Genesis Medical Scheme

 

Genesis Medical Scheme is an extremely viable, medium-sized South African medical scheme. It is an open medical aid, meaning that anyone is free to join and enjoy the benefits of excellent health cover while paying competitive monthly premiums.

GenesisGenesis Medical Scheme was recently rated as one of the top five most successful medical schemes in the country, as measured by claims ratio and access to health care providers.

Different

It publicizes itself as being “Different from the rest”. While all the medical aid schemes are more similar than they are different – doing their best to provide medical cover for South Africans – the Genesis medical aid scheme is subtly different in several ways.

An excellent way to judge the soundness of a medical scheme is to assess its liquidity (solvency ratio) meaning the amount of funds it has in order to pay claims.

The Medical Schemes Act requires a minimum solvency of 25 % to be maintained by all medical schemes. Currently Genesis has more than R220 million, which is over 4 times the legal minimum required by the Act.

No Limits

The Genesis medical aid scheme is based in Cape Town, although it serves people everywhere in South Africa. Its main attraction is that its members can choose any hospitals, doctors and pharmacies they like. Members are not limited to one hospital group or another, for instance.

Highlights

  • Some of the main features of the Genesis Medical Scheme are:
  • Extremely low average contributions increase of less than 5%
  • Access to any private hospital in SA from as little as R795 per adult per month
  • No network hospitals or doctors
  • Basic dentistry benefits of R25 000 per person per annum
  • Low child premiums
  • Do deposits payable in advance for hospital admissions

Four Plans

There are four straightforward choices of Genesis Medical Scheme plans:

Private Choice

is the least expensive option. It includes unlimited hospital cover at any state or private hospital in South Africa at Scale of Benefit rates, basic dentistry R25 000 per beneficiary per annum, emergency medical evacuation, limited in-hospital cover for certain major medical illnesses and cover for 25 chronic conditions.

Private

option is as above but includes hospital cover at private rates, in an out of hospital treatment for certain major medical conditions, MRI/CT scans and certain diagnostic scopes.

Private Plus

is the same as the private option but hospital cover is at the Genesis Private Rate. This option is designed for members who want limited day-to-day cover by means of a medical savings account.

Private Comprehensive

is the same as Private Plus but is designed for members who require extensive day-to-day cover (by way of a medical savings account plus other additional benefits). In addition to the generous medical savings account, this option offers members ample cover for consultations (at any practitioner registered with the Health Professions Council of SA) and cover for medication – both prescribed and over-the-counter.