Health4Me Marketing - SEESA SEB

 
Health4Me Marketing - SEESA SEB
Health4Me
        2021

Marketing
 Brochure
Health4Me Marketing - SEESA SEB
Health4Me
Health4Me Marketing - SEESA SEB
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
Health4Me Marketing - SEESA SEB
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
Health4Me Marketing - SEESA SEB
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

                              Gold

                   Major Medical Event Benefits

                             Standard

                                                                              3
Health4Me Marketing - SEESA SEB
Health4Me Day-to-day benefit summary
     Day-to-day Benefits                                            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                                  Standard

            Accident and emergency cover

            Hospital cash benefit and maternity lump sum benefit

            Funeral benefit

4
Health4Me Marketing - SEESA SEB
Health4Me Premiums
 GP visits:        Member type                                                                         Gold
 Unlimited with
 Hello Doctor       Employee                                                                                                  R320.00
 referral
                    Spouse                                                                                                    R320.00

                    Child                                                                                                     R160.00

                   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                                                                       Standard
 emergency
 cover              Employee                                                                                                   R92.00

                    Spouse                                                                                                     R92.00

                    Child                                                                                                      R52.00

 Hospital cash     Member type                                                                       Standard
 benefit and
 maternity lump     Employee                                                                                                   R111.00
 sum benefit

                    Spouse                                                                                                     R111.00

                    Child                                                                                                      R61.00

 Funeral benefit   Member type                                                                       Standard

                    Employee                                                                                                   R20.00

                    Spouse                                                                                                     R20.00

                    Child                                                                                                       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
Health4Me Marketing - SEESA SEB
Health4Me Day-to-day Benefits                                                                                   Gold

    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
    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
    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

    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
    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
6
Health4Me Marketing - SEESA SEB
Health4Me Day-to-day Benefits (continued)                                                                                     Gold

 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.

 Premiums               Member type                                                                                Gold
 (GP visits:
 Unlimited with         Employee                                                                                                      R320.00
 Hello Doctor
 referral)              Spouse                                                                                                        R320.00

                        Child                                                                                                         R160.00

                        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 Marketing - SEESA SEB
Health4Me Major Medical Event Benefits
Major medical event benefits can only be taken in conjunction with Health4Me day-to-day benefits.

    Benefit                                                                          Standard

    Accident and         Accident cover:
    emergency cover
                          Casualty benefit up to R30 000 per event

                          In-hospital benefit up to R1 000 000 per event
                         Covered at a private hospital for accidents that meet the qualifying criteria
                         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

                         Emergency (heart attack or stroke) cover:
                          Casualty benefit up to R30 000 per event

                          In-hospital benefit up to R500 000 per event
                         Covered at a private hospital for emergency (heart attack or 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
                          Employee                                                                                                                 R92.00
                          Spouse                                                                                                                   R92.00
                          Child                                                                                                                    R52.00

    Benefit                                                                          Standard

    Hospital cash         R1 000 per day in hospital, paid from day 1, provided that hospitalisation is longer than 48 hours
    benefit and
    maternity lump
                          Maximum of R20 000 payable per member per year
    sum benefit
                          Maximum of 20 days payable per member per year

                          R20 000 maternity lump sum benefit payable to a member if hospitalisation is due to childbirth, irrespective of number of
                          days member has been hospitalised

                                                                                     Premiums
                          Employee                                                                                                                 R111.00
                          Spouse                                                                                                                   R111.00
                          Child                                                                                                                    R61.00

8
Benefit                                                        Standard

Funeral benefit   Causes of death                                         Natural   Unnatural
(includes
                  Employee, spouse and children > 14                      R15 000   R30 000
repatriation
benefit)          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
                  Employee                                                           R20.00
                  Spouse                                                             R20.00
                  Child                                                               R9.00

                                                                                                9
Free 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

10
Employee
                                               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*394#     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
                                                                                                                               11
How 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.

12
13
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

Health4Me
You can also read
NEXT SLIDES ... Cancel