Provider Portal - Benefit summaries - Momentum

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View the benefits, health management programmes and chronic conditions covered by your patient’s medical scheme and option.

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Benefit summaries
Day-to-day benefit	For everyday medical expenses. The Day-to-day Benefit covers routine medical costs like doctors' visits and prescribed medication. Read more
In-hospital benefit	The Major Medical Benefit includes cover for hospitalisation, as well as certain specialised procedures and treatment, and specialised scans. It gives members option-specific benefits that cover them if they are hospitalised or need to have surgery. Read more
Chronic treatment	Momentum Medical Scheme offers a unique Chronic Benefit structure that empowers members to choose the level of chronic cover appropriate to their family's needs. Chronic benefit are subject to registration and approval. Read more
Health Platform Benefit	A unique benefit that encourages health awareness, enhances quality of life and gives peace of mind through preventative care and early detection tests. Read more

Healthcare programmes Members need to register on health management programmes to gain access to the benefits outlined below.
Maternity programme	Momentum Medical Scheme's comprehensive maternity programme is aimed at providing members with the support and quality care they need during their pregnacy and after delivery. The focused, quality care benefits include antenatal visits, scans, nurse home visits, paediatric visits and baby immunisations. Maternity Programme Focus Page
Oncology programme	Members benefit option and chronic provider determine which specialists and pharmacy they may use. Active treatment is when a patient receives chemotherapy, radiotherapy (radiation) or brachytherapy depending on their diagnosis. Treatment is approved is accordance with the SAOC or ICON guidelines, Scheme Rules and benefit design. Momentum Medical Scheme will pay for follow-up (non-active) treatment after the initial treatment is completed, subject to pre-authorisation. Oncology Programme Focus Page
HIV/Aids Programme management programme	At Momentum Medical Scheme, our management and treatment of HIV/Aids is aimed at giving members access to the most appropriate medical care for wellness, prevention and care, so members with HIV/Aids can live a normal and productive life. To get access to HIV/Aids benefits, members of Momentum Medical Scheme must register on the Lifesense HIV programme. HIV/Aids management programme focus page
Renal disease programme	The programme gives members who have a risk of renal failure, or who are currently in renal failure or transplant benefit, access to specialised care. This includes education, lifestyle support, medication, diet, haemodialysis, peritoneal dialysis or kidney transplantation. Chronic renal disease programme focus page
Mental health programme	This program covers various mental health disorders such as schizophrenia and depression, with treatment options including in-hospital care or outpatient consultations. Medication is covered for chronic conditions but not for others like depression and acute stress disorder. Mental Health Benefit Focus Page

Chronic condition lists
Prescribed minimum benefits (PMB)	Momentum Medical Scheme - chronic disease list

Disclaimer: Momentum Medical Scheme may specify certain principles, protocols, processes and limits relating to the use of your benefits. Benefits may differ depending on your option selection. Scheme Rules will always take precedence and are available on request.

Patient care

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Resources for you and your patient

Momentum Carecross GP Guide

Health4Me network GP patient education pad

Health4Me network GP IVR flow diagram