Formularies and Code lists


Note: Please find below formularies and lists of tariff codes applicable to Momentum Health Ingwe and Impact members, as well as Momentum Health4Me members.

Momentum Health 

Medicine formulary for all options

Open list   

Pathology list of applicable codes for Ingwe and Impact Options     

Open list

Radiology list of applicable codes for Ingwe and Impact Options

Open list

Dental list of applicable codes for Ingwe and Impact Options

Open list


Momentum Health4Me 

 Medicine formulary for Health4Me

 Open list 

 Radiology list of applicable codes for Health4Me      

 Open list 

 Pathology list of applicable codes for Health4Me

 Open list

 Dental list of applicable codes for Health4Me

 Open list