At a glance
- Plan type
- Comprehensive plan
- Hospitals
- Any private hospital
- Hospital and specialists
- 300% of Scheme tariff
- Day-to-day costs
- Day-to-day benefits
- Chronic conditions
- 62
- Children you pay for
- Up to 3
- Children on the plan to age
- 21
- Plan type
- Comprehensive plan
- Hospitals
- Any private hospital
- Hospital and specialists
- 300% of Scheme tariff
- Day-to-day costs
- Day-to-day benefits
- Chronic conditions
- 62
- 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 | R16 469 | R17 870 | +8.5% |
| Adult dependant | R13 075 | R14 187 | +8.5% |
| Child | R3 756 | R4 075 | +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
Any hospital
Hospitals
Any hospital
2027 Momentum Medical Scheme Marketing brochure, p3
Specialists in hospital
300% of Scheme tariff. A specialist who charges more leaves a shortfall.
Specialists in hospital
300% of Scheme tariff. A specialist who charges more leaves a shortfall.
2027 Momentum Medical Scheme Marketing brochure, p3
Chronic and cancer
Chronic conditions
62 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
Chronic conditions
62 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
2027 Momentum Medical Scheme Marketing brochure, p3
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
2.2 General practitioner 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p4
GP visits
From risk, freedom-of-choice; subject to overall day-to-day limit R36 100 per beneficiary; 100% MMSR. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p2
Specialist visits
2.1 Medical specialists 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p4
Specialist visits
From risk, freedom-of-choice; subject to overall day-to-day limit R36 100 per beneficiary; 100% MMSR. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p2
Prescribed medicine (acute)
Limited to R26 900 p.b. to a maximum of R44 200 per family subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p8
Prescribed medicine (acute)
From risk, freedom-of-choice; subject to overall day-to-day limit R36 100 per beneficiary; 100% MMSR. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p2
Basic dentistry
1.1 Conservative Dentistry (basic, including preventative) 100% of MMSR Subject to overall day-to day limit.
Momentum Annexure B(6) 2026 (Summit), p5
Basic dentistry
From risk, freedom-of-choice; subject to overall day-to-day limit R36 100 per beneficiary; 100% MMSR. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p2
Eyes (optometry)
Overall Optometry limit of R6 100 p.b. subject to overall day-to day limit.
Momentum Annexure B(6) 2026 (Summit), p10
Eyes (optometry)
From risk, freedom-of-choice; subject to overall day-to-day limit R36 100 per beneficiary; 100% MMSR. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p2
Basic X-rays
1.2 Out-of-hospital 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p6
Basic X-rays
From risk, freedom-of-choice; subject to overall day-to-day limit R36 100 per beneficiary; 100% MMSR. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p2
Blood tests (pathology)
2. Out-of-hospital 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p6
Blood tests (pathology)
From risk, freedom-of-choice; subject to overall day-to-day limit R36 100 per beneficiary; 100% MMSR. Per-category sub-limit not in these documents.
Momentum Focus on Individual Contributions 2027, p2
Full benefit list
Every benefit we hold for Summit, 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 300% of MMSR
Momentum Annexure B(6) 2026 (Summit), p4
Hospital stay and theatre
1.1. Accommodation in a general ward, high care ward and 100% of MMSR No limit
Momentum Annexure B(6) 2026 (Summit), 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
Momentum Annexure B(6) 2026 (Summit), p3
Step-down and sub-acute care
R75 000 per family – subject to PMBs
Momentum Annexure B(6) 2026 (Summit), p3
Mental health admissions
In-hospital (Psychiatry and Psychology) 100% of MMSR R50 600p.b.
Momentum Annexure B(6) 2026 (Summit), p5
Birth (in hospital)
Hospitalisation (accommodation, theatre fees, labour
Momentum Annexure B(6) 2026 (Summit), p7
Cancer treatment
1. Oncology Medicine and Treatment, excluding Specialised 100% of MMSR No limit.
Momentum Annexure B(6) 2026 (Summit), p9
Dialysis
Acute Dialysis 100% of MMSR No limit.
Momentum Annexure B(6) 2026 (Summit), p9
Organ and stem cell transplants
R28 700 for Cadaver donor costs; R59 000 for Live related donor costs (including transportation)
Momentum Annexure B(6) 2026 (Summit), p10
Internal prostheses
R92 200 pb per event, maximum of 2 events per year
Momentum Annexure B(6) 2026 (Summit), p10
HIV/AIDS
R96 800 per family subject to the Hospital benefit above – Subject to PMBs.
