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Genesis Medical Aid MED 200 Hospital Plan

Overall, the Genesis Medical Aid MED 200 Hospital Plan is a trustworthy and comprehensive hospital plan that offers 24/7 medical emergency assistance and emergency medical evacuation to up to 3 Family Members. The Genesis Medical Aid MED 200 Plan starts from R2,130 ZAR.

👤 Main Member Contribution	R2,130
👥 Adult Dependent Contribution	R2,130
🍼 Child Dependent Contribution	R610
↪️ Gap Cover	None
📉 Annual Limit	None
🧠 Mental Healthcare Program	Only PMBs
🏥 Hospital Cover	Unlimited
🏡 Home Care	Only visits from medical personnel
➡️ Oncology Cover	R550,000
👶 Maternity Benefits	✅ Yes

Genesis Medical Aid MED 200 Hospital Plan – 7 Key Point Quick Overview

✅ Genesis Medical Aid MED 200 plan Overview
✅ Genesis Medical Aid MED 200 plan Contributions
✅ MED-200 Plan Benefits and Cover Comprehensive Breakdown
✅ MED-200 Plan Exclusions and Waiting Periods
✅ Genesis Medical Aid MED 200 plan vs. Similar Plans from other Medical Schemes
✅ Our Verdict on The Genesis Medical Aid MED 200 plan
✅ Genesis Medical Aid MED 200 plan Frequently Asked Questions

Genesis Medical Aid MED 200 Hospital Plan Overview

The Genesis Medical Aid MED 200 Hospital Plan is one of 3, starting from R2,130 and includes emergency medical evacuation, MRI and CT scans in + out-of-hospital, auxiliary services, and more. Gap Cover is not available on the Genesis Medical Aid MED 200 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:

Genesis Medical Aid MED 200 Hospital plan Contributions

👤 Main Member	👥 Adult Dependent	🍼 Child Dependent
R2,130	R2,130	R610

MED-200 Plan Benefits and Cover Comprehensive Breakdown

✅ The hospital plan is best for families/individuals needing out-of-hospital benefits like X-rays & MRI/CT scans.
✅ Covers planned and emergency hospital admissions.
✅ 200% coverage of the Scheme Tariff for doctors and specialists.
✅ Provides significant benefits for basic dentistry.
✅ Dentistry benefits are covered by Genesis and not out of your pocket.

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Genesis Medical Scheme MED-200 In-Hospital and other related benefits

🟥 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 Root Canal Treatment Dentures Orthodontics Periodontal treatment Orthognathic surgery Osteotomies to correct congenital disorders Genioplasty and related costs
🟨 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.
🟦 Surgical Procedures performed in the doctor’s rooms	Covered up to 200% of the Scheme Tariff for qualifying procedures that would otherwise need hospitalization

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Genesis Medical Scheme MED-200 Combined In and Out-of-Hospital Benefits

📌 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.

Genesis Medical Scheme MED-200 Out-of-Hospital Benefits

📌 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.
📈 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>.

MED-200 Plan Exclusions and Waiting Periods

Genesis Medical Aid MED 200 plan Exclusions

Some general exclusions include, but are not limited to:

Bandages and aids
Patented foods, including baby foods and milk substitutes
Slimming preparations
Tonics and nutritional supplements
All costs for cosmetic procedures/treatment/medication, except if due to an accident, illness, or disease.
Operations for nasal or breast reconstruction except due to medical reasons.
All costs for operations, medicines, treatment, and procedures for obesity, cosmetic purposes, or of the member’s own choosing where this has no connection with any illness, presumed illness, accident, or other medical disability:
Medicines not registered with the Medicines Control Council
Toiletries and beauty preparations
Member-related traveling expenses
Charges for appointments that a beneficiary fails to keep
Elective (non-emergency) after-hours consultations
Medical examinations or mass inoculation of employees initiated by employers
Unproven or experimental treatment
Cosmetic and reconstructive surgery, treatment, or appliances

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Genesis Medical Aid MED 200 plan Waiting Periods

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:

A general waiting period of up to three months, during which members are required to pay their regular monthly contributions but are not entitled to any benefits, except for certain instances relating to PMBs, where treatment must be obtained from any public or state hospital in South Africa, subject to the Uniform Patient Fee Schedule (UPFS) tariff.
Secondly, there is a condition-specific waiting period of up to 12 months, during which members must pay their regular monthly contributions. However, any pre-existing health conditions will be excluded, and all medical costs incurred during the first 12 months will be borne by the member, except for certain instances relating to PMBs, where treatment must be obtained from any public or state hospital in South Africa, subject to the Uniform Patient Fee Schedule (UPFS) tariff.

