genesis medical scheme medical scheme

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