered, and state facilities must be used.
❤️ Mental Health Benefits	Only PMBs are covered, and state facilities must be used.
🦷 Basic Dentistry (fillings, extractions, etc.)	Examinations, fillings, and x-rays according to the tariff codes. Each beneficiary is entitled to one dental consultation per year. You must contact Momentum for pre-authorization if you have more than four fillings or extractions.
👩‍⚕️ General Practitioners (GPs)	Primary Care Network GP visits are unlimited. However, all visits from the 11th onward must be pre-authorized 3 virtual consultations per year from the Virtual GP Consultation Network, which includes Hello Doctor. Medication is prescribed during consultations.
⏰ Out-of-network GPS – casualties or after-hour visits	One visit per beneficiary per year, subject to authorization (the authorization must be obtained within 72 hours of the consultation to avoid a 30% co-payment and Momentum Medical Scheme covering 70% of the negotiated tariff). Two visits per family per year with R100 co-payment.
👨‍⚕️ Specialist Consultations	Two visits per family per year, maximum R2 440. 100% Momentum Medical Scheme Rate coverage. Your Primary Care Network provider must refer and pre-authorize. State facilities limit psychologists and psychiatrists to Prescribed Minimum Benefits.
🦵 Physiotherapy	This benefit is included in the Specialist Limit
🤓 Optometry and Optical, including glasses, contact lenses, refractive eye surgery, etc.	One eye exam and 1 pair of clear standard or bi-focal lenses with standard frame per beneficiary every 2 years. Your refraction measurement must be over 0.5 to receive glasses.
📌 Pathology (basic tests, including cholesterol)	There is a specified list of pathology tests covered.
❌ Radiology (basic scans such as X-Rays)	A specified list of black and white X-Rays is covered under this benefit.
📍 MRI, CT, PET scans, etc.	Only PMBs are covered, and state facilities must be used.
💊 Prescribed Medication	Subject to a predefined list of medicine as per the prescribed formulary.

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Health Platform Benefit

The Ingwe Primary Care Network and the Ingwe Active Network offer the Health Platform Benefit. Through a variety of programs, this benefit promotes health awareness, improves the quality of life, and provides peace of mind.

Preventative Care

🔎 Benefit	➡️ Eligibility	☑️ Frequency
🍼 Baby immunizations: R2 650 in private facilities for the first year. After the limit, the Department of Health baby clinics offers immunizations.	Children up to 6.	According to the Department of Health (DOH).
💉 Flu Vaccines	Children 6 months – 5 Years Beneficiaries 60 and older are high-risk beneficiaries	Once yearly
📌 Tetanus diphtheria Injection	All beneficiaries	As required

Early Detection Testing

🔎 Benefit	☑️ Eligibility	📉 Frequency
🦷 Dental Consultations	All	Once yearly
📌 Pap Smear and GP consult	Women 15>	Once yearly
👨‍⚕️ 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
✳️ HIV Testing	Beneficiaries 15>	Once every 5 years

Maternity Program

Only women who are registered in the program and who are not subject to waiting periods. Babies up to 1 year who are registered on the Maternity Programme

🔎 Benefit	☑️ Frequency
📌 Antenatal visits with a GP, Midwife, or gynecologist	7 Visits
👩‍⚕️ Nurse visits to the home of the pregnant member	1 Visit after discharge from the hospital following childbirth
🧪 Urine Testing using a dipstick	Included in the Antenatal visits
🩸 Blood Group, full blood count, hemoglobin estimation, and Rhesus Factor	1 Test
🅰️ Urinalysis	7 Tests
🅱️ Urine tests, including microscopic exams, etc.	As needed
✅ Scans and Ultrasounds	2 scans
🩺 Pediatrician Visitations	1 visit within the baby’s first year

Health Management Programs

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

🔎 Benefit	☑️ Eligibility	📉 Frequency
1️⃣ Cholesterol	All beneficiaries who are registered in the program.	As Required
2️⃣ Chronic Renal Failure	All beneficiaries who are registered in the program.	As Required
3️⃣ Diabetes	All beneficiaries who are registered in the program.	As Required
4️⃣ Drug and Alcohol Rehabilitation	All beneficiaries who are registered in the program.	As Required
5️⃣ HIV/AIDS	All beneficiaries who are registered in the program.	As Required
6️⃣ Hypertension (Cardio Care)	All beneficiaries who are registered in the program.	As Required
7️⃣ Mental Health	All beneficiaries who are registered in the program.	As Required
8️⃣ Oncology	All beneficiaries who are registered in the program.	As Required
9️⃣ Organ Transplants	All beneficiaries who are registered in the program.	As Required

Ingwe Plan Exclusions and Waiting Periods

Exclusions

Members of Momentum must note that while there are limitations and exclusions, 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 at the time of 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
Traveling expenses (excluding 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 Ingwe 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.

