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User Ratings
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Overall Rating
Service Rating
% Recommended
70 % from 168 reviews
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Overall Rating
Service Rating
% Recommended
61 % from 1178 reviews
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Overall Rating
Service Rating
% Recommended
71 % from 234 reviews
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Overall Rating
Service Rating
% Recommended
76 % from 113 reviews
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Monthly Premiums
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1 Adult
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2394.00
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465.00
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839.00
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1909.00
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2 Adults
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4632.00
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930.00
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1636.00
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3535.00
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2 Adults & 1 Child
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5280.00
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1047.00
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1888.00
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4107.00
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2 Adults & 2 Child
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5928.00
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1164.00
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2140.00
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4679.00
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2 Adults & 3 Child
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6576.00
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1281.00
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2392.00
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5251.00
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Fees Total Contributions Comments
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2012 pricing
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2012 pricing
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2012 Pricing
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2012 Pricing
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Package Features
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Medical Aid Package Comments
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Dimension Elite is the top option in the Dimension range and offers ample benefits for families and individuals who prefer to provide for their extensive day-to-day healthcare needs by means of insured benefits. The option also offers comprehensive cover for medical emergencies and hospitalisation. Add to that the preventative care benefits of the health and benefit booster and you can rest assured that your family's health is in good hands.
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The Core Plans offer you cover in hospital and for emergencies
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The Ingwe Option provides affordable access to entry-level cover. You have cover for hospitalisation up to R900 000 for your family per year. For your hospitalisation cover, you can choose to use either the Ingwe Network of private hospitals.
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From only R1 909 per month you get unlimited private hospital cover; no prescribed hospital lists and a generous amount of day-to-day cover (from R5 322 for a single member per year) plus a host of unique benefits like child rates for financially dependent children up to the age of 27; trauma counselling benefit, oral contraceptives paid from risk and trauma treatment from risk for those unpredictable growing up years.
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Medical Aid Package Qualify Min Salary
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6301
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Medical Aid Package Qualify Max Salary
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6250
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8399
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Medical Aid Package Type
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Comprehensive Plan
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Hospital Plan
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Network Plan
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Comprehensive Plan
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Medical Aid Package Child Age Limit
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26
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25
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21
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27
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In Hospital Benefits
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Any Hospital Comments
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Yes
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Contracted KeyCare Hospitals Only
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Prime Cure or Care Cross
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Yes
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Hospital Cover Percentage of Medical Aid Rate
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100%
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100%
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100%
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200%
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Hospital Cover Comments
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Benefit at 100% of scheme tariff
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100% of Discovery Health rate
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100% of the Momentum Health Rate
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•200% of Medical Aid Rate
•Hospitalisation costs: Accommodation in a general ward, high care ward & intensive care unit, use of operating theatres & hospital equipment, medicine, pharmaceuticals & surgical items. Negotiated tariff. Unlimited
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Hospital Overall Annual Limit Comments
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Unlimited
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Unlimited
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R900 000 per family per year
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Unlimited
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Hospital Specialist Cover Percentage of Medical Aid Rate
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100%
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100%
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200%
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Hospital Specialist Cover Comments
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Benefit at 100% of scheme tariff
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•100% of the Momentum Health Rate
•19 Procedures covered
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•100% of cost with Fedhealth specialist partners
•100% of Fedhealth Rate with non-Fedhealth specialist partners
•Other healthcare professionals including GPs, 200% of Fedhealth rate
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Hospital Co-Payment Comments
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See scheme details
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See Scheme Details
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See scheme details
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See Scheme details
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Hospital Oncology Benefits
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Unlimited. Benefit at 100% of scheme tariff
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We cover your cancer treatment if it is a Prescribed Minimum Benefit and if you go to a cancer specialist in our network.
