MEDICAL AID BENEFITS OVERVIEW
| Private Choice |
|---|
| Main Member R1,150 |
| Adult Dependant R1,150 |
| Child Dependant R390 |
|
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 R1,665 |
| Adult Dependant R1,665 |
| Child Dependant R455 |
|
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 plans
| Private Plus |
|---|
| Main Member R2,225 |
| Adult Dependant R2,225 |
| Child Dependant R455 |
|
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 |
|
Medical Savings
|
| Private Comprehensive |
|---|
| Main Member R2,400 |
| Adult Dependant R2,400 |
| Child Dependant R455 |
|
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 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.
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 Medical Aid Rate, further limited to R3 700
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.
(*) 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.