HEALTH4ME MARKETING - MOMENTUM CORPORATE PARTNERSHIP CONNECT
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Health4Me
2021
Marketing
Brochure
Health4Me
Why the need for quality,
affordable healthcare
solutions?
Access to healthcare is an integral component of an
employee’s health and wellbeing.
Private healthcare solutions, like medical schemes,
remain unaffordable for a large portion of the
workforce.
Momentum Health4Me allows employer groups
to offer cost-effective healthcare cover to their
employees earning less than R30 000 per month.
Health4Me
Page
2 Improve productivity
3 Who is eligible?
3 How does it work?
4 Benefits summary
5 Premiums
6 Day-to-day benefits
8 Major medical event benefits
10 Free benefits for your employees
12 How to join
Momentum Health4Me is not a medical scheme product, and is not a substitute
for medical scheme membership. The information provided in this brochure does
not constitute advice in terms of the Financial Advisory and Intermediary Services
Act. Momentum is a part of Momentum Metropolitan Life Limited, an authorised
financial services provider (FSP 6406) and registered credit provider.
momentum.co.za
Helping reduce absenteeism
and improve productivity
Health4Me
Absent employees, Research shows that this acute challenge in South Africa leads to a 4.8% loss of
GDP – which translates roughly to 10 “downtime” days per employee per year, and in turn
employees who are equates to a R12 billion loss in absenteeism, with an estimated presenteeism cost of R89
billion.
suffering from a lack of
quality healthcare and Health4Me addresses this challenge through benefit design that provides your
employees with improved access to quality, private healthcare and additional benefits.
who battle with the effects The carefully chosen, proven building blocks that make up our offering serve to improve
the physical and workplace wellness of all employees.
of physical and mental
health conditions, as well Starting with an integrated view of the health and wellbeing of participating employees,
Health4Me taps into deep insights gathered over a period of 16 years, allowing us to
as financial challenges, structure our benefits according to your company’s specific needs.
result in significant financial Our smart and integrated reporting enables our corporate clients to proactively manage
losses for many South the total wellness of their most valuable assets – their employees. By partnering with us,
leading South African firms are able to extend the benefits of private healthcare, a doctor
African companies – often on call, medical savings, employee assistance and wellness education to their workforce,
thereby improving the wellbeing of their employees and their bottom line.
not properly accounted for.
Day-to-day Hello HIV Onsite
benefits Doctor benefits wellness
Employee
Absenteeism
wellness
Major Employee Integrated
medical event Assistance reporting More4Me
benefits Programme
2
More health for more Health4Me
South Africans for less
Who is eligible for this product offering?
Employees earning a monthly income of less
than R30 000
Employees 18 years and older, for as long
as they are actively employed
Employer groups with 5 or more employees
Momentum Medical Scheme offers six medical scheme
options for employees earning above this threshold.
Employees moving from a Momentum Health4Me option
onto a Momentum Medical Scheme option may be subject
to underwriting.
How does it work?
In line with Momentum’s focus on innovation and flexibility,
Momentum Health4Me follows a building block approach.
Employers can choose the combination of benefits most
suitable to their employees’ needs and available budget.
Momentum Health4Me offers employer groups great value
by applying our extensive experience and skill in the field,
as well as our strong provider network partnerships, to
facilitate cost-effective provision of day-to-day, as well as a
comprehensive set of major medical event benefits, to your
employees.
