Genesis out-of-hospital benefits: 2017

By Staff Writer -

Below is a full list of how each Genesis plan pays for Out of hospital benefits.

Click here to compare out-of-hospital benefits across all schemes, or use the menu bar above for more options. Or go to the Genesis home page.

Genesis Private Choice 2017: Out Of Hospital Benefits
In brief: 100% scheme rate for specialists. R50,000 in-hospital limit for cancer, stroke, motor-neuron disease and organ transplant. Scheme pays out-of-hospital claims for: dentistry. Limits apply. All else paid out of pocket, unless PMB.
1. GP consultations:
  • Surgical procedures in doctor's rooms: covered for qualifying procedures that would otherwise necessitate admission to hospital
  • Otherwise, no benefit
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,000 R1,000 R325
Children: Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Specialists consultations:
  • No benefit, unless PMB
3. Pathology:
  • No benefit, unless PMB
4. General radiology:
  • No benefit, unless PMB
5. Specialised radiology:
  • No benefit, unless PMB
6. Supplementary Services: (Physio, etc)
  • No benefit, unless PMB

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Genesis Private 2017: Out Of Hospital Benefits
In brief: 100% scheme rate for specialists. R50,000 in-hospital limit for cancer, stroke, motor-neuron disease and organ transplant. Scheme pays out-of-hospital claims for: dentistry. Limits apply. All else paid out of pocket, unless PMB.
1. GP consultations:
  • Surgical procedures in doctor's rooms: covered for qualifying procedures that would otherwise necessitate admission to hospital
  • Otherwise, no benefit
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,500 R1,500 R365
Children: Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Specialists consultations:
  • No benefit, unless PMB
3. Pathology:
  • No benefit, unless PMB
4. General radiology:
  • No benefit, unless PMB
5. Specialised radiology:
  • Scheme pays 50% of scheme rate, limited to R6,000 per person
6. Supplementary Services: (Physio, etc)
  • No benefit, unless PMB

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Genesis Private Plus 2017: Out Of Hospital Benefits
In brief: 100% scheme rate for specialists. R50,000 in-hospital limit for cancer, stroke, motor-neuron disease and organ transplant. Scheme pays out-of-hospital claims for: dentistry. Limits apply. All else paid out of pocket, unless PMB.
1. GP consultations:
  • Surgical procedures in doctor's rooms: covered for qualifying procedures that would otherwise necessitate admission to hospital
  • Otherwise, paid from day-to-day benefit
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,900 R1,900 R365
Children: Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R4,140 R4,140 R

Compare with these plans:

2. Specialists consultations:
  • Paid from day-to-day benefit
3. Pathology:
  • Paid from day-to-day benefit
4. General radiology:
  • Paid from day-to-day benefit
5. Specialised radiology:
  • Scheme pays 50% of scheme rate, limited to R6,000 per person
6. Supplementary Services: (Physio, etc)
  • Paid from day-to-day benefit

View this plan

Genesis Private Comprehensive 2017: Out Of Hospital Benefits
In brief: 100% scheme rate for specialists. R50,000 in-hospital limit for cancer, stroke, motor-neuron disease and organ transplant. Scheme pays out-of-hospital claims for: dentistry, consults, medicine. Limits apply. All else paid out of pocket, unless PMB.
1. GP consultations:
  • Surgical procedures in doctor's rooms: covered for qualifying procedures that would otherwise necessitate admission to hospital
  • 4 consultations per adult with a registered provider, up to R400 per consult. Balance from day-to-day benefit.
  • Benefit applies to GPs, specialists, psychologists, chiropractors, dieticians, social workers, physio, biokinetics, optometrist, alternative treatments, homeopathy
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,200 R2,200 R365
Children: Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry, consults and medicine. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R1,740 R1,740 R

Compare with these plans:

2. Specialists consultations:
  • Surgical procedures in doctor's rooms: covered for qualifying procedures that would otherwise necessitate admission to hospital
  • 4 consultations per adult with a registered provider, up to R400 per consult. Balance from day to day benefit.
  • Benefit applies to GPs, specialists, psychologists, chiropractors, dieticians, social workers, physio, biokinetics, optometrist, alternative treatments, homeopathy
3. Pathology:
  • Paid from day-to-day benefit
4. General radiology:
  • Paid from day-to-day benefit
5. Specialised radiology:
  • 50% of scheme rate, limited to R6,000 per person
  • Paid from Overall Annual Limit (OAL)
6. Supplementary Services: (Physio, etc)
  • 4 consultations per adult with a registered provider, up to R400 per consult. Balance from day-to-day benefit.
  • Benefit applies to GPs, specialists, psychologists, chiropractors, dieticians, social workers, physio, biokinetics, optometrist, alternative treatments, homeopathy

View this plan


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