Overall, the Medihelp MedAdd Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and in-hospital procedures to up to 3 Family Members. The Medihelp MedAdd Medical Aid Plan starts from R1,465 ZAR.
|👤 Main Member Contribution||R1,465|
|👥 Adult Dependent Contribution||R1,465|
|🍼 Child Dependent Contribution||R480|
|🔁 Gap Cover||None|
|📉 Annual Limit||None|
|↪️ Hospital Cover||Unlimited|
|🟦 Screening and Prevention||☑️Yes|
|💙 Medical Savings Account||None|
|👶 Maternity Benefits||☑️Yes|
|🔎 Home Care||None|
The Genesis Medical Aid MED-100 plan is one of 3, starting from R1,465, and includes basic in-hospital benefits, basic dentistry, chronic condition cover, and some out-of-hospital benefits. Gap Cover is not available on the Genesis Medical Scheme MED-100 Plan. However, Genesis offers 24/7 medical emergency assistance, and according to the Trust Index, Genesis Medical Scheme has a trust rating of 4.2.
Genesis Medical Scheme has the following plans:
|👤 Main Member||👥 Adult Dependent||🍼 Child Dependent|
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|📌 Statutory Prescribed Minimum Benefits (PMBs)||Benefits for treatment in a public or state hospital are prescribed according to the law.
Benefits for treatment in private hospitals are subject to the limits and features indicated in the sections below.
|💴 Ward Fees||Covered up to 100% of the Scheme Tariff.|
|👩⚕️ GPs and Medical Specialists|
(Includes Maternity Benefits)
|Covered up to 100% of the Scheme Tariff.|
|🧠 Mental Illness||Only PMBs are covered.
Claims are covered 100% when service and treatment are obtained from a DSP.
Treatment in a non-DSP facility is covered up to 100% of the scheme tariff when admitted to the hospital.
Alternatively, claims are paid at the lower cost of R1,000 per contact out-of-hospital.
Limited to R42,000 per beneficiary per year.
|💊 In-Hospital Medicine||Covered up to 100% of the legislated cost.|
|📈 Pathology||Covered up to 100% of the Scheme Tariff.|
|📉 Basic Radiology||Covered up to 100% of the lower cost or the Scheme Tariff.|
|📊 MRI and CT scans||Subject to an R2,750 co-payment per scan when hospitalized.
Limited to two scans per family member yearly and R7,350 per scan.
Subject to pre-authorization.
The scheme does not cover the following scans:
Conservative back/neck conditions
|🦾 Internal Prostheses and Surgical Applications||Covered up to 50% of the cost, limited to R20,000 per beneficiary yearly.|
|🦿 External Prostheses and Surgical Applications||Covered up to 75% of the cost, limited to R19,000 per family yearly (for treating fractures)|
|🏈 Physiotherapy||Covered up to 100% of the Scheme Tariff.|
|🩸 Blood Transfusions||Covered up to 100% of the Scheme Tariff for materials, operator’s fees, and apparatus.|
|🦷 Dental Services and Treatment|
|Covered up to 100% of the Scheme Tariff.
Covers the surgical removal of bony impacted wisdom teeth when pathology and pain are directly related to wisdom teeth.
limited to the lower of cost R15,000 per case.
Covered up to 100% of the Scheme Tariff for child beneficiaries <9 years (extractions and fillings), limited to R10,000 or the lower cost per case.
Subject to the Genesis protocols and pre-authorization.
Limited to one hospital admission per beneficiary yearly.
|😊 Maxillo-Facial Surgery||Covered up to 100% of the Scheme Tariff.
Pre-authorization is required.
It must be a result of major trauma or an accident.
The following are excluded:
Conservative dental treatment
Root Canal Treatment
Osteotomies to correct congenital disorders
Genioplasty and related costs
|📍 Surgical Procedures performed in the doctor’s rooms||Covered up to 100% of the Scheme Tariff for qualifying procedures that would otherwise need hospitalization|
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|🎗️ Cancer||Limited to PMBs in a public or state hospital.|
|💛 Organ Transplants||Limited to PMBs in a public or state hospital.|
|🟨 Emergency Pre-Hospital Treatment / Transport and Evacuation||Covered up to 100% when using ER24 as the designated provider.|
|⚠️ Chronic Benefits||Subject to pre-authorization and registration|
|🟥 Prescribed Chronic Disease List (CDL) conditions||Limited to the extent of therapeutic algorithms.