Momentum Health4Me offering
Day-to-day Benefits
Bronze Silver Gold
Major Medical Event Benefits
Base Standard
3
Health4Me Day-to-day benefit summary
Day-to-day Benefits Bronze Silver Gold
GP visits
GP in room procedures
Hello Doctor
Specialist benefit
Acute medication
Chronic benefit
HIV benefit
Basic pathology
Basic radiology
Basic and emergency dentistry
Basic optometry
Maternity benefit
Flu vaccination
Health assessment
EAP Employee Assistance Programme
Multiply Starter
Health4Me Major medical event benefit summary
Major medical event benefits Base Standard
Accident and emergency cover
Hospital cash benefit and maternity
lump sum benefit
Funeral benefit
4
Health4Me Premiums
GP visits: Member type Bronze Silver Gold
Unlimited with
Hello Doctor Employee R186.00 R234.00 R294.00
referral
Spouse R186.00 R234.00 R294.00
Child R186.00 R234.00 R148.00
GP visit booster benefit Member type All options
Boost You can choose to pay
an additional premium in Employee
your
R30.00
order for your employees
to have unlimited Network Spouse R30.00
benefit GP visits without a
Hello Doctor referral Child R30.00
Accident and Member type Base Standard
emergency
cover Employee R65.00 R92.00
Spouse R65.00 R92.00
Child R38.00 R52.00
Hospital cash Member type Base Standard
benefit and
maternity lump Employee R67.00 R102.00
sum benefit
Spouse R67.00 R102.00
Child R33.00 R56.00
Funeral benefit Member type Base Standard
Employee R17.00 R20.00
Spouse R17.00 R20.00
Child R8.00 R9.00
Health4Me Health Insurance premiums are exempt from VAT.
Financial advisers selling Health4Me Health Insurance are required to have a FAIS Category 1.3 Long-term Insurance License.
Risk profile based quotations can be requested for groups with more than 50 employees, based on group demographics.
5
Bronze
Silver
Gold
Health4Me Day-to-day Benefits
GP visits There is no overall limit on the number of GP visits at a Network GP per member per
Unlimited year. Hello Doctor pre-authorisation is required for every GP visit from the 4th GP visit
with Hello onwards
Doctor Network GP visits can either be face-to-face or virtual consultations
referral 3 GP visits at a Network GP per member per year
2 Additional GP visits at a Network GP per member per year for members registered
on the Maternity Benefit, Chronic Benefit or HIV Benefit programme
Additional GP visits at a Network GP can be unlocked with pre-authorisation from
Hello Doctor via a tele-consult
GP in room Minor medical procedures performed as part of a Network GP consult in rooms,
procedures such as stitching of wounds and nebulisation
Hello Unlimited access to telephonic consultations and online/mobile health information
Doctor via Hello Doctor
Specialist Up to 2 visits, limited to R1 000 per visit and up to R2 000 per member/family per
benefit year
Members may consult any specialist, subject to a Network GP referral and
pre-authorisation
The specialist may refer the member for pathology and radiology according to the
Health4Me pathology and radiology lists
Members need to pay any shortfalls
Waiting periods may apply
Acute Provided in accordance with the Network prescribed acute medication formulary
medication Rules and protocols apply
Chronic Unlimited when provided in accordance with the Network prescribed chronic
benefit medication formulary
Unlimited pathology and radiology related to the chronic condition monitoring,
according to the Health4Me pathology and radiology lists
26 Chronic conditions are covered:
Addison’s Disease, Asthma, Bipolar Mood Disorder, Bronchiectasis, Cardiac
Dysrhythmias, Cardiac Failure, Cardiomyopathy, Chronic Obstructive Pulmonary
Disease, Chronic Renal Disease, Coronary Artery Disease, Crohn’s Disease,
Diabetes Insipidus, Diabetes Mellitus Type 1, Diabetes Mellitus Type 2, Epilepsy,
Glaucoma, Haemophilia, Hyperlipidaemia, Hypertension, Hypothyroidism, Multiple
Sclerosis, Parkinson’s Disease, Rheumatoid Arthritis, Schizophrenia, Systemic Lupus
Erythematosus and Ulcerative Colitis
Pre-authorisation is required
Waiting periods may apply
Basic Unlimited when members visit their Network GP, and are referred by their Network
pathology GP, according to the Health4Me pathology list
Basic Unlimited cover for black and white x-rays when members visit their Network GP,