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Momentum Ingwe Plan vs. Similar Plans from other Medical Schemes

🔎 Medical Aid Plan	🥇 Momentum Ingwe Plan	🥈 Bonitas BonStart	🥉 KeyCare Start Regional
🌎 International Cover	Up to R9.01 million	R10 million	None
👤 Main Member Contribution	R541	R1,378	R1,102
👥 Adult Dependent Contribution	R541	R1,378	R1,102
💙 Child Dependent Contribution	R466	R1,378	R664
🔁 Gap Cover	☑️ Yes	☑️ Yes	☑️ Yes
🏥 Hospital Cover	Unlimited	Unlimited	Network Hospital in the member’s region only – Unlimited
📉 Prescribed Minimum Benefits (PMB)	☑️ Yes	☑️ Yes	☑️ Yes
📊 Screening and Prevention	☑️ Yes	☑️ Yes	☑️ Yes
💶 Medical Savings Account	None	None	None

Our Verdict on The Ingwe Plan

The Momentum Ingwe option is a medical scheme that provides affordable medical coverage to individuals and families who prefer private healthcare facilities in South Africa. Furthermore, Ingwe Covers hospitalization and specialized procedures/treatments at Any hospital, the Ingwe Network of private hospitals, or State hospitals. The scheme also provides Prescribed Minimum Benefits to all beneficiaries, regardless of their health status. There is a limited network of private healthcare facilities, and many treatments are subject to the use of State facilities and not private hospitals. Furthermore, authorization is required for most treatments, which could delay access to certain services.

However, while Ingwe has some limitations, the plan is an entry-level option that still provides good value for money for individuals and families who prioritize affordability and access to quality medical care.

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Momentum Ingwe Plan Frequently Asked Questions

What is the Momentum Ingwe option?

The Ingwe Option offers affordable entry-level coverage. There is no annual maximum for hospitalizations. Members can choose to use any hospital, the Ingwe Network of private hospitals, or State hospitals for an even lower monthly premium.

Which hospitals does Momentum Ingwe Cover?

Momentum covers over 100 hospitals across South Africa. The hospitals you have access to will depend on your chosen option, whether State, Ingwe Network or any hospital in South Africa, Private or State.

What does Ingwe cover?

Depending on the provider you select, this benefit covers hospitalization and certain specialized procedures/treatment at any hospital, the Ingwe Network of private hospitals, or State hospitals. Claims up to 100% of the Momentum Medical Scheme Rate are covered.

What are the notable pros of the Momentum Ingwe Plan?

The notable pros of the Momentum Ingwe Plan include comprehensive hospitalization benefits, access to private hospitals and State hospitals, coverage for major medical benefits, and a wide range of additional benefits, such as dental, optometry, and pathology.

How much is the Momentum Ingwe Plan in 2024?

The Momentum Ingwe plan starts from R541 for the main member, making it one of the cheapest medical aid plans in South Africa for 2024.

Are there waiting periods for certain benefits under the Momentum Ingwe Plan?

Yes, there are waiting periods for certain benefits, such as maternity benefits and pre-existing conditions, as specified in the Plan Rules.

Does Momentum Ingwe cover dental?

Momentum Ingwe only covers basic dentistry, such as fillings and extractions.

Does the Momentum Ingwe Plan cover oncology treatment?

Yes, the Momentum Ingwe Plan covers oncology treatment, including chemotherapy and radiotherapy, as well as prescribed medication and related consultations.

Does the Momentum Ingwe Plan cover teeth whitening?

No, the Momentum Ingwe Plan does not cover cosmetic dental procedures, such as teeth whitening, as these are not deemed medically necessary.

Does Momentum Ingwe cover pregnancy?

On the Ingwe Option, antenatal visits, including urine dipstick tests, are covered by your Ingwe Primary Care Network general practitioner, gynecologist, or registered midwife.

What are the notable cons of the Momentum Ingwe Plan?

The notable cons of the Momentum Ingwe Plan include certain exclusions and limitations, such as waiting periods and co-payments, and the need to select healthcare providers to avoid out-of-pocket expenses carefully.

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.