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.

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.

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.

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.

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.

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.

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.

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.