2026 Rules Active
2026 Validated
Wants hospital flexibility but understands network penalties
Actuarial Objective
Targets members who select the Any-hospital path but still want to minimise penalty exposure by aligning day-to-day and chronic usage to the required network routing for that selection.
Running Actuarial Simulation...
More Plan Options
Save R-3823 pm
Sizwe Hosmed
Gold Ascend
Strategy: Gold "Ascend": Family Full-Choice Cover
Upgrade for +R4101 pm
Medihelp
MedPrime Elect
Strategy: Elect Post-Savings Day-to-Day Network Router
Key Terms for this Strategy
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries (like hip/knee replacements) that are not emergencies.
People Also Ask
Can I use any hospital on the Momentum Ingwe option?
No, if you choose the Ingwe Network option, you must use hospitals in the Ingwe Network. Using a non-network hospital will result in a 30% co-payment.
Is cancer treatment covered in private hospitals on Ingwe?
No, on the Ingwe Network option, oncology (cancer) benefits are limited to Prescribed Minimum Benefits (PMBs) at State facilities only.
Do I have to pay for casualty visits?
Yes, there is a R110 co-payment per visit. The benefit is limited to 1 visit per beneficiary per year (maximum 2 per family).
Are my chronic medicines covered at Dis-Chem or Clicks?
No, for the Ingwe Network option, you must obtain chronic medicine from Ingwe Primary Care Network providers or State facilities.
How many specialist visits can I have?
You are limited to 2 specialist visits per family per year, reimbursed up to R1,425 per visit. A referral from your network GP is required.
Is dentistry covered?
Yes, basic dentistry (fillings, extractions, cleaning) is covered at network dentists. Specialised dentistry like crowns or bridges is not covered.
What happens if I need an MRI scan?
For the Ingwe Network option, MRI and CT scans are limited to Prescribed Minimum Benefits (PMBs) and must be performed at State facilities.
Does Ingwe cover pregnancy?
Yes, the maternity programme covers 7 antenatal visits, 2 scans, and 1 paediatrician visit, provided you register on the programme.