Genesis Medical
Insurance in Cape Town

Genesis offers the perfect balance between affordability and quality healthcare. Genesis Medical Scheme, medical aid, insurance.

Always consult your own healthcare practitioner before taking any medication and/or supplements or embarking on any treatment. So what does Genesis Private Choice hospital plan offer that most don’t? Medical aid membership application made easy with on-line application. Statutory Prescribed Minimum Benefits (PMBs) in private hospitals are covered as per the Scheme Rules. Flu, or influenza, is a viral illness that occurs predominantly in the winter. Why don’t all medical aid schemes pay for preventative screening tests? This funding applies to all claims for treatment in private hospitals, even if the condition is listed as a PMB. Instead, we encourage you to make use of your electronic membership card. Foreign students wishing to study in South Africa and who wish to apply for membership in order to get a visa, are not eligible for membership of the Scheme. As with all medical schemes, Genesis is owned by all its members. Most out-of-hospital medical costs are paid from your day-to-day credit facility via a Savings Account. As a member of a new generation scheme you are responsible for managing most of your out-of-hospital costs, while the Scheme provides for the higher costs associated with hospital care. The Medical Schemes Act requires medical schemes to have reserves of at least 25% of the total contributions paid by members in a year. It follows that no medical scheme has financial backing. All medical schemes maintain a pool of funds that is used to pay claims. The success of any scheme lies in the ability of a scheme to maintain that pool of funds at a level that is sufficient for its members’ claims; hence the solvency requirements of a scheme as required by the Medical Schemes Act. At the beginning of each three months period in any financial year, the Scheme will make available a savings facility not exceeding three times the monthly savings contribution that is included in your monthly contribution. Savings benefit of those members joining the Scheme during a financial year, will be prorated to the end of the applicable three month period of that financial year. Expressly excluded from payment on the Private Choice benefit option, are scans related to dental conditions, conservative back treatment, migraine and diagnostic purposes. Scaling and polishing are regarded as preventative treatment, whereas our dental benefits are treatment orientated. All forms of preventative screening are funded from your available savings balance. Whilst in hospital, the Scheme will reimburse general practitioners and specialists at cost up to 100% of Medical Aid Rate on the Private Choice option. On the Private, Private Plus and Private Comprehensive options, general practitioners and specialists will be reimbursed at cost up to 200% of Medical Aid Rate. Statutory Prescribed Minimum Benefits (PMBs) in private hospitals are covered as per the Scheme Rules; in public or state hospitals, benefits are covered as prescribed by law.