Genesis Medical Aid Options Include Cover for Major Injury
Catastrophic events happen when we least expect them, which 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, and Genesis medical aid options in particular, want to rest assured that when unexpected things happen in life – that lead to injury or illness – that they will be covered financially.
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. Doctors, specialists and money owed to other providers of health care goods and services that are covered while you are in hospital will usually be reimbursed at what amounts to 100 or 200 percent of the scale of benefits applicable to whichever one of the Genesis medical aid options you have chosen.
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 the full bill (rather than a percentage of the scale of benefits) will be paid in full (in terms of the Act) if the member gets treatment at a public hospital.
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 be required to pay every month will depend on the funding option you choose when you sign up for one of the Genesis medical aid options.
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, all hospital costs (from bed to blood transfusions) will be covered at the accepted medical aid rate, at very least for general and high- and intensive care wards and recovery rooms. GP and specialist fees are also covered at 100 percent if the Private Choice option is taken; and at cost (up to 200 percent of the medical aid tariff) for those members who take the Private, Private Plus and Private Comprehensive Genesis medical aid options.
While the dentistry covered by all Genesis medical aid options is said to be “basic”, all members get quite good cover per beneficiary each year. As long as they go to a dentist who is registered, they will be covered 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.