MEDICAL AID BENEFITS OVERVIEW

Hospital cover medical aid plans

Private Choice
Main Member
R1,340
Adult Dependant
R1,340
Child Dependant
R440
Hospitalisation
Hospital & Related Accounts
Any Provider of Choice
Emergency Medical Evacuation
Basic Dentistry
Major Medical Illness
MRI / CT Scans
In-Hospital only
Private
Main Member
R1,850
Adult Dependant
R1,850
Child Dependant
R550
Hospitalisation
Hospital & Related Accounts
Any Provider of Choice
Emergency Medical Evacuation
Basic Dentistry
Major Medical Illness
MRI / CT Scans
In-& Out of Hospital
Diagnostic Scopes
e.g. Colonoscopy & Gastroscopy

Comprehensive medical aid plan

Private Comprehensive
Main Member
R2,640
Adult Dependant
R2,640
Child Dependant
R530
Hospitalisation
Hospital & Related Accounts
Any Provider of Choice
Emergency Medical Evacuation
Basic Dentistry
Major Medical Illness
MRI / CT Scans
In-& Out of Hospital
Diagnostic Scopes
e.g. Colonoscopy & Gastroscopy
Self Managed Fund (SMF)

Terms and conditions apply as set out in the Scheme Rules.

No matter which 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 Scheme Tariff 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 Scheme Tariff on the Private Choice option.

On the Private and Private Comprehensive options, general practitioners and specialists will be reimbursed at cost up to 200% of Scheme Tariff.

Basic dentistry benefits

All Genesis members enjoy cover for basic, as well as some enhanced dentistry benefits. This unique benefit includes the following services when obtained from a registered Dental Practitioner:

Three (3) dental oral examinations

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 Scheme Tariff, further limited to R5 000

Surgical removal of impacted wisdom teeth

One (1) scale and polish

One (1) dental implant limited to R10 000 per three year financial year cycle of membership

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.

(*)  Statutory prescribed minimum benefits (PMBs) in private hospitals are covered as per the Scheme Rules; in public or state hospitals, benefits are covered as prescribed by law.