Genesis Medical Plans Cover All the Bases

    November 1, 2017

    What do Genesis Medical Plans offer me?

    • Cover for in-hospital treatments
    • Some dentistry benefits
    • Affordable premiums
    • Straightforward terms
    • You pay for what you need

    Genesis medical plans include two different hospital plans. You can now recover in peace, knowing that your hospital bills have been taken care of. The plans pay out when you are hospitalized due to an emergency or due to an illness.

    Both of the Genesis medical plans for hospital cover allow for basic dentistry benefits of up to R25 000 per annum and consequently allow you to take care of dentistry work such as crowns, extractions, and Genesis Medical Plansfillings.

    You are not limited to a specific care network and so, consequently, you choose the hospital you want to visit and the doctors to consult with. That said, using a preferred provider can be useful in limiting your costs overall.

    The Genesis Medical Plans

    Private Choice: With premiums of R1000 per adult per month and R325 per child per month. This is the basic cover option and benefits are paid at 100% of the rates that the company sets out.

    Private: With premiums of R1500 per adult per month and R325 per child per month. This offers all the same benefits as the Private Choice but has additional benefits as well. Also, the benefits are paid at a rate of 200% in most cases and the annual limits are a lot higher.

    What is the Rate That the Company Sets Out?

    This is what the company agrees to pay per procedure. They look at how much they have paid, on average, in the past for a range of procedures and use these rates to determine what they pay out for your procedure.

    So, if the doctors charge you the same rate, you are covered in full. If the doctor’s charge over and above this rate, your cover will be determined by what plan you are on, up to a maximum of 200%.

    You Must Use Registered Healthcare Practitioners

    The healthcare practitioner you consult must be registered, as must the hospital or treatment facility you use.

    You Must Follow the Rules

    In non-emergency situations, it is advisable to get pre-authorization for hospitalization before being admitted.

    What is Covered?

    This will depend on the policy option that you choose, but most in-hospital expenses are covered. These are hospital policies so there are no day-to-day benefits on either, except when it comes to dentistry. Dentistry cover is limited to a total of R25 000 per individual per year.

    The main difference between the two policies is that the amount of cover on the Private plan is generally about double what you get on Private Choice and extends to a wider range of conditions.

    Emergency medical evacuation, radiology and pathology are provided for with both of the plans.

    Which Plan is Right for Me?

    This is going to depend on a few things, so ask yourself the following:

    • How much can I afford to pay a month? If you have a spouse and two children, for example, you would pay R3730 on the Private plan and R2650 on the Private Choice plan.
    • What level of cover do I need?

    By answering these questions, you can determine which of the plans is a good fit for you.

    All info was correct at time of publishing