Visit the official COVID-19 government website to stay informed: sacoronavirus.co.za

Major Medical Event Benefits

Our options in partnership with

Our options in partnership with Momentum

momentum logo 355 x 441

Benefits

Major medical event benefits can only be taken in conjunction with Health4Me day-to-day benefits.

Benefits

Accident and Emergency Cover*
Casualty benefit
Accident cover in-hospital benefit
Emergency cover (heart attack and stroke only) in-hospital benefit
Hospital Cash and Maternity Lump Sum Benefit
Payment per day in hospital (waiting periods apply) **
Maternity lump sum benefit (waiting periods apply)
Funeral Benefits (natural death waiting periods apply)
Principal member, spouse and children > 14 years
Children 6 - 13 years
Children 1 - 5 years
Children < 1 year
Stillborn babies (past 28 weeks gestation)

Base

Accident and Emergency Cover*
Casualty benefit
Up to R30 000 per event
Accident cover in-hospital benefit
Up to R200 000 per event at a private hospital
Emergency cover (heart attack and stroke only) in-hospital benefit.
Up to R250 000 per event at a private hospital
Hospital Cash and Maternity Lump Sum Benefit
Payment per day in hospital (waiting periods apply) **
R500 per day for stays > 48 hours
Maternity lump sum benefit (waiting periods apply)
R10 000 lump sum benefit if hospitalisation is due to childbirth, irrespective of number of days member has been hospitalised
Funeral Benefits (natural death waiting periods apply)
Natural Death
Accidental Death
Principal Member, Spouse and Children > 14 years​
R10 000
R20 000
Children 6 - 13 years
R5 000
R10 000
Children 1 - 5 years​
R2 500
R5 000
Children < 1 year
R1 250
R2 500
Stillborn babies (past 28 weeks gestation)
R750
R1 500
Premiums
Main Member

R147.50

Spouse

R147.50

Child

R78.80

Standard

Accident and Emergency Cover*
Casualty benefit
Up to R30 000 per event
Accident cover in-hospital benefit
Up to R1 000 000 per event at a private hospital
Emergency cover (heart attack and stroke only) in-hospital benefit.
Up to R500 000 per event at a private hospital
Hospital Cash and Maternity Lump Sum Benefit
Payment per day in hospital (waiting periods apply) **
R1 000 per day for stays > 48 hours
Maternity lump sum benefit (waiting periods apply)
R20 000 lump sum benefit if hospitalisation is due to childbirth, irrespective of number of days member has been hospitalised
Funeral Benefits (natural death waiting periods apply)
Natural Death
Accidental Death
Principal Member, Spouse and Children > 14 years​
R15 000
R30 000
Children 6 - 13 years
R7 500
R15 000
Children 1 - 5 years​
R3 750
R7 500
Children < 1 year
R1 875
R3 750
Stillborn babies (past 28 weeks gestation)
R1 125
R2 250
Premiums
Main Member

R211.10

Spouse

R211.10

Child

R116.50

* Accident and emergency cover

Emergency transportation, stabilisation and treatment cost paid in case of an accident that requires immediate medical treatment. If the benefit limit is exceeded, and further treatment is required, the member will be transported to a state facility for further care. An accident shall mean a medical emergency that is an external, unexpected event that is not traceable, directly or indirectly, to a member’s state of mental or physical health prior to the event. In the case of medical emergencies that do not fit the qualifying criteria, transportation, stabilisation and treatment at a state facility will be covered.

** Payment per day in hospital

Base

Maximum of R20 000 payable per member per year.
Maximum of 40 days payable per member per year.

Standard

Maximum of R20 000 payable per member per year.
Maximum of 20 days payable per member per year.