Genesis Hospital Plan Cover Grants Great Dental Benefits on All Packages

    February 23, 2017

    Unlike most entry-level to mid-range hospital plans, the Genesis hospital plan cover gives you up to 200% scheme tariffs on selected procedures. While the in-hospital cover is outstanding, there are no out-of-hospital benefits provided at all. This hospital plan is great for the elderly due to a host of at-home and conventional medical support. Here we take a look at Genesis’ rates, services and procedures covered by their outstanding hospital plan.


    Genesis Hospital Plan Cover & Contributions

    Genesis Hospital Plan CoverThis Genesis hospital plan cover medical scheme gives annual cover to a maximum of R550,000 per beneficiary. It includes both in and out of hospital services and procedures. The following monthly contributions charge:

    • R1500 for the Principal Member
    • R1500 per Adult Dependent
    • R365 per Child Dependent


    Scheme Rates for Medical Support

    Genesis supplies varying scheme tariffs based on the procedures required. All medical benefits have coverage, as per legal stipulations. The following scheme rates are applicable:

    200% of Medical Aid Rate

    • GP Consultations
    • Specialist Consultations
    • Psychiatric Treatment
    • Maxillo-facial Surgery
    • Doctor’s Room Surgical Procedures
    • Cancer Treatment
    • Strokes
    • Motor-Neuron Disease Management
    • Organ Transplants


    100% of Medical Aid Rate

    • Ward Fees
    • Internal Medicine
    • Surgical Appliances and Prosthetics
    • Pathology
    • X-rays
    • MRI & CT Scans
    • Physiotherapy
    • Dental
    • Blood Transfusion
    • Haemodialysis
    • In-Hospital Medicine
    • Emergency Pre-Hospital Care
    • Chronic Cover & Medicine


    Auxiliary Benefits from Genesis

    Diagnostic endoscopy comes with procedural limits. For a colonoscopy, you have a maximum budget of R4000, while gastroscopy comes with a R2750 limit per procedure. External medical and surgical appliances are covered at 75% of the cost to a maximum of R16,500 per beneficiary per year. Stroke rehabilitation has coverage at R80,000 per year, while immunosuppressant medication gives a budget of R84,000 per family per year. The highest you can push your dental budget is R25,000 per year, which should be enough for even serious dental complications. Although periodontal disease sufferers should be aware that there is no cover for advanced dentistry.

    Medical Services Which Are Limited or Not Covered

    Genesis gives you no cover for optical support, such as spectacles and contact lenses. There is no budget for external surgical appliances, nor out-of-hospital savings, medicines or consultations. Radiology and pathology services also have no coverage.  You also have no option of breast reduction or augmentation surgery, no any cosmetic procedure including obesity treatments.  Fertility and libido medicinal services are also to be paid out of pocket.

    Why Genesis is Better for Older Individuals

    When looking at the Genesis Hospital plan, it gives everything that would be expected of a top range private solution. The one thing that makes it stand out for the aged is the hospice care cover. R200 per day is for home care, and hospice accommodation is paid at a 100% scheme tariff. In-house doctor’s visits are at the same rate. Although the fact that no optical medicine has coverage may turn some older members away. The dentistry also only allows for one major in-hospital surgical procedure per year. So keep this mind.

    Genesis – Excellent Hospice Care & Good Scheme Tariffs

    If you have a PMB condition which you know needs constant attention, then check if it falls under the 200% tariff rate. If it does, this hospital plan may well make a worthy choice. Those who need hospice care should consider taking their medical aid from Genesis. However, younger individuals and young families may find better-suited hospital plans elsewhere. At R1500 per month, it is considerably more expensive that entry level hospital plans, but you do get the benefit of a 200% tariff in most cases.


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    All info was correct at time of publishing