Genesis Provides Cover for Catastrophic Events

February 21, 2015

The Genesis Medical Scheme started up two decades ago. It exists primarily to help people cover the cost of “catastrophic events” including major illness, disease or serious accidents.

Regarded as one of the country’s best medical aids, the scheme strives to provide “exceptional benefits at affordable prices”. It also prides itself on its high claims ratio. That is, its ability to cover claims made, and generally the access it provides to medical facilities overall.


Genesis is the Leading Value-for-money Medical Scheme

Both the full cover medical aid and Genesis hospital plans provide above-average value for money. The scheme’s benefit options have been found to offer 22 percent better value than other schemes, if one takes the benefit cover option into account. It is as much as 31 percent cheaper than other medical aids when compared to equivalent options.

The two options that really stand out are:

  1. Private Choice is an affordable, entry-level hospital plan. It includes dentistry, emergency medical “evacuation”, and in-hospital cover for 25 chronic conditions
  2. Private Comprehensive, a more expensive full cover option that is, as its name suggests, fully comprehensive. It is the most expensive option on offer at Genesis

Genesis Medical Scheme Family ChoicesThere are though two other Genesis options:

  1. Private, which costs a little more than Private Choice, but which offers unlimited hospital cover
  2. Private Plus, which comes with an even higher price tag, but which also offers limited daily cover from a medical savings account

All the Genesis Medical Scheme options (except Private Choice cover three major illnesses: cancer , stroke and organ transplant.

Genesis Members Can Pick and Choose

One of the greatest benefits of this particular medical aid scheme is that members are able to choose their preferred doctors or medical specialists, and the hospital they want to go to. Unlike some other medical aids, there is no obligation to go to “network hospitals” or use doctors or medical practitioners from a company network.

However, Genesis does not provide a healthcare service or treatment facility. Members who need medical treatment must go to registered healthcare practitioners and only in legitimate institutions. What this means is that you go wherever you want for treatment, and the scheme will reimburse your claims according to its terms and conditions.

A Choice of Funding Models


GenesisThere is a choice of funding models for people who take out Genesis medical insurance. While there are some quite “cheap” options, the company does not encourage members to opt for the cheapest of them all, but rather to look for an option that genuinely covers individual healthcare needs. Particularly, as they say, “It is important to take note of specific exclusions that may affect your cover.”

Approved conditions (which include prescribed minimum benefits or PMBs) may be treated in private hospitals, and the hospital account is normally covered in full. Members pay the fees of doctors and specialists, and any other healthcare service providers. Genesis then reimburses the member at 100 or 200 percent of the figure shown on the current scale of benefits. This, of course, depends on the funding model chosen. Patients are paid in full (in terms of the Medical Schemes Act) if they are treated at public hospitals.

You can apply for Genesis Medical Aid cover online.



All info was correct at time of publishing