radiology and are referred by their Network GP, according to the Health4Me radiology list
Basic and Covered at any dentist on the Dental Network
emergency Basic dentistry such as fillings, extractions, infection control, cleaning and polishing
dentistry of teeth
Specialised dentistry such as bridges, crowns, surgical extractions, implants, root canals,
gold fillings, dentures and braces are not covered
Provided in accordance with the Dental Network protocols and approved
Health4Me dentistry list
Waiting periods may apply
Basic Covered at any optometrist on the Optical Network
optometry Benefit available every 2 years
1 Eye test and 1 pair of clear standard single vision lenses, or 1 pair of bi-focal lenses,
with a standard frame
Sunglasses, tinted lenses, hard coating and contact lenses are not covered
Provided in accordance with the Optical Network protocols and approved
Health4Me optometry list
Waiting periods may apply
6
Bronze
Silver
Gold
Health4Me Day-to-day Benefits (continued)
HIV benefit Antiretroviral medication provided in accordance with the Network prescribed HIV
medication formulary
Post-exposure prophylaxis (PEP) medication provided in accordance with the
Network prescribed HIV medication formulary, to prevent HIV infection in the event
of accidental exposure to blood or fluids from an infected person, or by any other
means
Pathology related to condition monitoring according to the applicable Health4Me
pathology list
Pre-authorisation is required
Waiting periods may apply
Maternity Antenatal GP visits at a Network GP
benefit 2 2D foetal growth scans per member per pregnancy
Antenatal vitamins provided in accordance with the Network prescribed acute
medication formulary
Antenatal pathology tests when members visit their Network GP, and are referred
by their Network GP, according to the Health4Me antenatal pathology list
Antenatal support (access to credible, up to date information on all topics related to
parenthood) via BabyYumYum
Antenatal and post-partum support from a nurse or midwife via BabyYumYum
Nurse home visit on day after returning home from hospital after childbirth, as well
as 2 weeks later, via BabyYumYum
Registration and pre-authorisation is required
Flu 1 Flu vaccination per member per year at any pharmacy clinic, preferably a Dis-
vaccination Chem, Clicks, MediRite or Pick n Pay pharmacy clinic
Health 1 Health assessment (blood pressure test, cholesterol and blood sugar finger prick
assessment tests, height, weight and waist circumference measurements) per member per
year at a pharmacy clinic, preferably a Dis-Chem, Clicks, MediRite or Pick n Pay
pharmacy clinic
Employer groups with more than 10 employees can have onsite wellness days,
where members can do their annual health assessment
Employee Counselling and support services for adults, teenagers and children
EAP
Assistance Trauma and critical incidence counselling services
Programme
Legal assist, credit health and debt management services
Managerial support services
Telephonic services and onsite trauma support services
Road accident Advice for road accident claims (via EAP services)
claims
Workman’s Advice for injury on duty claims (via EAP services)
compensation
claims
Multiply Multiply Starter is free and offers rewards from a range of partners
Starter Members get great discounts and cashbacks on big brands like Dis-Chem, Makro,
NuMetro, Intercape and Mango Airlines, as well as on the Multiply online shop
Momentum Health4Me members have access to benefits at Momentum CareCross Network GPs, dentists and optometrists - view the lists of
these providers at momentum.co.za.
GP visits: Member type Bronze Silver Gold
Unlimited with
Hello Doctor Employee R186.00 R234.00 R294.00
referral
Spouse R186.00 R234.00 R294.00
Child R186.00 R234.00 R148.00
GP visit booster benefit Member type All options
Boost You can choose to pay
an additional premium in Employee R30.00
your order for your employees
to have unlimited Network Spouse R30.00
benefit GP visits without a
Hello Doctor referral Child R30.00
7
Health4Me Major Medical Event Benefits
Major medical event benefits can only be taken in conjunction with Health4Me day-to-day benefits.
