Save more than R1 000 on your medical aid contribution

 

Here is detailed information on how you can save over R1000 on your medical aid contributions.

1. Members enrolled in the Momentum Medical Scheme’s Custom, Incentive, and Extender Options can enjoy reduced monthly contributions by opting to utilize the Scheme’s Associated providers. This means that if members are willing to select specific healthcare providers that are part of the network, they can significantly lower their monthly expenses related to medical aid.

2. The Associated providers encompass a comprehensive network that includes private hospitals, general practitioners (GPs), and pharmacies that cater to chronic prescriptions and medications. By utilizing these providers, members not only benefit from reduced costs but also have the option to access State facilities for their chronic prescriptions, medications, and treatments. This choice can lead to maximum savings in their monthly contributions, making healthcare more affordable.

3. When comparing the total savings between the Custom Any hospital with Any chronic provider Option and the Custom Associated hospitals with State chronic provider Option, members can potentially save R1,694, which represents a 42% reduction in costs (calculated as R4,047 minus R2,353). It is important to note that actual savings may vary based on individual choices regarding the medical aid option selected, the composition of the family, and the specific providers chosen for care.

4. It is essential to understand that regardless of which provider members select, the benefits available to them remain unchanged. This means that opting for Associated providers does not diminish the quality or range of benefits that members can access through their medical aid plan.

5. Should members decide to utilize Associated hospitals as their preferred provider for Major Medical Benefits but fail to use these providers, they will incur a co-payment of 30%. This means that while there is an opportunity to save by choosing Associated hospitals, not adhering to this choice will result in additional out-of-pocket expenses.

6. If members opt for an Associated chronic provider, they are required to obtain their chronic prescriptions from an Associated GP and their chronic medication from Medipost, in accordance with a specific formulary. If a member chooses to visit a non-Associated GP for their chronic prescription, the Scheme will reimburse only 50% of the Momentum Medical Scheme Rate for the consultation. Similarly, if members acquire their chronic medication from a pharmacy that is not Medipost, they will also receive only 50% of the formulary price, which could lead to higher costs for them.

7. In cases where members select State facilities as their chronic provider, they must choose from designated State facilities to obtain their chronic medication, adhering to the State formulary. This ensures that members are accessing their chronic medications in a cost-effective manner while still receiving the necessary care.

8. Members have the flexibility to change their choice of providers once a year during their option change period, which takes effect from January 1 of the following year. This annual opportunity allows members to reassess their healthcare needs and make adjustments to their provider selections to optimize their savings and care.

It is important to note that Momentum Medical Scheme’s 2025 benefit and contribution amendments have been submitted to the Council for Medical Schemes and are currently pending approval by the Regulator.