Genesis Medical Scheme rates as one of the most successful medical aids in the country with Genesis Private Choice as its most successful hospital plan. They started in 1995, and have since established themselves as market leaders in the field because they are at least 31% cheaper than other medical schemes.
Comprehensive medical aid is unaffordable for the many South Africans who are battling to make ends meet each month. So for them, considering a hospital plan alone is their only option.
In a recent survey, the Private Choice Hospital Plan showed 63% more value for money than other equivalent Hospital Plan options. That is because it is for members who want unlimited hospital cover, covered at the medical aid rate. Another attractive benefit is the separate cover for dentistry.
Therefore, the Genesis Private Choice hospital plan is ideal for individuals and young families with children.
Contributions
- R950 per adult per month
- R320 for first child
- R250 for each child after that
- Thus, for a family of four (two adults and two children), it will be R2470
Waiting Periods
- The general waiting period is three months from the date of joining unless medication is in need for a PMB chronic condition.
- Also for pre-existing conditions – up to 12 months.
Benefits and Limits of the Genesis Private Choice hospital plan
- Excellent in-hospital benefits covered at 100% Medical Aid Rate.
- Basic Dentistry has a benefit of R25,000 per beneficiary per annum.
- Emergency medical evacuation.
- ER24 Emergency Contact Centre is the service provider when you need an ambulance.
- ER24 Emergency Contact Centre also includes inter-hospital transfers when necessary.
- You can use the 24/7 medical helpline for medically related enquiries.
- For some Major Medical Illnesses, there is a limited in-hospital benefit of R50,000 per beneficiary a year.
- This benefit includes cover for 25 chronic conditions at 100% if the formulary drugs are in use.
- Freedom of Choice
- All members may use their preferred hospital, doctor or specialist.
- No-one is forced to take advantage of a particular network hospital or doctor.
- The Medical Aid rate covers in-hospital doctors, specialists, pathology, and physiotherapy.
- 100% cover for psychiatric treatment in hospital but has a limit of R36,000 per beneficiary per annum.
- Scans
- The medical scheme pays for MRI/CT scans at whichever is the lowest price – the cost, or Medical Aid rate.
- For each scan, the member has a co-payment of R2750.
- Limited up to 2 scans per year, and R6250 per scan.
- There is no benefit for out-of-hospital scans.
- Also, scans need to be clinically motivated by a specialist and authorised by the scheme.
- You will get 20% discount if you keep yourself healthy by joining Planet Fitness.
- Blood transfusions are covered up to 100% of the Medical Aid Rate.
How to Apply
- You can apply on the Genesis Medical Scheme web page, online.
- Apply by downloading and printing an application form.
- You may send an SMS to Genesis, asking them to contact you and answer any questions you may have.
Conditions
- Children are not recognised as dependents when they reach the age of 21.
- Genesis will not pay for any claims submitted after four months.
- Hospital admissions not pre-approved will have a co-payment of R3,000.
Good health is of the utmost importance to enjoy a happy lifestyle. Therefore, if you go to hospital unexpectedly, you want to know that you will be receiving the best medical care possible. For peace of mind, you need to join Genesis Private Choice Hospital Plan to ensure that you will be getting just this.
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