Chronic Benefit ensures you're covered for certain life-threatening conditions, such as diabetes or heart disease, that need ongoing treatment.
When a chronic condition is managed effectively, it will likely result in fewer acute and long-term medical complications or side effects.
The Chronic Benefit covers a variety of life-threatening conditions that require ongoing treatment. These include the 26 conditions on the Chronic Disease List , according to the Medical Schemes Act’s Prescribed Minimum Benefits*, which ensures access to certain medical treatments for all medical scheme members, regardless of their level of cover.
Momentum Medical Scheme offers a unique structure that empowers you to choose a chronic provider that suits you, your family, and your pocket.
* The Prescribed Minimum Benefits (PMB) open_in_new are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected. The aim is to provide members with continuous care to improve their health and well-being and to make healthcare more affordable.
You need to get your chronic prescription from your Ingwe Primary Care or Ingwe Active Network doctor, and your chronic medication from Medipost pharmacy. Ensure that your prescription is sent to Medipost, they will arrange delivery of the medication to you.
Benefits are subject to the Network entry-level formulary.
You need to choose one of the designated State facilities to get your chronic prescription and medication, subject to the State formulary and medical management (including the doctor, pharmacy, blood tests, x-rays etc.).
If you voluntarily choose to get your chronic medication from a non-State pharmacy or outside of the State formulary, co-payments may apply.
The chronic provider that you have chosen determines how you get your chronic prescription and medication.
Any provider
You may get your chronic prescription and medication from any provider, subject to your option specific formulary.
If you choose to get your medication from the preferred list of medicines, and within the generic reference price if applicable, you will not pay a co-payment. If you choose to get your medication from outside the formulary (i.e. non-preferred items), a co-payment is payable.
A dispensing fee co-payment may also be payable when using pharmacies not contracted to Momentum Medical Scheme.
Associated provider
You need to get your chronic prescription from an Associated GP get_app and your chronic medication from Medipost, subject to an entry-level formulary.
If you choose to get your medication from outside the formulary, or your chronic prescription from a non-Associated GP, or your chronic medication from a pharmacy other than Medipost, copayments will apply. These co-payments will vary depending on your option.
State provider
You need to choose one of the designated State facilities to get your chronic prescription and medication, subject to the State formulary and medical management (including the doctor, pharmacy, blood tests, x-rays etc.).
If you choose to get your chronic medication from outside the State formulary, or your chronic medication from a pharmacy other than the State, co-payments will apply. These co-payments will vary depending on your option.
You have the freedom of choice to get your chronic prescription and medication from any provider, subject to a comprehensive formulary.
You have the freedom of choice to get your chronic prescription and medication from any provider, subject to a comprehensive formulary. If you choose to get your medication from outside the formulary, a co-payment is payable. A dispensing fee co-payment may also be payable when using pharmacies not contracted to Momentum Medical Scheme.
