MEDICAL AID BENEFITS OVERVIEW
No matter which hospital plan or full cover medical aid benefit option you select, you will enjoy comprehensive cover together with the following unique and incredible benefits:
Hospitalisation and related accounts
Hospital and related accounts (e.g. theatre costs, x-rays, pathology, physiotherapy, blood transfusion, medicines, etc.) will be covered at 100% of Medical Aid Rates for a general ward or intensive and high care wards of a private or provincial hospital, day clinic or the recovery room charges of an unattached operating theatre.*
Whilst in hospital, the Scheme will reimburse general practitioners and specialists at cost up to 100% of Medical Aid Rate on the Private Choice option.
On the Private, Private Plus and Private Comprehensive options, general practitioners and specialists will be reimbursed at cost up to 200% of Medical Aid Rate.
All Genesis members enjoy cover for basic dentistry up to R25 000 per beneficiary per annum. This unique benefit includes the following services when obtained from a registered Dental Practitioner:
- Three (3) dental consultations
- Six (6) fillings
- Unlimited extractions
- Six (6) plain x-rays for conservative dentistry
- Two (2) root canal treatments
- Crowns, dentures or bridges limited to the lower of cost or Medical Aid Rate, further limited to R3 200
- Surgical removal of impacted wisdom teeth
Flexibility and Freedom of Choice
All Genesis members have the luxury to choose their preferred hospital, doctor or medical specialist*, along with a choice of funding model. Members are neither forced to seek treatment in network hospitals, nor are they forced to make use of network medical practitioners.
Emergency medical evacuation
Genesis members have access to the ER24 Emergency Contact Centre for the management of any medical emergency, such as emergency pre-hospital treatment, evacuation and transport (including inter-hospital transfers) within the Republic of South Africa, when using ER24, as well as a 24/7 medical helpline service for medical related enquiries.