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Momentum Custom (Associated hospitals, Any chronic)

A hospital plan. It pays for hospital admissions; day-to-day costs are your own. Hospital cover is on Momentum’s hospital network.

In Momentum’s words

“The Custom Option provides cover for hospitalisation at private hospitals. There is no overall annual limit for hospitalisation. You can choose to have access to any hospital or you can choose to save on your monthly contribution by selecting to use a specific list of private hospitals (referred to as Associated hospitals, see page 40 for this list).”
Momentum’s own words: “Overview”, 2027 Momentum Medical Scheme Marketing brochure, p9

Main member

R3 749

R4 068

Day to day

Own pocket

Own pocket

Hospitals

Network

Network

Chronic

26 conditions

26 conditions

Ask AURA about Custom (Associated hospitals, Any chronic)

Answers from Momentum’s own documents

At a glance

Plan type
Hospital plan
Hospitals
Network hospitals
Hospital and specialists
100% of Scheme tariff
Day-to-day costs
Your own
Chronic conditions
26
Cancer
R300 000 a year
Children you pay for
Up to 3
Children on the plan to age
21
Plan type
Hospital plan
Hospitals
Network hospitals
Hospital and specialists
100% of Scheme tariff
Day-to-day costs
Your own
Chronic conditions
26
Cancer
R300 000 a year
Children you pay for
Up to 3
Children on the plan to age
20

Monthly contributions

2027 rates take effect on 1 January 2027. You pay for up to 3 children.

Member20262027Change
Main memberR3 749R4 068+8.5%
Adult dependantR2 958R3 210+8.5%
ChildR1 322R1 434+8.5%

Benefits

Momentum has published its full 2027 rules, but we hold only the main rows so far. A row without a 2027 entry shows the 2026 rule, marked.

Benefits in force for 2026.

In hospital

Hospitals
Network hospitals only (Associated Hospital Network)
Momentum Annexure B(3) 2026 (Custom), p1
Hospitals
Network hospitals only (Associated Hospital Network)
2027 Momentum Medical Scheme Marketing brochure, p3
Specialists in hospital
100% of Scheme tariff. A specialist who charges more leaves a shortfall.
Specialists in hospital
100% of Scheme tariff. A specialist who charges more leaves a shortfall.
2027 Momentum Medical Scheme Marketing brochure, p3

Chronic and cancer

Chronic conditions
26 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
Chronic conditions
26 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
2027 Momentum Medical Scheme Marketing brochure, p3
Cancer
Up to R300 000 a year.
Momentum Annexure B(3) 2026 (Custom), p14
Cancer
Up to R300 000 a year.
2027 Momentum Medical Scheme Marketing brochure, p10

Day to day

Maternity
Maternity Programme, paid from savings.
Momentum Focus on the Maternity Programme
Maternity
Maternity Programme, paid from savings.
2027 Momentum Medical Scheme Marketing brochure, p17
Children on the plan
As dependants up to age 21.
Children on the plan
As dependants up to age 20.
GP visits
day-to-day benefits are limited to PMBs at State Network Providers subject to Regulation 8 (3) and Annexure
Momentum Annexure B(3) 2026 (Custom), p7
GP visits
Not covered.
Momentum Focus on Individual Contributions 2027, p1
Specialist visits
Limited to PMBs at State Hospital Network facilities subject to part (4) in Annexure D
Momentum Annexure B(3) 2026 (Custom), p10
Specialist visits
Not covered.
Momentum Focus on Individual Contributions 2027, p1
Prescribed medicine (acute)
Not covered.
Momentum Annexure B(3) 2026 (Custom), p13
Prescribed medicine (acute)
Not covered.
Momentum Focus on Individual Contributions 2027, p1
Basic dentistry
1.1 Conservative Dentistry (basic, including preventative)
Momentum Annexure B(3) 2026 (Custom), p10
Basic dentistry
Not covered.
Momentum Focus on Individual Contributions 2027, p1
Eyes (optometry)
Not covered.
Momentum Annexure B(3) 2026 (Custom), p16
Eyes (optometry)
Not covered.
Momentum Focus on Individual Contributions 2027, p1
Basic X-rays
1.2 Out-of-hospital PMBs only
Momentum Annexure B(3) 2026 (Custom), p11
Basic X-rays
Not covered.
Momentum Focus on Individual Contributions 2027, p1
Blood tests (pathology)
2. Out-of-hospital PMBs only
Momentum Annexure B(3) 2026 (Custom), p11
Blood tests (pathology)
Not covered.
Momentum Focus on Individual Contributions 2027, p1

Full benefit list

Every benefit we hold for Custom (Associated hospitals, Any chronic), in Momentum’s own wording, from its 2026 documents. Momentum’s full 2027 list is not in our records yet.