Also take note that New Members 35 years or older may be subject to late-joiner penalties on Genesis Medical Aid Plans.

Genesis Medical Aid MED 200 plan vs. Similar Plans from other Medical Schemes

🔎 Medical Aid Plan	🥇 Genesis Medical Scheme MED-200	🥈 Bestmed Beat 2	🥉 Discovery Health Essential Delta Saver
👤 Main Member Contribution	R2,130	R2,545	R2,673
👥 Adult Dependent Contribution	R2,130	R1,976	R2,017
🍼 Child Dependent Contribution	R610	R1,071	R1,072
🌎 International Cover	None	R500,000 – R3 million	R5 million
➡️ Hospital Cover	Unlimited	Subject to scheme rules	Unlimited
☑️ Oncology Cover	R550,000	100% of the scheme tariff	R250,000

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Our Verdict on The Genesis Medical Aid MED 200 plan

The Genesis Medical Aid MED 200 plan is a comprehensive medical plan that offers a range of benefits to individuals and families. The plan is well-suited for those requiring in-hospital and out-of-hospital benefits, such as X-rays, MRI, and CT scans. The MED-200 plan offers coverage for planned and emergency hospital admissions and doctors and specialists are covered at 200% of the Scheme Tariff. Additionally, the plan provides substantial benefits for basic dentistry, covered by Genesis and not out of the individual’s pocket. However, one of the main disadvantages of the MED-200 plan is that it is relatively expensive compared to other medical plans on the market.

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Genesis Medical Aid MED 200 plan Frequently Asked Questions

What is the Genesis Medical Aid MED 200 plan?

The MED-200 plan is a medical plan offered by the Genesis Medical Scheme that provides in-hospital and out-of-hospital benefits, including coverage for X-rays, MRI, and CT scans.

What are the benefits of the MED-200 plan?

The MED-200 plan offers comprehensive coverage for both in-hospital and out-of-hospital services, including coverage for doctors and specialists at 200% of the Scheme Tariff and substantial benefits for basic dentistry.

Does the MED-200 plan cover out-of-hospital benefits?

Yes, the MED-200 plan covers a range of out-of-hospital benefits, including X-rays, MRI, and CT scans.

How does the MED-200 plan cover hospital admissions?

The MED-200 plan provides coverage for both planned and emergency hospital admissions.

What is the coverage rate for doctors and specialists on the MED-200 plan?

Doctors and specialists are covered at 200% of the Scheme Tariff on the MED-200 plan.

What is the Scheme Tariff, and how does it apply to the MED-200 plan?

The Scheme Tariff is the amount the Genesis Medical Scheme agrees to pay for medical services. For example, on the MED-200 plan, doctors and specialists are covered at 200% of the Scheme Tariff.

Does the MED-200 plan cover basic dentistry?

Yes, the MED-200 plan provides substantial benefits for basic dentistry, covered by Genesis and not out of the individual’s pocket.

What are the costs associated with the MED-200 plan?

The costs of the MED-200 plan depend on a range of factors, including the individual’s age, health status, and chosen coverage level.

How does the MED-200 plan compare to other medical plans on the market?

The MED-200 plan is relatively expensive compared to other medical plans. However, it offers comprehensive coverage for a range of medical services.

For whom is the MED-200 plan best suited?

The MED-200 plan is best suited for individuals and families requiring in-hospital and out-of-hospital benefits, including coverage for X-rays, MRI, and CT scans.

How does the MED-200 plan cover hospital admissions?

The MED-200 plan provides coverage for both planned and emergency hospital admissions.

What is the Scheme Tariff?

The Scheme Tariff is the amount the Genesis Medical Scheme agrees to pay for medical services. Doctors and specialists are covered on the MED-200 plan at 200% of the Scheme Tariff.

Can I choose my doctors and specialists on the MED-200 plan?

Yes, individuals on the MED-200 plan can choose their doctors and specialists.

How do I enroll in the MED-200 plan?

Individuals can enroll in the MED-200 plan by visiting the Genesis Medical Scheme website or contacting the scheme directly.

What is the claims process for the MED-200 plan?

The claims process for the MED-200 plan involves submitting a claim form and supporting documents to the Genesis Medical Scheme for reimbursement.

Can I change my coverage level on the MED-200 plan?

Yes, individuals on the MED-200 plan can change their coverage level, subject to certain terms and conditions.

Adriaan Schoeman

Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.