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
- PMB level of care
- Children on the plan to age
- 21
- Priced by
- Household income (6 bands)
- Plan type
- Hospital plan
- Hospitals
- Network hospitals
- Hospital and specialists
- 100% of Scheme tariff
- Day-to-day costs
- Your own
- Chronic conditions
- 26
- Cancer
- PMB level of care
- Children on the plan to age
- 20
- Priced by
- Household income (6 bands)
Monthly contributions
2027 rates take effect on 1 January 2027.
| Household income (2026) | Main member | Adult | Child |
|---|---|---|---|
| R0 - R1 550 | R645 | R645 | R581 |
| R1 551 - R9 400 | R1 425 | R1 425 | R652 |
| R9 401 - R12 500 | R1 814 | R1 814 | R680 |
| R12 501 - R18 000 | R2 492 | R2 492 | R733 |
| R18 001 - R23 500 | R3 576 | R3 576 | R1 053 |
| R23 501+ | R3 590 | R3 590 | R1 058 |
| Household income (2027) | Main member | Adult | Child |
|---|---|---|---|
| R0 - R1 600 | R699 | R699 | R629 |
| R1 601 - R9 800 | R1 537 | R1 537 | R703 |
| R9 801 - R13 100 | R1 957 | R1 957 | R734 |
| R13 101 - R18 850 | R2 689 | R2 689 | R791 |
| R18 851 - R24 500 | R3 858 | R3 858 | R1 136 |
| R24 501+ | R3 873 | R3 873 | R1 141 |
The income bands are the scheme's own and can move from year to year.
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 (Ingwe Hospital Network)
Momentum Annexure B(1) 2026 (Ingwe), p1
Hospitals
Network hospitals only (Ingwe 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
Cover at the PMB level of care, through ICON.
Momentum Annexure B(1) 2026 (Ingwe), p11
Cancer
Cover at the PMB level of care.
2027 Momentum Medical Scheme Marketing brochure, p6
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
No limit for in-person consultations at the out- of-hospital Network provider indicated in A (ii) of this Annexure 3 Virtual Consultations with GPs on the GP Virtual Consultation Network Subject to preauthorisation from the 11th consultation
Momentum Annexure B(1) 2026 (Ingwe), p7
GP visits
Network GP: no visit limit (11th+ visit pre-auth); plus 3 virtual GP consults/year.
Momentum Focus on Individual Contributions 2027, p1
Specialist visits
2 visits per family, limited to R1 425 per visit and a maximum of R2 850 per family per annum. Subject to referral and Pre- authorisation
Momentum Annexure B(1) 2026 (Ingwe), p7
Specialist visits
2 visits/family/year, R1 500/visit, max R3 000/family; 100% MMSR, referral + pre-auth.
Momentum Focus on Individual Contributions 2027, p1
Prescribed medicine (acute)
According to a fixed formulary dispensed by the out-of-hospital Network provider indicated in A(ii) of this Annexure
Momentum Annexure B(1) 2026 (Ingwe), p10
Prescribed medicine (acute)
Prescribed formulary at the network provider.
Momentum Focus on Individual Contributions 2027, p1
Basic dentistry
At the out-of-hospital Network provider indicated in A(ii) of this Annexure and subject to relevant protocols
Momentum Annexure B(1) 2026 (Ingwe), p7
Basic dentistry
Basic: 1 dental consult/year/beneficiary (pre-auth if >4 fillings/extractions).
Momentum Focus on Individual Contributions 2027, p1
Eyes (optometry)
One standard frame as per formulary p.b. every two years
Momentum Annexure B(1) 2026 (Ingwe), p12
Eyes (optometry)
1 eye test + standard frame + standard/bi-focal lenses per formulary every 2 years.
Momentum Focus on Individual Contributions 2027, p1
Basic X-rays
At chosen out-of-hospital Network provider indicated in A(ii) of this Annexure and subject to relevant protocols
Momentum Annexure B(1) 2026 (Ingwe), p8
Basic X-rays
Specific list of black-and-white x-rays.
Momentum Focus on Individual Contributions 2027, p1
Blood tests (pathology)
At the out-of-hospital Network provider indicated in A(ii) of this Annexure and subject to relevant protocols
Momentum Annexure B(1) 2026 (Ingwe), p8
Blood tests (pathology)
Specific list of pathology tests.
Momentum Focus on Individual Contributions 2027, p1
Full benefit list
Every benefit we hold for Ingwe (ingwe), 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(1) 2026 (Ingwe), p6
Hospital stay and theatre
No Limit in a general ward High care and intensive care limited to 10 days per admission
Momentum Annexure B(1) 2026 (Ingwe), p6
Medicine on discharge
To Take Home Medication 100% of MMSR Limited to 7 days’ supply
Momentum Annexure B(1) 2026 (Ingwe), p6
Step-down and sub-acute care
R17 500 per beneficiary – Subject to PMBs
Momentum Annexure B(1) 2026 (Ingwe), p7
Palliative care
Private Nursing and Hospice
Momentum Annexure B(1) 2026 (Ingwe), p7
Mental health admissions
In and out of hospital (Including psychiatry and psychology)
Momentum Annexure B(1) 2026 (Ingwe), p7
Birth (in hospital)
No limit in the chosen Hospital Network subject to part (4) in Annexure D Note: Only emergency caesareans are covered.
