1 reviews | Active since Jun 2017
Genesis Medical Aid
<p>I have had a very bad experience with Genesis medical aid.</p> <p>I signed up in late 2016, in 2017 they changed the medical aid saving benefits from yearly to quarterly.</p> <p>Aftermany complains about their service or the doctors that cant even find my profile with genesis and not paying the doctors.</p> <p>On the 18/4/2017 I requested my saving amount that was left for the quarter, they eventually rep**** my email and said my balance was R352.71! The doctors submitted the claim and they only paid R7 and some change to the R350 account, although my savings available...</p> <p> </p> <p>I then gave my notice on to leave them becuase I was very unhappy with the way I got treated,my queries was handled and offcourse, them not paying the doctors bills wth the available savings funds. </p> <p> </p> <p>When I queried the medical aid about the last payment, they said they will not pay it because I left genesis medical iad and becuase I left genesis, my savings that I had was gone. </p> <p> </p> <p>I dont understand this, because I received the balance of my savings amount on the 18/04/2017, the claim was submitted on 24/04/2017, I only cancelled my membership, with one month notice on 02/05/2017 but the claim was refused to be paid because I decided to leave genesis medical aid.</p> <p> </p> <p>I will never recomend Genesis to any person as I feel they are only in to take your money and dont really care about the people who pay them.</p> <p> </p> <p>Thank you</p> <p>Chris </p> <p> ********** 540</p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p>
Dear Chris
Thank you for the above information. We will most certainly look into the matter and revert back with the necessary detail and / or information.
Yours sincerely
The Genesis Team
Dear Chris
Thank you for the above information. We will most certainly look into the matter and revert back with the necessary detail and / or information.
Yours sincerely
The Genesis Team
Dear Chris
We are really sorry that, despite our telephone calls and emails to you in February, March and April this year, you still did not understand our savings benefit and in particular, your available savings balance.
We have really done our best to explain the savings allocation, as well as providing you with a full list of all the claims that we paid from your available savings balance.
You are right in that the savings benefit has changed in 2017. We informed all our members about this change at the end of 2016. The change, in a nutshell, means that, at the beginning of each three months period in any financial year, the Scheme will make available a savings facility not exceeding three times the monthly savings contribution that is included in your monthly contribution. In addition, any amount unused from a previous three month period in the same financial year, or any unused balance that accumulated from a previous year, plus any other amount transferred from another medical scheme, will be added to your available savings balance.
To apply this in your particular instance, you received a savings benefit on 1 January 2017, for the period 1 January to 31 March 2017. Then, on 1 April 2017, you received another benefit, for the period 1 April to 30 June 2017. You however terminated your membership effective 31 May 2017, which means that your savings benefit was also terminated effective 31 May 2017. You did not pay a medical aid contribution to the Scheme in June 2017; hence, the full benefit for the second quarter was not available to use, as you were no longer a member of the Scheme in June 2017.
To try and explain this by using an example where a member has an annual savings benefit… A member may have a savings benefit of R1 000 per month, or R12 000 for the year. The Scheme would, in good faith, make the benefit available upfront to the member on the basis that they will recover the savings benefit from the member’s monthly contributions over the 12 months in that year. The member may then use the R12 000 as he / she sees fit, during that year, but if he / she uses the full R12 000 upfront and then resigns at the end of March that year, he / she would have used more than the pro-rated portion of the savings benefit, and would have to pay the R9 000 back to the scheme. Savings contributions are always built into members’ monthly contributions; so members will receive a stated savings benefit for a specific period that they can then use, on the condition that the medical scheme receives all the monthly contributions during that period. All medical schemes with savings benefits work on this basis.
At the time when you enquired about your balance, the amount quoted to you was calculated ‘till the end of June 2016. At that time, we were unaware of the fact that your membership would be terminated at the end of May. There was therefore no malicious intent on our side and the reason why your day-to-day claims were not paid from your savings benefit, was simply because your available benefit was depleted. It had been used to pay the claims as listed in our email correspondence to you.
We trust that the above explanation will assist you.
Yours sincerely
The Genesis Team
Dear Chris
We are really sorry that, despite our telephone calls and emails to you in February, March and April this year, you still did not understand our savings benefit and in particular, your available savings balance.
We have really done our best to explain the savings allocation, as well as providing you with a full list of all the claims that we paid from your available savings balance.
You are right in that the savings benefit has changed in 2017. We informed all our members about this change at the end of 2016. The change, in a nutshell, means that, at the beginning of each three months period in any financial year, the Scheme will make available a savings facility not exceeding three times the monthly savings contribution that is included in your monthly contribution. In addition, any amount unused from a previous three month period in the same financial year, or any unused balance that accumulated from a previous year, plus any other amount transferred from another medical scheme, will be added to your available savings balance.
To apply this in your particular instance, you received a savings benefit on 1 January 2017, for the period 1 January to 31 March 2017. Then, on 1 April 2017, you received another benefit, for the period 1 April to 30 June 2017. You however terminated your membership effective 31 May 2017, which means that your savings benefit was also terminated effective 31 May 2017. You did not pay a medical aid contribution to the Scheme in June 2017; hence, the full benefit for the second quarter was not available to use, as you were no longer a member of the Scheme in June 2017.
To try and explain this by using an example where a member has an annual savings benefit… A member may have a savings benefit of R1 000 per month, or R12 000 for the year. The Scheme would, in good faith, make the benefit available upfront to the member on the basis that they will recover the savings benefit from the member’s monthly contributions over the 12 months in that year. The member may then use the R12 000 as he / she sees fit, during that year, but if he / she uses the full R12 000 upfront and then resigns at the end of March that year, he / she would have used more than the pro-rated portion of the savings benefit, and would have to pay the R9 000 back to the scheme. Savings contributions are always built into members’ monthly contributions; so members will receive a stated savings benefit for a specific period that they can then use, on the condition that the medical scheme receives all the monthly contributions during that period. All medical schemes with savings benefits work on this basis.
At the time when you enquired about your balance, the amount quoted to you was calculated ‘till the end of June 2016. At that time, we were unaware of the fact that your membership would be terminated at the end of May. There was therefore no malicious intent on our side and the reason why your day-to-day claims were not paid from your savings benefit, was simply because your available benefit was depleted. It had been used to pay the claims as listed in our email correspondence to you.
We trust that the above explanation will assist you.
Yours sincerely
The Genesis Team