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Overall, the Genesis Medical Aid MED 200 Plus Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and cover for major medical illnesses to up to 3 Family Members. The Genesis Medical Aid MED 200 Plus Plan starts from R3,000 ZAR.
👤 Main Member Contribution | R3,000 |
👥 Adult Dependent Contribution | R3,000 |
🍼 Child Dependent Contribution | R610 |
🔁 Gap Cover | None |
🧠 Mental Healthcare Program | Only PMBs |
🏥 Hospital Cover | Unlimited |
📉 Oncology Cover | R550,000 |
💙 Prescribed Minimum Benefits | ✅ Yes |
😷 Screening and Prevention | ✅ Yes |
💶 Medical Savings Account | ✅ Yes |
The Genesis Medical Aid MED 200 Plus Plan is one of 3, starting from R3,000 and includes cover for major medical illnesses, diagnostic scopes, auxiliary services, MRI and CT scans, and a Self-Managed Fund (SMF) covers medical expenses that would otherwise be out-of-pocket. Gap Cover is not available on the Genesis Medical Aid MED 200 Plus 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 |
R3,000 | R3,000 | R610 |
POLL: 5 Best Medical Aids under R1500
🟥 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 200% 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 200% 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 | Covered up to 100% of the lower cost or the Scheme Tariff when hospitalized. Subject to pre-authorization. Scans for conservative back/neck conditions cover up to 50% of the lower cost or the Scheme Tariff, limited to R7,600 per beneficiary yearly. |
🟨 Internal Prostheses and Surgical Applications | Covered up to 100% of the cost, limited to R30,000 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). Subject to pre-approval. |
🟦 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 (Basic Dentistry) | 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 200% of the Scheme Tariff. Pre-authorization is required. It must be a result of major trauma or an accident. The following are excluded: Tooth implants Conservative dental treatment Fillings X-rays Tooth Extractions, etc. |
🟨 Pain Relief (Epidural injection) | Applies to conservative back or neck (spinal/vertebral) conditions. Paid up to 75% of the cost. Limited to R5,000 per beneficiary yearly. |
🟩 Hemodialysis | Covered up to 100% of the cost and limited to R300,000 per member family per year according to the Scheme Tariff. |
🟦 Breast Reduction and Augmentation | Covered up to 100% of the cost. Paid from available SMF. |
🟪 Cosmetic Surgery Treatment for obesity Elective or Planned Procedures not directly caused by or related to accident, illness, or disease | Covered up to 100% of the cost. Paid from available SMF. |
🟥 Impotence Treatment | Covered up to 100% of the cost. Paid from available SMF. |
🟧 Surgical Procedures performed in the doctor’s rooms | Covered up to 200% of the Scheme Tariff for qualifying procedures that would otherwise need hospitalization |
📌 Procedures in and out-of-hospital | Limited to R550,000 per beneficiary per year. Covered up to 200% of the scheme tariff for: Cancer Stroke Motor-neuron diseases Organ Transplant |
🎗️ Cancer | Subject to the overall annual limit, with a sub-limit of R250,000 per beneficiary per year for: Oncologist Consultations Chemotherapy Radiotherapy MRI, CT, and PET scans Bone Scans Pathology Tests Medication Materials |
💛 Organ Transplants | Covers the cost of immunosuppressants up to R84,000 per beneficiary yearly. |
🟨 Hospice – Accommodation | Covered up to 100% of the cost. |
📍 Hospice – Home Care Visits | Limited to R200 per day. |
🏡 Hospice – Home Visits by a Medical Practitioner | Covered up to 100% of the Scheme Tariff. |
📈 Colonoscopy | Limited to R6,000 per procedure. |
📉 Gastroscopy | Limited to R3,800 per procedure. |
⚠️ Emergency Pre-Hospital Treatment Transport and Evacuation (includes inter-hospital transfers in South Africa) | 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. |
📌 Self-Managed Fund (SMF) | Limited to R8,160 per adult per year. SMF is pro-rated and advanced quarterly. |
💊 Medicine | Covered up to 100% of the legislated cost. Subject to available SMF. |
