Genesis Medical Aid Members Qualify for Gap Cover

December 10, 2021

I am willing to bet that you have heard about gap cover for Genesis medical aid members. Or what we also call top up cover. Maybe you know what it is, maybe not. Let’s go over it together.

The basic idea with gap covers is that they will cover you for shortfalls in specialist treatment costs. You may have a medical aid plan, or a hospital plan, or both but you may still need gap cover.

But My Genesis Medical Aid Pays 100% for Hospital Cover

That may be true but when they say 100%, what do they mean? Do they mean that they will pay the whole bill, regardless of medical aid rates? Or will they pay 100% of medical aid rates? That distinction can make a big difference.

And, what about the annual caps for the policy? These might seem impossible to reach, but even a minor surgery can cost tens of thousands of Rands.

Genesis Medical Aid

But I Have a Genesis Hospital Plan

A hospital plan different from a medical aid in that it is a more specialised cover. That does not mean that you have the full cover, though. Most hospital plans pay out regarding the basic medical aid rates and do have caps in place.

You can quite easily reach the cap, or you may have to pay  more than the basic medical aid rate.

What Gap Cover Will Do for You

Gap cover kicks in when you have to pay rates that are higher than the basic Genesis medical aid rates during a hospital stay.

Gap cover closes the gap between what your medical aid pays out and what appears on the bill.

Which Gap Cover Should I Choose?

There are some different options available to you. In this instance, we will discuss Xelus Gap Cover. The option you choose will depend on your needs.

Xelus Gap Cover has been designed to reduce the financial burden on clients during a medical crisis. The cover helps you to pay for the medical shortfall so that you can continue to get the care you need.

There are several different plans available. You can choose the plan that suits your needs and budget best.

Xelus is a highly efficient organisation that offers real value for money for clients.

Comprehensive Cover You Can Afford

Xelus offers a comprehensive product that covers a range of conditions. Cover includes the treatment of cancer, and the policy will cover co-payments and deductibles as well.

Xelus also includes wellness cover for those who are working but not insured. The processes related to this are efficient and cost effective.

The gap cover works through the primary health care practitioners to manage that needs regarding care for employees.

Who Can Join?

As long as you are a current member of any of the registered medical aid schemes, you can join. These include Genesis, of course, but also

Liberty

Sizwe

Discovery

GEMS

Bonitas

Are There Exclusions?

All gap covers do have some exclusions to make them more affordable. Exclusions from Xelus include injuries that are self-inflicted, attempted suicide and cosmetic surgery.

Will I need to Wait for Cover?

The initial cover kicks in after three months except where there is a pre-existing condition or when it comes to maternity. The maternity benefit kicks in after 12 months. The waiting period when it comes to pre-existing conditions depends on the condition.

If you are a South African, have a medical aid and want to get a FREE quote for gap cover, please submit the form on this page.

 

All info was correct at time of publishing