Covered up to 100% of the cost of formulary medicine.
|🟧 Basic Dentistry||Covered at the lower of cost or Scheme Tariff for the following qualifying dental benefits when obtained from a registered Dental Practitioner (per beneficiary annually):
Three (3) oral examinations by a dentist.
Six (6) fillings.
Tooth extraction procedures.
Six (6) radiographs for conservative dentistry (excluding wide-angle/panorex imaging and CT/MRI scans).
Two (2) root canal treatments, excluding wisdom tooth root canal treatment.
Crowns, bridges, or dentures are limited to the lower cost or Scheme Tariff and R5,250.
Surgical removal of bony impacted wisdom teeth where pathology and pain are directly related to wisdom teeth.
One (1) scale and polish.
One (1) dental implant is limited to R10,000 per three-year membership cycle.
|🟨 Mammogram||Covered up to 100% of the lower cost or the Scheme Tariff, limited to the following:
One claim per year for female beneficiaries <39 years when prescribed by a GP or gynecologist.
One claim per year for female beneficiaries 40 years>.
|🟩 Cervical (Pap) Smear||One test per year for female beneficiaries 18 years> when prescribed by a GP or gynecologist.|
|🟦 Prostate Specific Antigen (PSA) Test||One test per year for male beneficiaries 50 years>.|
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Some general exclusions include, but are not limited to:
The imposition of waiting periods by Genesis is at the discretion of the Scheme, following an assessment of the health profile of the applicant. This measure prevents individuals from joining the Scheme solely to access hospital services in the immediate future. There are two types of waiting periods as follows:
Also take note that New Members 35 years or older may be subject to late-joiner penalties on Genesis Medical Aid Plans.
|🔎 Medical Aid Plan||🥇 Genesis Medical Scheme MED-100||🥈 KeyHealth Essence||🥉 Bonitas BonStart|
|👤 Main Member Contribution||R1,465||R1,814||R1,338|
|👥 Adult Dependent Contribution||R1,465||R1,454||R1,338|
|🍼 Child Dependent Contribution||R480||R654||R1,338|
|🔁 Gap Cover||❎ None||☑️ Yes||☑️ Yes|
|💙 Hospital Cover||Unlimited||Unlimited||Unlimited|
|💶 Prescribed Minimum Benefits||☑️ Yes||☑️ Yes||☑️ Yes|
|🩺 Screening and Prevention||☑️ Yes||☑️ Yes||☑️ Yes|
MED-100 is a comprehensive medical aid plan offered by Genesis Medical Scheme. The plan provides generous cover for in-hospital treatment, including specialists and doctors, with no co-payments required. Members also benefit from out-of-hospital benefits, including coverage for chronic medication, basic dentistry, and maternity services. However, the plan has some drawbacks. For instance, certain out-of-hospital benefits for cancer are only limited to PMB treatment in public/state hospitals, which could be a disadvantage for those who prefer private healthcare. Additionally, the plan imposes waiting periods at the discretion of the Scheme, which could be inconvenient for some members. Overall, MED-100 is a comprehensive medical aid plan with good in-hospital and out-of-hospital benefits. However, potential members should carefully consider its limitations and restrictions before deciding.
MED-100 is a comprehensive medical aid plan offered by Genesis Medical Scheme, covering in-hospital and out-of-hospital treatment.
MED-100 covers in-hospital treatment, including specialists and doctors, with no co-payments required.
MED-100 provides cover for chronic medication, basic dentistry, and maternity services.
Yes, MED-100 imposes waiting periods between three to twelve months at the discretion of the Scheme.
There is a general waiting period of up to three months and a condition-specific waiting period of up to 12 months.
Yes, MED-100 covers cancer treatment, but certain out-of-hospital benefits are limited to PMB treatment in public/state hospitals.
Yes, MED-100 covers chronic medication.
Yes, MED-100 covers basic dentistry.
Yes, MED-100 covers basic maternity services.
Premiums for MED-100 depend on age, gender, and the number of dependents. MED-100 costs R1,465 per month for all adults and R480 for all children.
MED-100 has a network of private hospitals and state hospitals.
Pre-existing conditions are excluded from coverage under MED-100 for the first 12 months.
No, MED-100 does not require co-payments.
MED-100 excludes certain treatments, procedures, cosmetic surgery, and experimental treatments.
To apply for MED-100, complete an application form and submit it to Genesis Medical Scheme. You may also need to undergo a medical examination.
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