🤓 Prescription Glasses/Contact Lenses | Covered up to 100% of the cost. Paid from available SMF. |
👩⚕️ Consultation Benefit Includes the following: GPs Medical Specialists Speech Therapy Audiology Psychologists Chiropractors Dieticians, etc. | Covered up to 200% of the Scheme Tariff. Subject to the available SMF. The provider must be registered with the Health Professions Council in South Africa. |
📈 Basic Radiology | Covered up to 50% of the lower cost or the Scheme Tariff. Limited to R5,000 per beneficiary per year. |
📉 MRI and CT scans | Covered up to 50% of the lower cost or the Scheme Tariff. Limited to R7,600 per beneficiary per year. |
📊 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. |
🦷 Advanced Dentistry | Covered up to 100% of the cost. Paid from the available SMF. |
➡️ 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>. |
Some general exclusions include, but are not limited to:
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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-200 Plus | 🥈 Medshield MediValue Compact | 🥉 Discovery Essential Core |
👤 Main Member Contribution | R3,000 | R2,476 | R2,855 |
👥 Adult Dependent Contribution | R3,000 | R2,166 | R2,141 |
🍼 Child Dependent Contribution | R610 | R696 | R1,146 |
📈 Annual Limit | None | Unlimited Hospital Cover | Unlimited |
📉 Hospital Cover | Unlimited | Unlimited | Unlimited |
📊 Oncology Cover | R550,000 | Unlimited, subject to PMBs | R250,000 |
READ more about Medical Insurance
The Genesis Medical Aid MED 200 Plus Plan is a comprehensive healthcare plan that covers both in-hospital and out-of-hospital medical expenses. The plan offers generous day-to-day benefits through a Self-Managed Fund. It covers doctors and specialists at 200% of the Scheme Tariff. Additionally, basic dentistry is covered as an additional benefit. While the plan does provide substantial coverage, it may not be suitable for those looking for lower-cost options, as it comes with a relatively high monthly contribution. Therefore, the MED-200 Plus Plan is an excellent choice for individuals and families looking for comprehensive medical coverage and willing to pay a higher premium for peace of mind.
You might also like: Genesis Medical Scheme MED-100
You might also like: Genesis Medical Scheme MED-200
The Genesis Medical Aid MED 200 Plus Plan is a comprehensive healthcare plan that covers both in-hospital and out-of-hospital medical expenses.
The plan covers in-hospital expenses, out-of-hospital expenses such as X-rays and MRI/CT scans, day-to-day benefits through a Self-Managed Fund, and 200% coverage for doctors and specialists.
A Self-Managed Fund is a savings account that allows you to manage your day-to-day medical expenses and claim back from the fund.
The Scheme Tariff is the predetermined amount Genesis pays for medical services doctors and specialists provide.
The MED-200 Plus Plan offers substantial benefits for basic dentistry, covered by Genesis and not from the individual/family’s pocket.
Yes, the plan is ideally suited for individuals/families who require in-hospital cover for planned and emergency hospital admissions.
No, the plan may not be suitable for those looking for lower-cost options, as it comes with a relatively high monthly contribution.
MED-200 costs R2,815 for adults per month and R580 per child.
Yes, you can add dependents such as spouses, children, and parents to the plan.
The waiting period for the plan varies depending on the type of medical service needed. It can range from 3 to 12 months.
Yes, you can change your plan if your medical needs change. However, certain conditions and waiting periods might apply.
No, you can only claim for medical expenses that occurred within the current year.
You can claim by submitting a claim form and supporting documents to Genesis.
The processing time for a claim varies, but Genesis aims to process claims within 5 working days.
You can contact Genesis through their website, email, or phone.
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