Momentum Annexure B(1) 2026 (Ingwe), p9
Procedures in the doctor’s rooms
Special Procedures/Treatment as listed in Annexure F
Momentum Annexure B(1) 2026 (Ingwe), p12
Cancer treatment
Limited to PMBs and PMB level of care subject to part (4) in Annexure D
Momentum Annexure B(1) 2026 (Ingwe), p11
Dialysis
Limited to PMBs at State Hospital Network facilities subject to part (4) in Annexure D
Momentum Annexure B(1) 2026 (Ingwe), p10
Organ and stem cell transplants
Limited to PMBs subject to part (4) in Annexure D
Momentum Annexure B(1) 2026 (Ingwe), p11
Internal prostheses
Internal prosthesis
Momentum Annexure B(1) 2026 (Ingwe), p12
HIV/AIDS
R42 300 per family, subject to PMBs
Momentum Annexure B(1) 2026 (Ingwe), p13
Day procedures
Prior Authorisation for Major Medical Benefits shall be obtained from the Scheme before a beneficiary is admitted (except in the case of an emergency) 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(1) 2026 (Ingwe), p5
Medical appliances
R7 000 per family
Momentum Annexure B(1) 2026 (Ingwe), p12
Day to day
GP visits
No limit for in-person consultations at the out- of-hospital Network provider indicated in A (ii) of this Annexure 3 Virtual Consultations with GPs on the GP Virtual Consultation Network Subject to preauthorisation from the 11th consultation
Momentum Annexure B(1) 2026 (Ingwe), p7
GP visits
1 visit p.b, limited to 2 visits per family per year. R110 co-payment per visit applies. Subject to Pre-authorisation, failing which a 30% co-payment will apply
Momentum Annexure B(1) 2026 (Ingwe), p7
Specialist visits
2 visits per family, limited to R1 425 per visit and a maximum of R2 850 per family per annum. Subject to referral and Pre- authorisation
Momentum Annexure B(1) 2026 (Ingwe), p7
Casualty visits
No limit for PMBs
Momentum Annexure B(1) 2026 (Ingwe), p7
Prescribed medicine (acute)
According to a fixed formulary dispensed by the out-of-hospital Network provider indicated in A(ii) of this Annexure
Momentum Annexure B(1) 2026 (Ingwe), p10
Over-the-counter medicine
Not covered. No benefit
Momentum Annexure B(1) 2026 (Ingwe), p10
Chronic medicine (Chronic Disease List)
Limited to the CDL as contained in the PMBs and in accordance with a fixed formulary
Momentum Annexure B(1) 2026 (Ingwe), p10
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(1) 2026 (Ingwe), p5
Basic dentistry
At the out-of-hospital Network provider indicated in A(ii) of this Annexure and subject to relevant protocols
Momentum Annexure B(1) 2026 (Ingwe), p7
Specialised dentistry
Limited to PMBs at State Hospital Network facilities subject to part (4) in Annexure D
Momentum Annexure B(1) 2026 (Ingwe), p8
Eyes (optometry)
One standard frame as per formulary p.b. every two years
Momentum Annexure B(1) 2026 (Ingwe), p12
Blood tests (pathology)
At the out-of-hospital Network provider indicated in A(ii) of this Annexure and subject to relevant protocols
Momentum Annexure B(1) 2026 (Ingwe), p8
Basic X-rays
At chosen out-of-hospital Network provider indicated in A(ii) of this Annexure and subject to relevant protocols
Momentum Annexure B(1) 2026 (Ingwe), p8
MRI, CT and PET scans
Limited to PMBs at State Hospital Network facilities subject to part (4) in Annexure D
Momentum Annexure B(1) 2026 (Ingwe), p8
Physiotherapy and other therapists
Only Physiotherapy covered
Momentum Annexure B(1) 2026 (Ingwe), p6
Alternative healthcare
Limited to PMBs at State Hospital Network facilities subject to part (4) in Annexure D
Momentum Annexure B(1) 2026 (Ingwe), p4
Psychologist and counselling visits
Limited to PMBs at State Hospital Network facilities, subject to part (4) in Annexure D
Momentum Annexure B(1) 2026 (Ingwe), p7
Maternity care (out of hospital)
7 General practitioner or Gynaecologist antenatal visits per confinement
Momentum Annexure B(1) 2026 (Ingwe), p9
Contraceptives
Not covered. Unless a benefit is a PMB, if it is not explicitly listed, it is not covered
Momentum Annexure B(1) 2026 (Ingwe), p5
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(1) 2026 (Ingwe), p5
Screening and prevention
Screening and prevention
Full general physical examination according to the following age bands
Momentum Annexure B(1) 2026 (Ingwe), p14
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’s 2026 documents name no chronic conditions beyond the Chronic Disease List on Ingwe (ingwe).
Questions about Ingwe (ingwe)
Answered from Momentum’s documents.
How does Momentum describe Ingwe (ingwe)?
In Momentum’s own words (2027 Momentum Medical Scheme Marketing brochure, p5): “There is no overall annual limit for hospitalisation. For your hospitalisation cover, you can choose to use either the Connect Network of private hospitals, the Ingwe Network of private hospitals (see page 40 for these lists), or Any hospital.”
How much does Ingwe (ingwe) cost in 2027?
From 1 January 2027 it depends on household income. In the lowest band, R699 a month for the main member; in the highest, R3 873.
What is the difference between Ingwe (ingwe) and Ingwe (any)?
Ingwe (ingwe) uses Momentum’s hospital network; Ingwe (any) lets you use any hospital. In 2027 the main member pays R699 on Ingwe (ingwe) and R4 905 on Ingwe (any).
Does Ingwe (ingwe) pay for GP visits and day-to-day costs?
No. Ingwe (ingwe) is a hospital plan, so day-to-day costs are your own.
How many chronic conditions does Ingwe (ingwe) cover?
26: the 27 on the Chronic Disease List and others the scheme adds.
Is cancer treatment covered?
Yes, at the PMB level of care.
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?
Ingwe (ingwe) 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.
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.