ES
Edwin S
1 reviews | Active since Sept 2025
26 Jul 2021, 09:39
PATHETIC SERVICE and COVER. Please choose another medical aid.
Pathetic service, was misinformed before addmission. Spoke directly to one of the agents who advised me as to what the process should be for admission. Given it was an emergency as I had broken my leg I was immediately admitted and surgery took place only to be slapped with a +R40K bill that medical aid wouldnt be covering due it not being an emergency! never recieved one call or message as to my treatment or recovery was going. One star review is too much for the non existent service I recieved. Would not recommend to anyone else, there are better plans oout there.
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Genesis Medical Scheme's replyOfficial
26 Jul 2021, 13:38Dear Edwin
As a medical scheme, we really go to great lengths to keep our members informed about their benefits, how Prescribed Minimum Benefits (PMBs) work, the use of Designated Services Providers (DSPs), etc.
As much as the Scheme has a responsibility to keep their members informed and up to date, there is also an onus on our members to understand their benefits and possible limits.
Although your injury must have been incredibly painful, it did not meet the criteria of a “medical emergency” in terms of the Scheme Rules. We have explained this to you.
With respect to PMBs, Genesis offers a choice of funding model for members to decide which suits them best. Should they choose to be treated in a private hospital, the benefits and limits, as set out in the Rules, will apply. Any shortfalls (i.e. in respect of the rates charged by doctors) that there may be, will be for their account.
Unfortunately, when doctors charge more than the reimbur*****t rate (Scheme Tariff) applicable to a member’s benefit option, their claims will not be settled in full.
We have written many articles on this subject and do our best to communicate with our members as well.
Yours sincerely
GENESIS MEDICAL SCHEME
Genesis Medical Scheme's reply26 Jul 2021, 13:38
Official
Dear Edwin
As a medical scheme, we really go to great lengths to keep our members informed about their benefits, how Prescribed Minimum Benefits (PMBs) work, the use of Designated Services Providers (DSPs), etc.
As much as the Scheme has a responsibility to keep their members informed and up to date, there is also an onus on our members to understand their benefits and possible limits.
Although your injury must have been incredibly painful, it did not meet the criteria of a “medical emergency” in terms of the Scheme Rules. We have explained this to you.
With respect to PMBs, Genesis offers a choice of funding model for members to decide which suits them best. Should they choose to be treated in a private hospital, the benefits and limits, as set out in the Rules, will apply. Any shortfalls (i.e. in respect of the rates charged by doctors) that there may be, will be for their account.
Unfortunately, when doctors charge more than the reimbur*****t rate (Scheme Tariff) applicable to a member’s benefit option, their claims will not be settled in full.
We have written many articles on this subject and do our best to communicate with our members as well.
Yours sincerely
GENESIS MEDICAL SCHEME