At a glance
- Plan type
- Hospital plan with a savings account
- Hospitals
- Network hospitals
- Hospital and specialists
- 200% of Scheme tariff
- Savings account
- R533 a month for the main member (10%)
- Chronic conditions
- 32
- Cancer
- R400 000 a year
- Children you pay for
- Up to 3
- Children on the plan to age
- 21
- Plan type
- Hospital plan with a savings account
- Hospitals
- Network hospitals
- Hospital and specialists
- 200% of Scheme tariff
- Savings account
- R579 a month for the main member (10%)
- Chronic conditions
- 32
- Cancer
- R400 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.
| Member | 2026 | 2027 | Change |
|---|---|---|---|
| Main member | R5 333 | R5 787 | +8.5% |
| Adult dependant | R4 292 | R4 658 | +8.5% |
| Child | R1 993 | R2 163 | +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
200% of Scheme tariff. A specialist who charges more leaves a shortfall.
Specialists in hospital
200% of Scheme tariff. A specialist who charges more leaves a shortfall.
2027 Momentum Medical Scheme Marketing brochure, p3
Chronic and cancer
Chronic conditions
32 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
Chronic conditions
32 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
2027 Momentum Medical Scheme Marketing brochure, p3
Cancer
Up to R400 000 a year.
Momentum Annexure B(4) 2026 (Incentive), p13
Cancer
Up to R400 000 a year.
2027 Momentum Medical Scheme Marketing brochure, p12
Day to day
Medical savings account
10% of your contribution goes into a savings account for day-to-day costs.
Medical savings account
10% of your contribution goes into a savings account for day-to-day costs.
Momentum Focus on Individual Contributions 2027, p1
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
2.2 General practitioners 100% of Cost Savings – Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p8
GP visits
From Savings (10% of contribution); any provider; subject to available savings. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p1
Specialist visits
2.1 Medical specialists 100% of Cost Savings – Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p8
Specialist visits
From Savings (10% of contribution); any provider; subject to available savings. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p1
Prescribed medicine (acute)
2. Prescribed acute medication 100% of medication rate Savings
Momentum Annexure B(4) 2026 (Incentive), p13
Prescribed medicine (acute)
From Savings (10% of contribution); any provider; subject to available savings. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p1
Basic dentistry
1.1. Conservative Dentistry (basic, including 100% of Cost Savings – Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p9
Basic dentistry
From Savings (10% of contribution); any provider; subject to available savings. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p1
Eyes (optometry)
1. Frames 100% of Cost Savings
Momentum Annexure B(4) 2026 (Incentive), p15
Eyes (optometry)
From Savings (10% of contribution); any provider; subject to available savings. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p1
Basic X-rays
1.2 Out-of-hospital 100% of Cost Savings – subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p10
Basic X-rays
From Savings (10% of contribution); any provider; subject to available savings. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p1
Blood tests (pathology)
2. Out-of-hospital 100% of Cost Savings – subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p10
Blood tests (pathology)
From Savings (10% of contribution); any provider; subject to available savings. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p1
Full benefit list
Every benefit we hold for Incentive (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
1.1 Medical Specialists 200% of MMSR
Momentum Annexure B(4) 2026 (Incentive), p8
Hospital stay and theatre
1.1. Accommodation in a general ward, high 100% of MMSR
Momentum Annexure B(4) 2026 (Incentive), p8
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(4) 2026 (Incentive), p6
Step-down and sub-acute care
R70 000 per family per annum – subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p8
Mental health admissions
Costs covered in chosen Network Provider hospital subject to part (4) in Annexure D, limited to R50 600 p.b. per annum
Momentum Annexure B(4) 2026 (Incentive), p10
Birth (in hospital)
Costs covered in a Network Provider Hospitals subject to part (4) in Annexure D
Momentum Annexure B(4) 2026 (Incentive), p11
Procedures in the doctor’s rooms
Specialised Procedures/Treatment as listed in Annexure F
Momentum Annexure B(4) 2026 (Incentive), p16
Cancer treatment
Limited to R400 000 p.b per annum, after which limit is reached a 20% co-payment will apply
Momentum Annexure B(4) 2026 (Incentive), p13
Dialysis
Acute Renal Dialysis 100% of MMSR No limit.
