Momentum Health & Multiply
A cricketer’s tool of trade is his/her body. It therefore very important that SACA’s members have good health insurance to assist in keeping them fit and healthy. Since 2012, SACA’s preferred medical aid scheme has been Momentum Health.
The Momentum Health sponsorship gives players access to quality healthcare insurance and first-class service to back it up. In addition to the plan option benefit, players receive the following healthcare benefits from SACA through the Momentum Health sponsorship:
- Free monthly Multiply membership for the entire family. Multiply is the Momentum Health rewards and loyalty program
- Automatic Level 5 HealthReturns per month (and related Multiply points) for the principal member. This is paid into the player’s HealthSaver account
- Dedicated VIP service channels for SACA members
- Subsidised premiums for certain categories of contracted players (under the MOU)
- Subsidised premiums for six months for players who have lost their contracts
Professional cricketers depend on their health to make a living. Injury and illness are an inevitable part of life and even more so for cricketers and professional sportsmen and sportswomen. It is important to safeguard your cricket career and general health with good health insurance.
Momentum Health is an open scheme and anyone can join. All current professional and semi-professional contracted cricketers who are SACA members are eligible for the additional benefits negotiated by SACA for players on Momentum Health
Momentum Health offers players comprehensive medical insurance backed up by industry leading service. SACA’s arrangements include a number of additional benefits for players:
1. Free monthly Multiply membership for the whole family (normal cost would be: Single member R169pm, Family of two R199pm and Family of three or more R219pm)
2. Guaranteed HealthReturns of R500pm for the Principal member, paid into the player’s HealthSaver account
3. VIP dedicated service channels
Players have a choice between three plan options: Custom, Incentive and Extender. Players can further choose their in-hospital provider network and chronic provider network to manage their monthly premiums accordingly
Medical claims can submitted to Momentum Health in one of three ways:
1. Claims sent from the doctor/service provider directly to Momentum Health and then paid directly to the doctor/service provider.
2. Claims submitted by the member to Momentum Health where the player has paid the doctor/service provider and is now claiming a refund. When submitting claims this way, ensure that the receipts or statements you receive from the doctor/service provider and submit to Momentum Health, have the “ICD-10” or “NAPPI” code relating to the procedure or medication you have purchased. Once you have these receipts or statements you may send them to email@example.com or firstname.lastname@example.org
3. Claims submitted by the member to Momentum Health on behalf of the doctor/service provider, where no payment has been made by the player. Momentum Health will pay the claim in full or in part (depending on your cover and the procedure) and where there is a shortfall, the balance will be for the player’s account.
Claims may be rejected for the following reasons:
1. The codes on the claim are not correct
The code provided on the claim/statement should correspond to the service received.
2. Claims sent too late
All claims must be sent to Momentum Health within four months of the treatment/event. The onus is on the member and not the service provider to make sure that claims are received and paid within this period. If Momentum Health receives the statement or claim outside of the four month period the claim may be rejected and will be for the player’s own account.
3. No pre-authorisation
Certain treatments and procedures require pre- authorisation from Momentum Health for the procedure to be covered, for example, when a player is having an operation in hospital. Typically these can be authorised either online on Momentum Health’s website or on Momentum Health’s mobi app
4. Duplicated claims
A claim will be rejected if the same claim was already submitted to and paid by the scheme. Players are able to check their claims history and status online or on their monthly statement which is sent after the 15th of each month.
Claims submitted incorrectly will not be paid. Players will receive a claims statement explaining the reason the claim has been rejected. The claim will then be returned and the player or healthcare service provider would need to provide the correct information and then re-submit the claim.
Players who have lost contracts or retired from the game are able to maintain their Momentum Health memberships in their personal capacity. For the first six months after the loss of contract or retirement, SACA will pay 100% a player’s Momentum Health and KaeloXelus premiums for the first two months, 75% for month three and four and 25% for the final two months for the principal member and all dependents. After six months, the player will be responsible for the full premiums in his/her personal capacity.
Multiply is Momentum Health’s rewards and wellness programme designed to reward players for the everyday things that help you live a healthy lifestyle. SACA pays for the monthly premium on behalf of players and their registered dependants. Multiply benefits include discounted: flights, Virgin Active membership, Canon equipment, Takealot specials, top-up Pick-n-Pay SmartShopper points and many more. For full details relating to these benefits and other benefits, visit https://www.momentum.co.za/for/you/rewards
By joining Momentum Health through SACA, players and their family (as dependants on the medical scheme) automatically become members of Multiply and SACA pays their monthly premium in full. In order to engage with the programme click on https://www.momentum.co.za/for/you/rewards and register as an online member and follow the prompts to earn points and make use of the discounts on offer.
In the event that a player retires or loses their contract, they can choose whether they would like to remain a member of Multiply in their personal capacity. The monthly premium would then be for the player’s account