MEDICAL AID BENEFITS OVERVIEW
| 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.