genesis MEDICAL SCHEME MEDICAL SCHEME
Post on 31-Dec-2015
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genesis MEDICAL SCHEME
MEDICAL SCHEME
Unique Benefits
• The luxury to choose
• Unique basic dentistry benefit – R25 000 per person p.a.
• Child dependant rates exceptionally well positioned
• Out of hospital MRI / CT benefits
• No upfront deposits prior to hospitalisation
• Provides excellent financial cover (200% on 3 of the 4 benefit options)
• Strong financial position
• Average contribution increase 4.95% (2013)
Scheme Philosophy
Founded on principle that medical aid
is not about loyalty and / or incentive
programmes, but to provide the best
possible financial cover during times
of life-threatening diseases or ill-
health, at any provider of choice.
Financial sustainability
• One of the top 5 open schemes
over the past 9 years
• Share 4th position - 2011
Financial sustainabilityPosition Scheme Reserves per
member to pay claims
3 Genesis Medical Scheme R30,450
9 Fedhealth Medical Scheme R12,021
10 Bestmed R10,734
11 Bonitas Medical Fund R10,073
12 Spectramed R9,906
14 Medihelp R9,822
17 Liberty R8,011
19 Discovery Health MS R6,990
20 Keyhealth R6,504
23 Momentum Health R5,625
25 Resolution Health MS R1,833
2013 Benefits
R 795
R 1 185
R 1 445
R 1 990
2013 Benefits - an overview
All Benefit Options
• Designed to provide cover at cost up to R25 000 per beneficiary p.a.
for the more essential and routine procedures, such as fillings,
extractions and crowns that help prevent long-term serious problems
from developing
• In-hospital surgical removal of impacted teeth (R9 000 per admission)
• Dental benefit for extractions & fillings for children < 8 years (once in a
lifetime benefit)
• All dental procedures paid at lower of cost or Scale of Benefits
Dental benefits
2013 Benefits - an overview
Private Plus & Private Comprehensive
Private Plus Private Comprehensive
Per adult R2 700 R4 320
Two (2) adults R5 400 R8 640
Medical savings
2013 Benefits - an overview
Private Comprehensive
• 100% of cost up to R2 400 per adult p.a. - balance subject to
available savings benefit
• Medicine benefit is determined by the number of adults within
the membership and is a pooled benefit that is available to be
used by all beneficiaries within the membership
Medicine benefit
Per adult R2 400
Two (2) adults R4 800
Medicines
2012 Benefits - an overview
Private Comprehensive
• Six (6) consultations per adult p.a. up to R275 per consultation
with any practitioner registered with the Health Professions
Council of SA
• Consultation benefit is determined by the number of adults within
the membership and is a pooled benefit that is available to be
used by all beneficiaries within the membership
Consultation benefitPer adult 6 x R275 = R1 650
Two (2) adults 12 x R275 = R3 300
Consultations
Day-to-day benefit summary (per adult)
Private Choice
Private Private Plus Private Comprehen-
sive
Consultations R1 650
Medication R2 400
Savings R2 700 R4 320
Dental R25 000 R25 000 R25 000 R25 000
TOTAL R25 000 R25 000 R27 700 R33 370
2013 Contributions
2013
Private Choice
Adult R795
First Child Dependant R320
Additional children R85 each
Private
Adult R1 185
Child R335
Additional children R90 each
Private Plus
Adult R1 445
Child R335
Additional children R90 each
Private Comprehensive
Adult R1 990
Child R335
Additional children R90 each
Contact
New membership 0861 joinnow
0861 546 6669
Enquiries 0860 10 20 10
Website www.genesismedical.co.za
The Genesis website is a comprehensive tool for members, service providers, employers and brokers and provides information ranging from benefit information to a rates calculator, press office and password protected personal details.
This presentation contains a summary of benefits and is for information purposes only. It does not include all
relevant benefits, limitations and exclusions.
Thank You
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