In hospital

Surgery and anaesthetics
100% of MMSR
Momentum Annexure B(3) 2026 (Custom), p9
Hospital stay and theatre
Accommodation in a general ward, high care ward and intensive care unit
Momentum Annexure B(3) 2026 (Custom), p9
Day procedures
A standard co-payment of R2 000 is payable per authorisation for all Hospital admissions, including Dental admissions.
Momentum Annexure B(3) 2026 (Custom), p4
Day procedures
failing which a co-payment of 30% on the whole event shall apply and the Scheme will be responsible for 70% of the negotiated tariffs
Momentum Annexure B(3) 2026 (Custom), p6
Step-down and sub-acute care
R67 000 per family – subject to PMBs
Momentum Annexure B(3) 2026 (Custom), p9
Mental health admissions
Costs covered in chosen Network Provider hospital subject to part (4) in Annexure D, limited to R47 300 p.b. per annum
Momentum Annexure B(3) 2026 (Custom), p11
Birth (in hospital)
Costs covered in Network Provider hospitals subject to part (4) in Annexure D
Momentum Annexure B(3) 2026 (Custom), p12
Procedures in the doctor’s rooms
Specialised Procedures/Treatment as listed in Annexure F
Momentum Annexure B(3) 2026 (Custom), p17
Cancer treatment
R300 000 p.b. per annum, after limit is reached; a 20% co-payment will apply.
Momentum Annexure B(3) 2026 (Custom), p14
Dialysis
1. Acute Renal Dialysis 100% of MMSR No limit
Momentum Annexure B(3) 2026 (Custom), p15
Organ and stem cell transplants
R26 000 for Cadaver donor costs; R53 000 for Live related donor costs (including transport) - Subject to PMBs
Momentum Annexure B(3) 2026 (Custom), p15
Internal prostheses
R62 000 p.b per event, maximum of 2 events per year
Momentum Annexure B(3) 2026 (Custom), p16
HIV/AIDS
R89 500 per family subject to the Hospital benefit above - subject to PMBs
Momentum Annexure B(3) 2026 (Custom), p18
Medicine on discharge
To Take Home Medication 100% of MMSR Limited to 7 days’ supply
Momentum Annexure B(3) 2026 (Custom), p9
Medical appliances
R8 400 per family
Momentum Annexure B(3) 2026 (Custom), p17

Day to day

GP visits
day-to-day benefits are limited to PMBs at State Network Providers subject to Regulation 8 (3) and Annexure
Momentum Annexure B(3) 2026 (Custom), p7
Specialist visits
Limited to PMBs at State Hospital Network facilities subject to part (4) in Annexure D
Momentum Annexure B(3) 2026 (Custom), p10
Casualty visits
3.1 Emergency Casualty 100% of Cost No limit
Momentum Annexure B(3) 2026 (Custom), p9
Prescribed medicine (acute)
Not covered. 2. Prescribed acute medication No Benefit No Benefit
Momentum Annexure B(3) 2026 (Custom), p13
Over-the-counter medicine
Not covered. 1. Over-the-counter medication (Incl. Vitamins) No Benefit No Benefit
Momentum Annexure B(3) 2026 (Custom), p13
Chronic medicine (Chronic Disease List)
Chronic medication for CDLs as contained in the PMBs, dispensed by the chosen Network Provider
Momentum Annexure B(3) 2026 (Custom), p13
Chronic medicine (other conditions)
Not covered. Unless a benefit is a PMB, if it is not explicitly listed, it is not covered
Momentum Annexure B(3) 2026 (Custom), p8
Basic dentistry
1.1 Conservative Dentistry (basic, including preventative)
Momentum Annexure B(3) 2026 (Custom), p10
Specialised dentistry
1.2 Specialised Dentistry PMBs only
Momentum Annexure B(3) 2026 (Custom), p10
Eyes (optometry)
Not covered. 1. Frames No Benefit No Benefit
Momentum Annexure B(3) 2026 (Custom), p16
Blood tests (pathology)
2. Out-of-hospital PMBs only
Momentum Annexure B(3) 2026 (Custom), p11
Basic X-rays
1.2 Out-of-hospital PMBs only
Momentum Annexure B(3) 2026 (Custom), p11
MRI, CT and PET scans
2.2 Out-of-hospital PMBs only
Momentum Annexure B(3) 2026 (Custom), p11
Physiotherapy and other therapists
2. Out-of-hospital PMBs only
Momentum Annexure B(3) 2026 (Custom), p9
Alternative healthcare
Acupuncturist, Physiotherapy, Homeopathy, Naturopathy, Herbology, Audiology,
Momentum Annexure B(3) 2026 (Custom), p8
Psychologist and counselling visits
3. Out-of-hospital PMBs only Limited to PMBs at State Hospital Network
Momentum Annexure B(3) 2026 (Custom), p11
Maternity care (out of hospital)
12 antenatal visits per confinement (Subject to registration on the maternity management programme)
Momentum Annexure B(3) 2026 (Custom), p12
Contraceptives
Not covered. Unless a benefit is a PMB, if it is not explicitly listed, it is not covered
Momentum Annexure B(3) 2026 (Custom), p8
Care after a hospital stay
Not covered. Unless a benefit is a PMB, if it is not explicitly listed, it is not covered
Momentum Annexure B(3) 2026 (Custom), p8