Benefit Base Standard
Accident and Accident cover: Accident cover:
emergency cover
Casualty benefit up to R30 000 per event Casualty benefit up to R30 000 per event
In-hospital benefit up to R200 000 per event In-hospital benefit up to R1 000 000 per event
Covered at a private hospital for accidents that fit the Covered at a private hospital for accidents that meet the
qualifying criteria qualifying criteria
An accident shall mean a medical emergency that is an An accident shall mean a medical emergency that is an
external, unexpected event that is not traceable, directly or external, unexpected event that is not traceable, directly or
indirectly, to a member’s state of mental or physical health indirectly, to a member’s state of mental or physical health
prior to the event prior to the event
Emergency (heart attack or stroke) cover: Emergency (heart attack or stroke) cover:
Casualty benefit up to R30 000 per event Casualty benefit up to R30 000 per event
In-hospital benefit up to R250 000 per event In-hospital benefit up to R500 000 per event
Covered at a private hospital for emergency (heart attack or Covered at a private hospital for emergency (heart attack or
stroke) events that meet the qualifying criteria stroke) events that meet the qualifying criteria
Emergency transportation, stabilisation and treatment cost paid in case of an accident or an emergency (heart attack or
stroke) 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 and treatment
In the case of medical emergencies that do not fit the qualifying criteria, transportation, stabilisation and treatment at a state
facility will be covered
Premiums Premiums
Employee R65.00 Employee R92.00
Spouse R65.00 Spouse R92.00
Child R38.00 Child R52.00
Benefit Base Standard
Hospital cash R500 per day in hospital, paid from day 1, provided that R1 000 per day in hospital, paid from day 1, provided that
benefit and hospitalisation is longer than 48 hours hospitalisation is longer than 48 hours
maternity lump
sum benefit Maximum of R20 000 payable per member per year Maximum of R20 000 payable per member per year
Maximum of 40 days payable per member per year Maximum of 20 days payable per member per year
R10 000 maternity lump sum benefit payable to R20 000 maternity lump sum benefit payable to
a member if hospitalisation is due to childbirth, a member if hospitalisation is due to childbirth,
irrespective of number of days member has been irrespective of number of days member has been
hospitalised hospitalised
Waiting periods may apply Waiting periods may apply
Premiums Premiums
Employee R67.00 Employee R102.00
Spouse R67.00 Spouse R102.00
Child R33.00 Child R56.00
8Benefit Base Standard
Funeral benefit Causes of death Natural Unnatural Causes of death Natural Unnatural
(includes
Employee, spouse and R10 000 R20 000 Employee, spouse and R15 000 R30 000
repatriation children > 14 children > 14
benefit)
Children 6 - 13 years R5 000 R10 000 Children 6 - 13 years R7 500 R15 000
Children 1 - 5 years R2 500 R5 000 Children 1 - 5 years R3 750 R7 500
Children < 1 year R1 250 R2 500 Children < 1 year R1 875 R3 750
Stillborn babies R750 R1 500 Stillborn babies R1 125 R2 250
(past 28 weeks gestation) (past 28 weeks gestation)
Waiting periods may apply to natural causes of death Waiting periods may apply to natural causes of death
Premiums Premiums
Employee R17.00 Employee R20.00
Spouse R17.00 Spouse R20.00
Child R8.00 Child R9.00
9Free benefits for your employees
More4Me
More4Me is available to employees on Momentum Health4Me and certain
medical scheme options, as long as the employer has at least 15 employees
covered by Momentum Health4Me and the respective medical scheme.
This benefit incentivises members with monthly airtime, based on their Healthy
Heart Score.
Participating members will receive the following benefits:
Free monthly airtime
Activation airtime Airtime voucher Monthly airtime
Value Condition Value Condition Value Condition
Members who go for their
Up to Up to
500MB 500MB health assessment at a
Based on their Healthy Heart Score, members will
data Upon registration, members data Wellness Day managed by
receive monthly airtime for a period of 12 months,
will receive R50 airtime Momentum, will receive their
R50 R50 Healthy Heart Score and R50
until their next health assessment is due
airtime airtime
airtime on the spot
Up to 1GB data Green
Members can convert their
airtime to data if they choose R80 Healthy
Heart Score
airtime
Up to 500MB data Amber
R50 Healthy
Heart Score
airtime
Multiply Starter Up to 250MB data
R25
Red
Healthy
Heart Score
airtime
Members have access to Multiply Starter for free. Multiply Starter
offers great discounts and cashbacks on big brands.
