No, the Summit Option provides unlimited oncology cover. However, chemotherapy and adjuvant medication are subject to Momentum's Reference Pricing, so sticking to the formulary is important to avoid co-payments. Strategy reference: max-2026.

You will have a co-payment of R3,500 per scan for MRI, CT, and PET scans, regardless of whether it is done in or out of hospital. This applies even if you get pre-authorisation. Strategy reference: max-2026.

The scheme covers the procedure, but the internal prosthesis (the artificial joint itself) is limited to R92,200 per beneficiary per event. You can claim for up to 2 such events per year. Strategy reference: max-2026.

Yes, the Summit Option allows you to use any private hospital. There is no network restriction, so you are covered at the hospital of your choice. Strategy reference: max-2026.

Yes, the plan covers 62 chronic conditions, which is significantly more than the standard 26. This includes additional cover for conditions often excluded on lower plans, subject to the R34,500 day-to-day limit. Strategy reference: max-2026.

Day-to-day expenses like GP visits and scripts are paid from a Risk benefit (not savings) up to an annual limit of R34,500 per beneficiary. This limit is combined with your additional chronic cover. Strategy reference: max-2026.

No, you can see any specialist. Associated specialists are covered in full, and all other specialists are covered up to 300% of the scheme rate, reducing the likelihood of shortfalls. Strategy reference: max-2026.

No, the Summit Option does not have a Medical Savings Account. Instead, it offers a generous 'risk-based' day-to-day benefit of R34,500 per beneficiary. Strategy reference: max-2026.