With effect from 1 January 2021, your current Private Plus benefit option will be discontinued.
This decision was approved by the Trustees of Genesis Medical Scheme having regard to the massive financial hardship caused to many members by the Covid-19 pandemic. The discontinuation of the PLUS option will result in all members with a positive personal savings balance being refunded that money and, in addition, members will be given the opportunity of keeping their medical aid cover while opting for a lower monthly contribution. Members that want a higher out of hospital benefit have the option of choosing the COMPREHENSIVE option at a higher contribution.
This change follows the Scheme’s philosophy of being a medical scheme with its core focus centered on the provision of in-hospital risk benefits plus basic dentistry benefits.
As a result of this change you will have the option of moving to one of the following benefit options:
1. Private benefit option; or
2. Private Comprehensive benefit option.
The table below highlights the most important differences between your current Private Plus option (2020) and what the cost and benefits will be on the other two options in 2021.
* Contribution increases in 2021 will be R85 per adult per month and R30 per child per month across all benefit options.
HOW DOES THE PRIVATE OPTION WORK?
By electing to change to the PRIVATE option all of the benefits that you enjoyed under the PLUS option will remain exactly the same EXCEPT for the fact that you will not have a personal savings account for any out of hospital medical expenses. However, your monthly contribution will be reduced by R375 per adult or R750 for a family of 2. This saving will then be entirely under your personal control to invest and use for those out of hospital expenses. In addition, if you do not spend any of the savings you will earn the interest on those funds.
In summary then, apart from not having day-to-day benefits on our PRIVATE option, all other benefits will remain exactly the same as on your current Private Plus option, e.g. in-hospital benefits, dentistry, scopes and scans, chronic benefits, cancer cover, etc. are all exactly the same.
HOW DOES THE PRIVATE COMPREHENSIVE OPTION WORK?
If you elect to move to our PRIVATE COMPREHENSIVE option your monthly contribution will increase by R415 per adult and all your benefits will remain exactly the same as on your current Private Plus option, e.g. in-hospital benefits, dentistry, scopes and scans, chronic benefits, cancer cover, etc., but you will have more day-to-day benefits. The only difference between the PLUS and the COMPREHENSIVE options is with regard to your out-of-hospital benefits which increase as a result of the higher monthly contribution.
Currently, your day-to-day benefits are managed via your savings account whereas on the Private Comprehensive option it will be managed via a Self-Managed Fund (SMF). The annual day-to-day benefit of R8 160 per adult per annum is higher than your current day-to-day benefits of R4 740 per adult per annum.
At the beginning of each three months period in any financial year, the Scheme will make available a SMF benefit not exceeding three times the SMF contribution that is included in your monthly contribution. In addition, any amount unused from a previous three-month period in the same financial year, will be added to your available SMF balance. At the end of each financial year, any unused balance in the SMF will be forfeit to the Scheme.
IN SUMMARY
- Should you select the PRIVATE benefit option, your monthly contributions will decrease by R375 per adult and you will enjoy exactly the same risk cover and dental benefits as on your current option. Out-of-hospital expenses will be self-funded.
- Should you select the PRIVATE COMPREHENSIVE benefit option your monthly contributions will increase by R415 per adult and you will enjoy exactly the same risk cover and dental benefits as on your current option. Your out-of-hospital benefits will increase by approximately 72% (R4 740 per adult p.a. to increase to R8 160 per adult p.a.)
- Any unused balance on your personal medical savings account will be refunded to you during January 2021. Should you be facing financial hardship and be in need of the money sooner, you are welcome to engage with the Scheme concerning payment of any savings claims that you incur prior to 31 December 2020.
NEXT STEPS
Please consider your benefit options for 2021 and then inform us of your decision as soon as possible.
Also note that any positive savings balance at year-end will be refunded to you during January 2021.
What is set out above is a summary of the changes. Should you be in any doubt about what all of this means or if you are unclear about what to do, we invite you to contact the Scheme by using this email address only: option-change@genesismedical.co.za. A consultant will then call you to discuss with you your options and assist you however possible. Please do not use any other email address but the one stated herein for queries in regard to this change.
* Contribution and benefit increases are subject to registration by the Registrar of Medical Schemes.
