What type of Momentum Health plan do you have?

Comprehensive

Hospital Plan

Network Plan

Not Sure

Main Member Age Bracket

Number of Dependants

1

2

3

4+

Have You Experienced Any Of The Following?

Are You Aware Specialists Can Charge Up To 300% Of Medical Aid Tariffs?

Yes

No

Not Sure

Do You Know If Your Nearest Hospital Is Fully Covered By Your Plan?

Yes

No

Not Sure

Would You Like Options That Work Alongside Your Current Medical Aid?

Yes

No

Not Sure

Great - Are you based in Columbus?

Yes

No

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