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Limited to Prescribed Minimum Benefits in State Facilities
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Limited to R400000 per family per year. See health care professional tariff
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Hospital Transplant Benefits
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Unlimited. Benefit at 100% of scheme tariff
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See Scheme Details
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Limited to Prescribed Minimum Benefits in State Facilities
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Limited to R295000 per family per year. See health care professional tariff
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Hospital Dialysis Benefits
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Unlimited. Benefit at 100% of scheme tariff
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See Scheme Details
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Limited to Prescribed Minimum Benefits in State Facilities
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100% Fedhealth rate, limited to R295000 per family per year
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Hospital Pathology Benefits
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Unlimted at 100% applicable tariff
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100% of Discovery Health rate
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Limited to Prescribed Minimum Benefits
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Unlimited. 100% of Fedhealth Rate
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Hospital Radiology Benefits
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100% of the scheme tariff R20860 per family per year
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100% of Discovery Health rate
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Limited to Prescribed Minimum Benefits
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Unlimited. 100% of Fedhealth Rate
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Hospital Scopes/Scans/MRI Benefits
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Scans falls under radiology and MRI's under specialised radiology. Scopes falls under endoscopic procedures and is paid as follows: 100% of the applicable tariff unlimited (in and out of hospital)
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If your scan is related to an approved hospital stay, we pay it from your Hospital Benefit. If it is not, we pay it from your Specialist Benefit, up to R2 300 for each person. We do not pay for MRI or CT scans that are related to conservative back or neck treatment (this is treatment for your back or neck that is not surgery).
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Limited to Prescribed Minimum Benefits
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Unlimited. 100% of Fedhealth Rate
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Hospital HIV Benefits
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See scheme details
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Unlimited 100% of Discovery Health rate
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•Immune deficiency related to HIV; At preferred provider
•Anti-retroviral treatment; R22 700 per family
•Aids related admissions; R24 200 per family
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Unlimited, See health care professional tariff
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Hospital Dental Benefits
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•Subject to Denis protocols and pre-authorisation
•100% of the Medihelp Dental Tariff R600 co-payment per admission 20% co-payment in case of no pre-authorisation
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No benefit
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Not covered. maxillo-facial trauma covered in State facilities
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•Maxillo-facial surgery: surgical removal of tumours & neoplasms, sepsis, trauma & congenital birth defects; unlimited subject to approval
•Osseo-integrated implants & orthognathic surgery; 100% of Fedhealth rate, subject to OHEB, savings & Safety Net. Included in Advanced Dentistry limit
•Oral surgery; 100% of Fedhealth rate, subject to OHEB, savings & Safety Net. Included in Advanced Dentistry limit
•Emergency treatment in casualty ward; Unlimited, 100% of Fedhealth rate
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Hospital Physiotherapy Benefits
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Unlimited. Benefit at 100% of scheme tariff
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Unlimited
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R8 400 per beneficiary
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Unlimited. 200% of Fedhealth Rate
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Hospital Maternity Benefits
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See scheme details
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•R19 500 for uncomplicated delivery
•R29 000 for complicated delivery
•Covered in private Ingwe Network hospitals
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•Accommodation in a general ward, use of operating theatres, labour ward & hospital equipment, medicines, pharmaceuticals, surgical items, midwife, GP, specialist, attendant anaesthetist & paediatrician, non-surgical procedures & tests; Unlimited, see healthcare professional tariff
•Post-natal midwifery benefit, 4 days. 100% of Fedhealth rate
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Hospital Nursing Benefits
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Unlimited. Benefit at 100% of scheme tariff
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No Benefit
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100% of Fedhealth rate, limited to R13700 per family
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Hospital Prosthesis Benefits
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100% of the scheme tariff/cost with sublimits. See scheme details
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No Benefit
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•Internal; 100% of cost with limits. See scheme details
•External; 100% of cost limited to R8 400 per family
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Hospital Ambulance Benefits
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Unlimited emergency medical services are provided by Netcare 911
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Emergency evacuation in South Africa by Netcare 911
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Unlimited with Europ Assistance
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Hospital Other Benefits
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Chronic and Medicine Benefits
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Chronic Disease Comments
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26
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You have cover for a list of chronic conditions if your medicine is on the KeyCare medicine list. You must get your approved medicine from one of our network pharmacies or from your chosen GP. If you get your medicine anywhere else, you have to pay a 20% co-payment.