Momentum Annexure B(6) 2026 (Summit), p12
Medicine on discharge
To Take Home Medication 100% of MMSR Limited to 7 days’ supply
Momentum Annexure B(6) 2026 (Summit), p4
Procedures in the doctor’s rooms
1. Specialised Procedures/Treatment as listed in Annexure F 300 % of MMSR No limit.
Momentum Annexure B(6) 2026 (Summit), p11
Chronic medicine (Chronic Disease List)
3.1 PMBs in CDL 100% of medication rate at any Provider No limit
Momentum Annexure B(6) 2026 (Summit), p8
Care after a hospital stay
Certain day-to-day care after a traumatic incident resulting Authorisation shall be obtained from the Scheme No Limit
Momentum Annexure B(6) 2026 (Summit), p11
Medical appliances
R40 100 per family subject to R23 200 per family hearing aids sub-limit, subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p13
Day to day
GP visits
2.2 General practitioner 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p4
Specialist visits
2.1 Medical specialists 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p4
Casualty visits
3.1 Emergency Casualty 100% of MMSR No limit
Momentum Annexure B(6) 2026 (Summit), p4
Prescribed medicine (acute)
Limited to R26 900 p.b. to a maximum of R44 200 per family subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p8
Over-the-counter medicine
Not covered. 1. Over-the-counter medication (Including Vitamins) No benefit No benefit
Momentum Annexure B(6) 2026 (Summit), p8
Basic dentistry
1.1 Conservative Dentistry (basic, including preventative) 100% of MMSR Subject to overall day-to day limit.
Momentum Annexure B(6) 2026 (Summit), p5
Specialised dentistry
Limited to R20 700 p.b, to a maximum of R49 800 per family, subject to overall day-to day limit.
Momentum Annexure B(6) 2026 (Summit), p5
Eyes (optometry)
Overall Optometry limit of R6 100 p.b. subject to overall day-to day limit.
Momentum Annexure B(6) 2026 (Summit), p10
Blood tests (pathology)
2. Out-of-hospital 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p6
Basic X-rays
1.2 Out-of-hospital 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p6
MRI, CT and PET scans
2.2 Out-of-hospital 100% of MMSR Subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p6
Physiotherapy and other therapists
R9 840 per family subject to overall day-to day limit – Subject to PMBs
Momentum Annexure B(6) 2026 (Summit), p4
Psychologist and counselling visits
3. Out-of-hospital 100% of MMSR R29 600 per family, subject to overall day-to day limit
Momentum Annexure B(6) 2026 (Summit), p5
Chronic medicine (other conditions)
3.2 Additional Chronic non CDL Conditions ** 100% of medication rate at any Provider
Momentum Annexure B(6) 2026 (Summit), p8
Maternity care (out of hospital)
12 antenatal visits per confinement (Subject to registration on the programme)
Momentum Annexure B(6) 2026 (Summit), p6
Contraceptives
Not covered. If a benefit is not explicitly listed, the benefit is not covered
Momentum Annexure B(6) 2026 (Summit), p3
Screening and prevention
Screening and prevention
Full general physical examination by any provider according to the following age bands
Momentum Annexure B(6) 2026 (Summit), 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 also names these on Summit’s 2026 chronic list:
- ADHD
- Allergic Rhinitis
- Ankylosing Spondylitis
- Depression
- Eczema / Atopic Dermatitis
- Gout
- Menopause & HRT
- Obsessive-Compulsive Disorder (OCD)
- Osteoporosis
- Psoriasis
- PTSD
- Stroke
Others on its list have no page of ours yet.
Questions about Summit
Answered from Momentum’s documents.
How does Momentum describe Summit?
In Momentum’s own words (2027 Momentum Medical Scheme Marketing brochure, p15): “The Summit Option provides cover for hospitalisation at any hospital. There is no overall annual limit for hospitalisation. Extensive day-to-day and chronic benefits are available from any provider.”
How much does Summit cost in 2027?
From 1 January 2027: R17 870 a month for the main member, R14 187 for an adult dependant and R4 075 for a child. You pay for up to 3 children.
How much is Summit going up for 2027?
For the main member, from R16 469 to R17 870 a month, +8.5%.
Does Summit pay for GP visits and day-to-day costs?
It has day-to-day benefits; the fact sheet above lists what we hold.
How many chronic conditions does Summit cover?
62: 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?
Summit pays specialists in hospital at 300% 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.