Choosing the right medical aid cover for you and your family can be a daunting task, as you are buying medical insurance cover for the unknown, perhaps unexpected events in your life. At Genesis we’ve simplified the process, making it as easy as possible for you to select an affordable plan that’s tailored to your needs.
For a personalised plan or quote, complete the Quick Enquiry form. Alternatively, to find out how our benefits can give you the peace of mind you deserve, call us or use the online chat facility on this website to speak to one of our consultants during business hours.
Since 1995, Genesis has been one of the leading medical aids in South Africa, providing healthcare funding for what may be described as mainly catastrophic events, such as big accidents, illness or disease. We have a proud heritage of providing exceptional benefits at affordable prices, where some of our benefit options have been awarded as providing best value for money in the open medical scheme market. We were also rated as one of the most successful schemes in South Africa as measured by our claims ratio, our ability to pay claims, the access we offer to medical facilities and the benefits provided vs contributions levied.*
Genesis has built up reserves far in excess of the minimum legal requirements and is able to boast a very high claims-paying ability to help put your mind at rest. Over the last several years, we have also been at the forefront of low contribution increases coupled with increased benefits, which is a tribute to the sound management and administration of the Scheme. With an average annual contribution increase of only 5.5% for 2016, which is the lowest of all open medical schemes for the fourth consecutive year, Genesis members continue to save on below-inflation contribution increases.
With benefit options ranging from affordable hospital plans to more comprehensive medical aid cover with savings for day-to-day healthcare expenses, we offer our members excellent financial cover, affordable contributions, more value for money and better service than most other medical schemes in South Africa.
All Genesis members have the luxury of choosing their preferred hospital, doctor or medical specialist along with a choice of funding model. Members are not forced to seek treatment in network hospitals, nor are they required to make use of network medical practitioners. Genesis does however not provide any kind of healthcare service or treatment. Treatment can only be provided by / in a registered healthcare practitioner(s) and / or institution(s). The function of the Scheme is therefore to provide the funding for such treatment and will accordingly reimburse members’ claims in terms of its Rules.
Genesis covers all approved conditions, including Prescribed Minimum Benefits (“PMBs”), in private hospitals, where the benefits and limits, as set out in the Scheme Rules, apply. Hospital accounts will usually be paid in full in terms of tariff agreements with the hospital. In private hospitals, the charges of attending doctors / specialists and other healthcare service providers, will be reimbursed at 100% or 200% of Medical Aid Rate, depending which benefit option you are on.
This funding applies to all claims for treatment in private hospitals, even if the condition is listed as a PMB. Shortfalls relating to treatment received in private hospitals usually pertain to charges for attending doctors / specialists if they charge more than 100% or 200% of the Medical Aid Rate. To this end, should your claim be listed as a PMB and you want it to be paid according to the law as provided for in section 29(1)(p) of the Medical Schemes Act (“paid in full”), then treatment may be obtained from any public or state hospital in South Africa and the Uniform Patient Fee Schedule (UPFS) tariff will apply. If in any doubt, please call the Call Centre for further information.
We encourage prospective members not to look for the cheapest medical aid cover, but for the benefit option that will provide the best cover considering your healthcare needs. It is important to take note of specific exclusions that may affect your cover.
We hope that you will join the Genesis family of members and put to rest one of life’s difficult decisions.