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26 conditions
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39 conditions
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Medicines To Take Out Benefits
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R260 per case
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Out of pocket
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7 days supply
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7 days supply
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Medicines Acute Benefits
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80% of the Medicine price R2800 per single member per year R5300 per family per year
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See scheme details
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Medicines Prescribed Benefits
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80% of the Medicine price R2800 per single member per year R5300 per family per year
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From prefered provider
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100% of MPL, Subject to OHEB and Safety Net
R7 170 per beneficiary per year, R14 400 per family per year before and after Safety Net
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Medicines Over Counter Benefits
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See scheme details
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Out of pocket
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100% of MPL, subject to savings, does not accumulate to safety net
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Day-to-Day Cover
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D2D Package Type
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Comprehensive cover with sublimits
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No Benefit
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Network Provider
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MSA + OHEB with sublimits + Sublimits after Threshold
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D2D Package Comments
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Day-to-Day benefits covered at 100% of Applicable Tariff subject to sublimits
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Benefits are only available at the chosen preferred provider and are subject to the preferred provider’s protocol. formulary and officehours. Sub-limits apply per year unless stated otherwise
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Day-to-Day Medical Savings Account (MSA) Value
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Annual value
(1 Adult)
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0
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0
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1992.00
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Annual value
(2 Adults)
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0
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0
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3684.00
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Annual value
(2 Adults 1 Child)
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0
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0
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4284.00
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Annual value
(2 Adults 2 Children)
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0
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0
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4884.00
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Annual value
(2 Adults 3 Children)
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0
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0
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5484.00
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Day-to-Day Out of Hospital Expense Benefits (OHEB) Value
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Annual value
(1 Adult)
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1
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1.00
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3330.00
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Annual value
(2 Adults)
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2.00
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2.00
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5740.00
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Annual value
(2 Adults 1 Child)
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3.00
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3.00
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6070.00
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Annual value
(2 Adults 2 Children)
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4.00
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4.00
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6400.00
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Annual value
(2 Adults 3 Children)
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4.00
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4.00
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6730.00
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Day-to-Day Benefits
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D2D GP Comments
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100% of the scheme tariff/cost R1850 per single member per year R3550 per family per year
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No benefit
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•Limited to provider network
•Out-of-network GP, casualty or after-hours visit; 1 visit per beneficiary per year, subject to authorisation. Maximum of two visits per family per year, limited to R770 per event, 20% co-payment applies
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•Fedhealth GP partners; Subject to OHEB then unlimited from Risk
•non-Fedhealth GP partners; 100% of Fedhealth rate, Subject to OHEB, savings and Safety Net. Unlimited once Safety Net is reached
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D2D Specialist Comments
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100% of the scheme tariff/cost R1850 per single member per year R3550 per family per year
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AT KeyCare certain specialists covered up to M = R2300
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2 visits per family per year, up to R1 150 per family per year, and/or R700 per event 10% co-payment applies. Subject to referral by preferred provider and pre-authorisation
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•Fedhealth partners; 100% Fedhealth rate, subject to OEHB then unlimited from risk
•non-Fedhealth partners; 100% of Fedhealth rate, subject to OHEB and Safety Net. Unlimited once Safety Net is reached
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D2D Dentistry Comments
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All benefits are subject to clinical protocols determined by Denis. See scheme details
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No benefit
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•Basic, limited to provider network
•Specialised, not covered
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•Advanced, Up to 100% of Fedhealth rate. Subject to OHEB and Safety Net R5 380 per beneficiary per year, R16 200 per family per year before and after Safety Net
•Conservative. Up to 100% of Fedhealth rate. Subject to OHEB and Safety Net. Unlimited once Safety Net is reached
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D2D Optical Comments
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•Optometric examinations Benefits are available per 24-month cycle per beneficiary; 1 comprehensive consultation, including refraction test, tonometry and visual fields test