Screening and prevention

Screening and prevention
Full general physical examination by a chosen Network Provider according to the following age bands
Momentum Annexure B(3) 2026 (Custom), p19

Conditions

The Chronic Disease List conditions are Prescribed Minimum Benefits on every medical aid. How each one works on a medical aid:

Momentum’s 2026 documents name no chronic conditions beyond the Chronic Disease List on Custom (Associated hospitals, Any chronic).

Questions about Custom (Associated hospitals, Any chronic)

Answered from Momentum’s documents.

How does Momentum describe Custom (Associated hospitals, Any chronic)?

In Momentum’s own words (2027 Momentum Medical Scheme Marketing brochure, p9): “The Custom Option provides cover for hospitalisation at private hospitals. There is no overall annual limit for hospitalisation. You can choose to have access to any hospital or you can choose to save on your monthly contribution by selecting to use a specific list of private hospitals (referred to as Associated hospitals, see page 40 for this list).”

How much does Custom (Associated hospitals, Any chronic) cost in 2027?

From 1 January 2027: R4 068 a month for the main member, R3 210 for an adult dependant and R1 434 for a child. You pay for up to 3 children.

How much is Custom (Associated hospitals, Any chronic) going up for 2027?

For the main member, from R3 749 to R4 068 a month, +8.5%.

What is the difference between Custom (Associated hospitals, Any chronic) and Custom (Any hospital, Any chronic)?

Custom (Associated hospitals, Any chronic) uses Momentum’s hospital network; Custom (Any hospital, Any chronic) lets you use any hospital. In 2027 the main member pays R4 068 on Custom (Associated hospitals, Any chronic) and R4 852 on Custom (Any hospital, Any chronic).

Does Custom (Associated hospitals, Any chronic) pay for GP visits and day-to-day costs?

No. Custom (Associated hospitals, Any chronic) is a hospital plan, so day-to-day costs are your own.

How many chronic conditions does Custom (Associated hospitals, Any chronic) cover?

26: the 27 on the Chronic Disease List and others the scheme adds.

Until what age can children stay on as dependants?

Up to age 20 in 2027 (21 in 2026).

Will I have a shortfall if my specialist charges more?

Custom (Associated hospitals, Any chronic) pays specialists in hospital at 100% of the Scheme tariff. If a specialist charges more than that, the difference is a shortfall. Gap cover is the product that pays shortfalls.

Compare my picks →On this plan? Get help with it →Custom (Any hospital, Any chronic) →All Momentum plans →Momentum 2027 price changes →Gap cover →

Factual information from Momentum Medical Scheme’s published documents. It is not advice. Compiled by Eldon de Waal, CFA, the licensed advisor behind AURA. Catalogue v175, built 2026-10-19.

© 2026 Silverhurst Wealth Partners (Pty) Ltd. Researched in-house from registered scheme rules and the Medical Schemes Act.

Quote it, link to it and cite it — AI systems included. Do not republish it, in any form, without attribution.

SWP-custom-associated-hospitals-any-chronic-2026.10-1c4894aa · last checked 2026-10-19