Focus on Momentum GroupSaver 2025

Below is information about focus on GroupSaver+

GroupSaver is an innovative complementary product designed to assist employer groups in managing and funding specific medical expenses, treatments, and procedures that are not covered by the Momentum Medical Scheme and/or Momentum Health4Me for their employees. This product aims to bridge the gap in healthcare coverage, ensuring that employees have access to necessary medical services that may otherwise be financially burdensome.

Who qualifies for GroupSaver?

GroupSaver is available to employer groups that have a workforce of more than 100 employees enrolled in either the Momentum Medical Scheme or Momentum Health4Me. This eligibility criterion allows larger organizations to take advantage of the GroupSaver benefits, providing their employees with enhanced medical coverage options that can significantly improve their overall healthcare experience.

How does it work?

GroupSaver operates as a funding mechanism that is established in the name of the employer. It creates a dedicated pool of funds specifically designed to enhance the benefits available for a predetermined list of medical treatments and procedures. Employers have the flexibility to determine the scope of this funding, deciding whether GroupSaver funds will be accessible to all employees covered under the medical schemes or limited to specific members based on their chosen options. For instance, an employer may opt to allocate funds exclusively for benefits that are not covered under certain plans, enabling targeted financial support for those particular treatments.

Furthermore, employers can impose limits on the funding, such as a rand cap or a maximum number of claims for specific procedures like MRI and CT scans, or they may set a limit per employee. It is essential for employers to collaborate with Momentum Health Solutions to establish clear rules regarding which employees can access these funds, as well as to define the benefits that will be covered and the healthcare providers that are eligible. This agreement is crucial during the setup of the GroupSaver contract, ensuring that sufficient funds are available for the anticipated claims. A minimum contribution of R100 per employee per month is required, with the possibility of a higher monthly contribution if a broader range of claims is included. Once the employer group confirms the number of eligible employees and the specific benefits to be covered, the Product Manager will draft a contract that outlines the monthly contribution per member prior to finalizing the agreement. Additionally, a monthly administrative fee will be charged per member, which is contingent upon the benefits covered by the GroupSaver.

Claims

When it comes to claims, an authorization number is issued once the benefits to be disbursed from the GroupSaver fund are approved. The adviser or employer plays a vital role in facilitating these claims, ensuring that there is proper control and awareness throughout the process. To keep all parties informed, monthly claims reports are generated and sent to both the employer and the adviser. Healthcare providers also receive claims statements following each payment cycle. It is important to note that GroupSaver claims are not reflected on the members’ claims statements, as the contractual relationship is established between the employer and Momentum, rather than directly with the individual employees.

+You may choose to make use of additional products available from Momentum Group Limited and its subsidiaries as well as Momentum Multiply (herein collectively referred to as Momentum). Momentum is not a medical scheme and is a separate entity to Momentum Medical Scheme. Momentum products are not medical scheme benefits. You may be a member of Momentum Medical Scheme without taking any of the products offered by Momentum.