•Spectacles - Frame and/or lens enhancements R700
•Lenses - One pair of standard high-quality clear lenses
•Contact lenses R1,510
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No benefit
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One eye test and one pair of clear standard or bi-focal lenses with standard frame as per formulary per beneficiary every two years. Subject to qualifying criteria
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Frames, single vision, bifocal or multifocal lenses, contact lenses and optometric examinations. 100% of Fedhealth rate. Subject to OHEB and Safety Net. R2 420 per beneficiary per year, R7 330 per family per year before and after Safety Net
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D2D Physiotherapy Comments
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100% of the scheme tariff/cost R1850 per single member per year R3550 per family per year
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No Benefit
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100% of Fedhealth rate. Subject to OHEB, Savings and Safety Net. Subject to Additional medical services sub-limit of R8 440 per family per year before and after Safety Net
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D2D Pathology Comments
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100% of the scheme tariff R1900 per family per year
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Unlimited within provider network
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100% of Fedhealth rate. Subject to OHEB and Safety Net. Unlimited once Safety Net is reached
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D2D Radiology Comments
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100% of the scheme tariff R1900 per family per year
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Unlimited within provider network
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100% of Fedhealth rate. Subject to OHEB and Safety Net. Unlimited once Safety Net is reached
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D2D Psychiatric Comments
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100% of the scheme tariff/cost R1850 per single member per year R3550 per family per year
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No benefit
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No Benefit
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Up to specialised partner rate. Subject to OHEB, Savings and Safety Net. Subject to Additional medical services sub-limit of R8 440 per family per year before and after Safety Net
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D2D Substance Abuse Comments
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100% of the scheme tariff/cost R1850 per single member per year R3550 per family per year
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No Benefit
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See scheme details
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D2D Screening Comments
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See scheme details
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See scheme details
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See scheme details
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D2D Maternity Comments
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See scheme details
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See scheme details
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100% of Fedhealth rate. Subject to OHEB and Safety Net
2 antenatal scans per pregnancy before and after Safety Net
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D2D Prostheses And Extra Aids Comments
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•Artificial eyes, speech and hearing aids100% of the scheme tariff/cost R5350 per beneficiary per 3-year cycle
•Artificial limbs and wheelchairs 100% of the scheme tariff/cost R4280 per beneficiary per 3-year cycle
•Other appliances, including hyperbaric oxygen treatment 100% of the scheme tariff/cost R410 per beneficiary per year
•Stoma components and urine bags 100% of the scheme tariff/cost Unlimited
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No benefit
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No Benefit
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•See scheme details
•Appliances: General medical and surgical appliances, CPAP apparatus for sleep apnoea, glucometers, hearing aids and repairs thereof, large orthopaedic orthotics, stoma products, wheelchairs etc. 100% of Fedhealth rate, Subject to OHEB, Savings and Safety Net. R8 440 per family per year before and after Safety Net.
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D2D Nursing Comments
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100% of the scheme tariff/cost R1850 per single member per year R3550 per family per year
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No benefit
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No Benefit
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100% of Fedhealth rate. Subject to OHEB and Savings. Does not accumulate to Safety Net
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D2D Other Comments
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Health and Benefit booster - preventative care benefit
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•A Health Assessment has been added for all adult members once a year. The assessment includes the following tests: Body Mass Index. blood pressure test. cholesterol and blood sugar finger-prick tests
• earn up to R5 400 per adult per year from Momentum’s
HealthReturns programme in only a few steps – including going for a free Health Assessment, complying with appropriate treatment where applicable, and being active
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Day-to-Day Threshold
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D2D Threshold Cover Benefit Comment
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No benefit
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No benefit
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Yes
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D2D Threshold Principal Value
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9290.00
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D2D Threshold Adult Value
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7070.00
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D2D Threshold Child Value
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2380.00
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D2D Threshold Child2 Value
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2380.00
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D2D Threshold Child3 Value
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2380.00
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D2D Threshold Limit Benefit Comment
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No benefit
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See scheme details for benefits that are limited before safety net
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D2D Threshold Limit Principal Value
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99999999
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D2D Threshold Limit Adult Value
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99999999
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D2D Threshold Limit Child Value
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99999999
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D2D Threshold Limit Child2 Value
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99999999
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D2D Threshold Limit Child3 Value
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99999999
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