Momentum Medical Scheme
Open scheme · ~3rd-largest open scheme · Administered by Momentum Health Solutions
Momentum 2027 contributions: what changed, option by option →
Overview
Momentum Medical Scheme (formerly Momentum Health Medical Scheme) is a registered non-profit open medical scheme regulated by the Council for Medical Schemes under the Medical Schemes Act. It is South Africa's third-largest open medical scheme and is administered by Momentum Health Solutions, the same group that from 1 June 2026 also administers Bonitas Medical Fund and continues to administer the Government Employees Medical Scheme (GEMS).
Sources: Momentum Medical Scheme 2024 marketing brochure; IOL, "Momentum becomes second-largest medical aid administrator as earnings rise" (19 Mar 2026).
Membership Profile
Momentum Medical Scheme is the third-largest open medical scheme in South Africa. The Scheme reports a younger-than-average beneficiary profile by open-scheme standards — average age 34.7 years (2023) — which contributes to its risk-pool stability and pricing position.
Membership requirements
Open to any South African resident; no employer, industry or professional restrictions. Standard Medical Schemes Act waiting periods (general three months, condition-specific twelve months) and late-joiner penalty rules apply.
Sources: Momentum Medical Scheme 2024 brochure; Discovery Health, "Medical scheme comparison" (Momentum Health benchmark, 2024).
Financial Health
Momentum Medical Scheme reports a statutory solvency ratio in excess of 31%, well above the regulated 25% minimum. The Scheme has historically positioned itself as financially stable and conservatively reserved.
Contribution position
The 2026 average annual contribution increase was 9.9%, among the higher increases in the open-scheme market and notably above CPI of approximately 5%. The Scheme has confirmed no benefit reductions for 2026.
Sources: Aon EB Alert — Momentum Medical Scheme 2026; Moonstone, "Contribution increases ease slightly — except for one scheme".
Plans & Options
Momentum Medical Scheme offers 6 plan options, organised from entry-level network plans to a top-tier comprehensive plan. The Scheme uses a Provider-Choice model on most plans (Associated, Any, or Plus) which sets the network width and a corresponding contribution tier.
| Plan | Category | Day-to-day model | From (2026) |
|---|---|---|---|
| Ingwe | Entry-level network | Insured GP & basic dentistry on network | Income-banded |
| Evolve | Network hospital + day-to-day | Network day-to-day | R2,029 pm |
| Custom | Hospital + chronic | Hospital plan | R2,585 pm |
| Incentive | Savings (10% MSA) | MSA | R3,362 pm |
| Extender | Comprehensive | MSA + ATB | R7,939 pm |
| Summit | Top-tier comprehensive | Unlimited MSA + ATB | Upper |
Sources: Momentum Health 2026 Brochure; medicalaid.com — Momentum 2026 plan pages; Aon EB Alert — Momentum 2026.
Key Benefits & Differentiators
Provider-Choice model. Most Momentum plans separate the network decision from the plan decision: members select the same benefit set but at different contribution levels depending on whether they want Associated (defined network), Any (open-provider), or Plus (premium-network) access. This is a relatively unusual structure in the SA market.
HealthSaver — separate savings vehicle. Momentum offers a HealthSaver product separate from the medical scheme's medical savings account: members can voluntarily contribute additional, tax-friendly funds to cover non-PMB, day-to-day expenses, and unspent balances do not lapse annually.
Real Rewards (when combined with Multiply). Members combining Momentum Medical Scheme with Multiply (Momentum's wellness programme) and other Momentum financial services receive integrated rewards across the product set.
Chronic, oncology and mental health
All plans cover the 27 PMB Chronic Disease List conditions. Mid-tier and above add a defined additional chronic list. Oncology cover follows defined Rand thresholds with ICON protocol management; ex-gratia review is available for cases falling outside protocol. Mental health benefits include PMB-level cover on all plans, with additional outpatient psychology consultations on mid-tier and above.
Sources: Momentum 2026 Plan Brochures; HealthSaver Application form (2024); Multiply programme overview.
Wellness & Loyalty
Momentum operates Multiply, a separately priced rewards programme that spans health, motor, education, and shopping rewards. Multiply integrates with Momentum Medical Scheme by funding preventive screenings, dental check-ups, and wellness assessments, and by rewarding members for healthy behaviour (exercise tracking, screenings completed, no claims).
Source: Momentum Multiply 2026 programme overview.
Claims & Service
Claims can be submitted via the Momentum app, the online member portal, email, or by provider direct-billing. Momentum Health Solutions operates one of the larger administrator platforms in South Africa, having recently become the second-largest medical aid administrator in the country following the Bonitas contract award and continued GEMS administration.
Service details
Dispute resolution follows the standard CMS process: internal dispute committee → CMS adjudication.
Source: IOL, "Momentum becomes second-largest medical aid administrator as earnings rise" (19 Mar 2026).
How the Scheme Is Set Up
Momentum Medical Scheme's compact 6-plan range, Provider-Choice flexibility, and younger demographic is designed around: younger working professionals who want to choose a benefit set independently of network width (Provider-Choice); families wanting integrated rewards across multiple Momentum products (Multiply, life insurance, retirement); and members on the Custom or Extender plans seeking traditional hospital + chronic cover with the option to top-up via HealthSaver.
The 2026 contribution increase (9.9%) was at the upper end of the open-scheme range, which may matter for price-sensitive prospective members.
Source: Momentum 2024 Marketing Brochure; medicalaid.com Momentum plan comparison.
Each plan in detail
One page per plan: contributions and what it covers, in Momentum’s own words, with the source for every line.
- Custom (Any hospital, Any chronic)
- Custom (Any hospital, Associated chronic)
- Custom (Any hospital, State chronic)
- Custom (Associated hospitals, Any chronic)
- Custom (Associated hospitals, Associated chronic)
- Custom (Associated hospitals, State chronic)
- Evolve
- Extender (Any hospital, Any chronic)
- Extender (Any hospital, Associated chronic)
- Extender (Any hospital, State chronic)
- Extender (Associated hospitals, Any chronic)
- Extender (Associated hospitals, Associated chronic)
- Extender (Associated hospitals, State chronic)
- Incentive (Any hospital, Any chronic)
- Incentive (Any hospital, Associated chronic)
- Incentive (Any hospital, State chronic)
- Incentive (Associated hospitals, Any chronic)
- Incentive (Associated hospitals, Associated chronic)
- Incentive (Associated hospitals, State chronic)
- Ingwe (any)
- Ingwe (connect)
- Ingwe (ingwe)
- Summit
Programmes you have to ask for
7 of these 13 programmes do not start on their own. You have to register, apply or get authorisation before the benefit applies — and until you do, you are paying for cover you are not receiving.
Read from Momentum Medical Scheme’s own documents. Each page quotes the wording and names the source. Compare programmes across every scheme →