Terrible Service

Dear Adam 

 

As promised, we’ve done a detailed analysis of all your dental claims this year. 

 

We have absolutely no idea why you are under the impression that the Scheme only paid R1.70 for your root canal treatment.  To the contrary, we have covered the full cost of your first two root canal treatments.  You are entitled to two root canal treatments per annum  -  this benefit you have received.  Your subsequent root canal treatments unfortunately fall outside your annual benefits for root canal treatment. 

 

As you may or may not be aware, your dental benefits that have been paid by the Scheme this year are the equivalent of about 13 months' contributions in respect of your benefit option. 

 

Your comment about a waste of money on Genesis is therefore completely and utterly misplaced, as you have been on the receiving end of substantial dental benefits, given the entry-level hospital plan that you are on.  In fact, your dental claims that have been paid by the Scheme are more than the entire annual allocation of a medical savings benefit on some of the most expensive medical aid benefit options in SA.  Genesis is the ONLY open medical scheme in SA that would have paid such a generous portion of your dental claims.  Members of other medical schemes in SA would have had to fund this expense either from their medical savings benefit, or their own pocket.  

 

We will be in contact with you and send you a detailed summary of your dental claims vs benefits for 2024.  

 

Yours sincerely 

 

GENESIS MEDICAL SCHEME