Travel Fitness and health
10% discount in-store
7,5% off 10% off 20% off
Lifestyle and entertainment
10% off 15% off 15% off
Fitness devices Electronics and appliances
4% Pay as little as R51
10% back 12,5% back 5% back
Online Multiply shop vouchers
Health and beauty
Choose cashbacks or choose discounts
Vouchers
when you buy on the Multiply online shop.
Same reward, more choice
5% 2% 5% 15%
Magazines
2% 2% back
Kids and Education 25% off
Online
Career Safety and security
Guidance
50% off Pay as little as R75 22,5%
20% off security installations
10Employee
EAP Assistance
Programme
Trauma assist
Counselling
Legal assist
Debt assist
Members have access to confidential, multilingual support
and counselling services, via a toll-free number. They can also
download the Momentum Wellness app from Google Play or the
App Store.
Counselling and support for adults
Confidential support services that provide preventative and
Members
proactive interventions for the early detection, identification and/
or resolution of work, personal and health problems, that may
adversely affect a member’s state of mental or physical wellbeing,
can talk to as well as their ability to perform at work.
Counselling and support for children and teenagers
a doctor Confidential support services that provide preventative and
proactive interventions for the early detection, identification and/
on their or resolution of problems that children and teenagers face, that
may adversely affect their state of mental or physical wellbeing,
Dial *120*1019# phone such as self-image problems, peer pressure, performance anxiety,
bullying, depression and/or exposure to drugs.
Trauma/critical incidence counselling
Members can access trauma support from experts and
professionals 24 hours a day, 7 days a week.
Members get free access to Hello Doctor, a
mobile-phone-based service that gives them 24/7 Assistance will be provided for members who have experienced
access to doctors within minutes – it’s like having a physical and/or emotional trauma, such as rape, hijacking, child
doctor on call in their pocket wherever they go. abuse, death or suicide of a close family member, armed robbery
or assault, domestic violence, kidnapping and/or abduction.
They can download the Hello Doctor app from the
Google Play or App Store and get expert health Legal assist, credit health and debt management
advice from qualified South African medical services
doctors through their phone, tablet or computer, at Members who need legal, debt or financial wellness advice can
absolutely no cost to them! get assistance from fully qualified and experienced attorneys,
financial consultants and debt rescue consultants.
WhatsApp support Managerial support
Members can quickly and easily engage with us Coaching and support for leaders and managers, to assist and
via WhatsApp if they have any queries about equip them to deal with the challenges they may face in the
their benefits or membership workplace.
Momentum Health4Me
WhatsApp business 1 2 3 4
0860 10 29 03 Assessment Education Guidance Referral
11How do you join Health4Me?
Application process
We need a fully completed company application form
and membership template (a list of employees you
would like to provide cover for) to be completed and
submitted to us via email at:
health4menewbusiness@momentum.co.za.
Member education
We will activate your membership and arrange for
member education sessions, either electronically (for
groups with less than 50 members) or via a dedicated
account executive (for groups with more than 50
members), to provide your staff with training on how to
access and use their benefits.
Your employees can also access product information via
our website or contact our call centre for assistance with
any queries they may have regarding their benefits.
Employer support
We will provide employer web portal training to
show you how to manage your company profile
online. You will be able to:
Add and remove members
Do transfers of members between branches
Draw member listings at any time
during the month
Close-off your billing whenever convenient for you.
Once you have closed off your billing, your invoice
and pro-forma billing statement will be
emailed to you
Lodge hospital cash and maternity lump sum
benefit and funeral benefit claims
Search for providers on our Networks and access
videos and benefit information for your staff
members
Reporting and illness trend information
Bi-annual reporting is also available to show you
the value we offer your employees on Momentum
Health4Me.
1213
For more information and quotes, email us at H4MeQuotes@momentum.co.za
Momentum Health4Me is not a medical scheme product, and is not a substitute for medical scheme membership.
The information provided in this brochure does not constitute advice in terms of the Financial Advisory and Intermediary Services Act.
Momentum is a part of Momentum Metropolitan Life Limited, an authorised financial services provider (FSP 6406) and registered credit provider.
momentum.co.za
Version 2021_2
Health4MeYou can also read
