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2023-02-11 7:09 AM

Genesis Medical Scheme Review 2023

By Parddon Khumalo

Genesis Medical Scheme is a medical cover that provides up to 200% of the scheme tariff when hospitalised. The contributions to medical aid have a minimum premium of R1,465.00 and a maximum premium of R2,815.00 per month.

Children can be covered for as little as R480.00 per month and as much as R580.00 per month. The Genesis Medical Scheme charges flat premiums and does not require an individual assessment when obtaining coverage.

All of the available plans include basic dental benefits. Basic dental benefits include:

  • 3 oral dental examinations
  • There are 6 fillings.
  • Extractions are unlimited.
  • 6 straightforward x-rays for conservative dentistry
  • 2 root canal procedures
  • Crowns, dentures, or bridges are limited to the lower of cost or Scheme Tariff, with a further R5,250.00 limit.
  • Surgical extraction of impacted wisdom teeth
  • 1 scale and polish
  • 1 dental implant is limited to R10,000.00 per membership cycle of 3 years.

The Genesis Medical Scheme offers three distinct plans. These plans are discussed in depth further below.

The Genesis Medical Scheme Plans

Genesis Comprehensive Medical Aid Plan

The Genesis Comprehensive medical aid plan pays for ward fees up to 100% of the scheme tariff. The plan provides coverage to members for up to 200% of scheme tariffs for visits to general practitioners and medical specialists.

A monthly contribution of R2,815.00 is required to join the comprehensive medical aid plan. Adults can join the scheme for a monthly fee of R2,815.00. In addition, children can be added to the plan for R580.00 per month.

Comprehensive medical aid also covers mental illness. When hospitalized due to mental illness, the plan pays up to 200% of the scheme tariff. The annual cover is limited to R42,000.00 per beneficiary.

The Genesis Comprehensive Medical Aid Plan covers a wide range of medical situations. The following medical events are covered by the comprehensive medical aid plan:

  • Medicines used in hospitals (100% of legislated cost).
  • Pathology services (pays costs of up to 100% of the scheme tariff).
  • Maxillo-Facial surgery.
  • Plain radiography (100% of the lower of cost or scheme tariff).
  • MRI and CT scans (100% of the lower cost or scheme tariff when hospitalised).
  • Internal medical/ surgical appliances (100% of cost up to R30,000.00 p.a)
  • External medical/ surgical appliances (75% of cost up to R19,000.00 p.a)
  • Physiotherapy
  • Blood transfusion.
  • Basic dentistry benefit.
  • Hemodialysis, and more.

Genesis Med 100 Plan

The Med 100 plan is an in-hospital medical plan that covers 100% of ward fees. The plan also covers the cost of general practitioners’ and medical specialists’ fees up to 100% scheme tariff.

The Genesis Med 100 plan also includes coverage for mental illness treatment and pays up to 100% of the scheme tariff. The plan pays the lower of the cost or R1,000.00 per out-of-hospital contact and caps the benefit at R42,000.00 per year.

The plan charges the main member’s monthly contribution of R1,465.00. A primary member can add additional adults for R1,465.00 per adult. Children can also be added to the plan for R480.00 per month.

The Genesis Med 100 plan comes with the following benefits:

  • Physiotherapy costs of up to 100% of scheme tariff.
  • Basic dental care.
  • Blood transfusion costs of up to 100% of the scheme tariff.
  • Internal medical or surgical appliances to the cost of 50% of up to R20,000.00 per beneficiary.
  • External medical or surgical appliances to the cost of 75% of cost up to R19,000.00 per member family p.a
  • Surgical procedures in doctor’s rooms of up to 100% of scheme tariff.
  • Emergency pre hospital treatment and more.

Genesis Med 200 Plan

Genesis Med 200 is a medical aid plan that covers ward fees up to 100% of the scheme tariff. The plan also covers the costs of general practitioners and medical specialists, up to 200% of the scheme tariff.

The main member of the Med 200 plan contributes R2,025.00 per month. Adults can join the plan for R2,025.00 per month. Furthermore, children can be covered for a lower premium of R580.00.

The following benefits were included in the plan:

  • Basic dentistry.
  • MRI or CT scans in hospital and out of hospital.
  • Emergency medical evacuation.
  • Private hospitalisation.
  • Major medical illness conditions in hospital and out of hospital.
  • Diagnostic scopes such as colonoscopy.
  • Auxiliary services such as mammograms and more.

Advantages of the Genesis Medical Scheme

  • The plans available are diverse.
  • There are many benefits to each medical plan.
  • The comprehensive cover is very affordable.
  • Children can benefit from the Genesis Medical Scheme at a discount.
  • Cover for major illness is available on all medical plans.

Disadvantages of the Genesis Medical Scheme

  • There are no executive medical plans.
  • There are no rewards for joining the medical scheme.

Conclusion

Genesis Medical Scheme has always been one of South Africa’s most affordable private healthcare schemes. Since its inception in 1995, the scheme has built a solid reputation for having a thorough understanding of private healthcare. 

When compared to other medical schemes in South Africa, Genesis medical aid is inexpensive. The medical scheme offers more than one plan, each with numerous benefits.

Children can also be included in medical plans at significantly reduced rates. The Genesis Medical Scheme does not accommodate those who require executive medical assistance, which is the scheme’s main disadvantage.

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Parddon Khumalo