Genesis Medical Aid Options Include Cover for Major Injury
March 16, 2015
Catastrophic events happen when we least expect them. And that is why Genesis medical aid options incorporate cover for “big accidents, illness or disease”.
Genesis Medical Scheme acknowledges that most people in the market for medical aid schemes in general want peace of mind. They want to know that when unexpected illness or injury happen in life, they will have financial cover.
How Genesis Medical Aid Options Work
Genesis Medical Scheme offers its members a choice of funding models and, provided approval is given prior to treatment, will usually pay hospital accounts in full, in line with the hospital’s tariff agreements.
They cover doctors, specialists and money owed to other providers of health care goods and services in hospital.
Genesis usually reimburse these at what amounts to 100 or 200 percent of the scale of benefits applicable. That relates to whichever one of the Genesis medical aid options you chose.
Genesis is operated in terms of the Medical Schemes Act, which is the legislation that covers medical schemes. This of course means that the statutory prescribed minimum benefits (known as PMBs) in all private hospitals are covered in terms of Genesis scheme rules. Generally, Genesis pays the full bill (rather than a percentage of the scale of benefits) in full (in terms of the Act) for public hospital costs.
As with most reputable medical aid schemes, Genesis encourages new members to make sure that they research all the Genesis medical aid options before deciding which plan to take. This is because healthcare needs differ from person to person and family to family.
The amount you will have to pay every month will depend on the the Genesis medical aid option.
General Benefits of Genesis Medical Aid Options
There are certain benefits that all Genesis medical aid options cover:
- Unlimited hospitalisation
- Basic dentistry
- Emergency medical evacuation
Generally, you have cover for all hospital costs (from bed to blood transfusions) at the accepted medical aid rate, at very least for general and high- and intensive care wards and recovery rooms. Genesis also covers GP and specialist fees at 100 percent under the Private Choice option; and at cost (up to 200 percent of the medical aid tariff) for those members who take the Private, Private Choice, Private Plus and Private Comprehensive Genesis medical aid options.
While Genesis covers “basic” dentistry under all Genesis medical aid options, all members get quite good cover per beneficiary each year. As long as they go to a registered dentist, they will have cover for three consultations; unlimited fillings, extractions and X-rays; root canals; crowns and temporary crowns (with limits of R2 500 per crown); and the surgical extraction of any wisdom teeth that have become impacted.
All Genesis medical aid options also include ER24 emergency transport and treatment.
All info was correct at time of publishing