Momentum Annexure B(4) 2026 (Incentive), p12
Organ and stem cell transplants
R28 700 for Cadaver donor costs; R59 000 for Live related donor costs (including transport) – subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p14
Internal prostheses
R67 000 p.b per event, maximum of 2 events per year
Momentum Annexure B(4) 2026 (Incentive), p15
HIV/AIDS
R96 800 per family subject to Hospital Benefit
Momentum Annexure B(4) 2026 (Incentive), p17
Medicine on discharge
To Take Home Medication 100% of MMSR Limited to 7 days’ supply
Momentum Annexure B(4) 2026 (Incentive), p8
Medical appliances
R8 800 per family
Momentum Annexure B(4) 2026 (Incentive), p15
Care after a hospital stay
Certain day-to-day care after a traumatic incident resulting from the following conditions will be covered
Momentum Annexure B(4) 2026 (Incentive), p18
Day to day
GP visits
2.2 General practitioners 100% of Cost Savings – Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p8
Specialist visits
2.1 Medical specialists 100% of Cost Savings – Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p8
Casualty visits
3.1 Emergency Casualty 100% of Cost No limit
Momentum Annexure B(4) 2026 (Incentive), p8
Prescribed medicine (acute)
2. Prescribed acute medication 100% of medication rate Savings
Momentum Annexure B(4) 2026 (Incentive), p13
Over-the-counter medicine
1. Over-the-counter medication (Incl. Vitamins) 100% of medication rate Savings
Momentum Annexure B(4) 2026 (Incentive), p13
Chronic medicine (Chronic Disease List)
3.1. CDLs as contained in the PMBs
Momentum Annexure B(4) 2026 (Incentive), p13
Chronic medicine (other conditions)
3.2. Acne, Eczema, Psoriasis, Pemphigus, Attention Deficit Hyperactivity Disorder and Allergic Rhinitis
Momentum Annexure B(4) 2026 (Incentive), p13
Basic dentistry
1.1. Conservative Dentistry (basic, including 100% of Cost Savings – Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p9
Specialised dentistry
1.2. Specialised Dentistry 100% of Cost Savings – Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p9
Eyes (optometry)
1. Frames 100% of Cost Savings
Momentum Annexure B(4) 2026 (Incentive), p15
Blood tests (pathology)
2. Out-of-hospital 100% of Cost Savings – subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p10
Basic X-rays
1.2 Out-of-hospital 100% of Cost Savings – subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p10
MRI, CT and PET scans
2.2 Out-of-hospital 100% of Cost Savings
Momentum Annexure B(4) 2026 (Incentive), p10
Physiotherapy and other therapists
2. Out-of-hospital 100% of cost Savings - Subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p8
Psychologist and counselling visits
The benefit is subject to the member’s personal medical savings account (PMSA) as described in Annexure E
Momentum Annexure B(4) 2026 (Incentive), p10
Medical appliances
2. Out-of-hospital (including hearing aids, 100% of Cost Savings – subject to PMBs
Momentum Annexure B(4) 2026 (Incentive), p15
Maternity care (out of hospital)
12 antenatal visits per confinement (Subject to registration on the maternity management programme).
Momentum Annexure B(4) 2026 (Incentive), p11
Contraceptives
Not covered. Unless a benefit is a PMB, if it is not explicitly listed, it is not covered
Momentum Annexure B(4) 2026 (Incentive), p7
Screening and prevention
Screening and prevention
Full general physical examination by a Network Provider according to the following age bands
Momentum Annexure B(4) 2026 (Incentive), p19
Conditions
The Chronic Disease List conditions are Prescribed Minimum Benefits on every medical aid. How each one works on a medical aid:
- Addison's Disease
- Asthma
- Bipolar Disorder
- Bronchiectasis
- Dysrhythmia
- Heart Failure
- Cardiomyopathy
- COPD
- Chronic Kidney Disease
- Coronary Artery Disease
- Crohn's Disease
- Type 1 Diabetes
- Type 2 Diabetes
- Epilepsy
- Glaucoma
- Haemophilia
- HIV (Human Immunodeficiency Virus)
- High Cholesterol
- Hypertension
- Hypothyroidism
- Multiple Sclerosis
- Parkinson's Disease
- Rheumatoid Arthritis
- Schizophrenia
- Systemic Lupus Erythematosus (SLE)
- Ulcerative Colitis
Momentum also names these on Incentive (Associated hospitals, Any chronic)’s 2026 chronic list:
Others on its list have no page of ours yet.
Questions about Incentive (Associated hospitals, Any chronic)
Answered from Momentum’s documents.
How does Momentum describe Incentive (Associated hospitals, Any chronic)?
In Momentum’s own words (2027 Momentum Medical Scheme Marketing brochure, p11): “The Incentive 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 Incentive (Associated hospitals, Any chronic) cost in 2027?
From 1 January 2027: R5 787 a month for the main member, R4 658 for an adult dependant and R2 163 for a child. You pay for up to 3 children.
How much is Incentive (Associated hospitals, Any chronic) going up for 2027?
For the main member, from R5 333 to R5 787 a month, +8.5%.
What is the difference between Incentive (Associated hospitals, Any chronic) and Incentive (Any hospital, Any chronic)?
Incentive (Associated hospitals, Any chronic) uses Momentum’s hospital network; Incentive (Any hospital, Any chronic) lets you use any hospital. In 2027 the main member pays R5 787 on Incentive (Associated hospitals, Any chronic) and R6 543 on Incentive (Any hospital, Any chronic).
Does Incentive (Associated hospitals, Any chronic) have a medical savings account?
Yes. 10% of your contribution goes into a savings account, which pays for day-to-day costs such as GP visits and medicine.
How many chronic conditions does Incentive (Associated hospitals, Any chronic) cover?
32: 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?
Incentive (Associated hospitals, Any chronic) pays specialists in hospital at 200% of the Scheme tariff. If a specialist charges more than that, the difference is a shortfall. Gap cover is the product that pays shortfalls.
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.