Benefits
The Momentum CareCross model was developed to curb escalating medical costs, and to provide core healthcare cover. This model offers good value for money, with each member linked to a chosen GP.Day-to-Day Services
Members qualify for medically necessary consultations at a network GP. The GP will provide consultations and will prescribe acute medication according to the list of specified generic medications on the acute formulary. Should a member be diagnosed with a chronic condition, the GP will complete an application form for the registration of the chronic condition. We will approve the chronic condition subject to the chronic conditions list and chronic formulary.
After-Hours / Emergency Visits
If members need to visit a non-network GP for an emergency or when travelling, then we will reimburse medical scheme members in accordance with their benefits for out-of-network/emergency visits. Members must pay the GP and then claim back the cost using the patient reimbursement form.
Pathology & Radiology Benefits
Pathology and radiology tests are subject to a list of basic blood tests and x-rays. These tests must be requested by the member’s chosen network GP.
Dental Benefits
Basic dentistry services are to be obtained at our network of dentists. Network benefits and protocols apply. Please contact your medical scheme for specialised dentistry benefit information.
Optometry Benefits
Optometry benefits are available at network optometrists and are limited to white standard mono- or bifocal lenses, with a basic frame. Optical benefits outside of the network benefits, will be for the member’s own account. The benefit is available per beneficiary every 2 years.
Please note: This information is intended to provide a summary of the available benefits offered via the Momentum CareCross networks. The specific benefits will however vary according to each option and medical scheme. This information does not replace the Rules of the Scheme, which takes precedence over any wording on this site.