Genesis Medical Scheme
Claimed Business
Genesis Medical Scheme
Claimed Business
9 Reviews (last 12 months)
Does not respond to reviews
AI Review Summary
Based on recent customer reviews, Genesis Medical Scheme faces severe criticism regarding the denial of Prescribed Minimum Benefit (PMB) claims, particularly for cancer treatment and emergency hospitalisations. Multiple members report prolonged disputes over coverage for life-threatening conditions, with the scheme citing legal technicalities to refuse funding. Mental health coverage limitations and lack of empathy toward vulnerable members, including retirees and young children, are recurring concerns. A small number of loyal members praise the personalised service and family-like atmosphere of the smaller scheme, but the overwhelming sentiment reflects deep frustration with claims handling and perceived disregard for member welfare.
Performance(last 12 months):
0Trustindex Rating
#14Ranked In Health & Medical
16h 32mReply Time
-50 NPSUnlikely
Replied to 63% of negative reviews
Reply time on negative reviews: 16 hours 26 min
TrustIndex
0
Ranking
#14
in Health & Medical
Avg Reply
16h 32m
NPS Score
-50
Recommended: Unlikely
Replied to 63% of negative reviews
Reply time on negative reviews: 16 hours 26 min
Review Distribution
1.6|9 Reviews
May '25 - Apr '26
5(11.1%)
4(0%)
3(0%)
2(11.1%)
1(77.8%)
5(11.1%)
4(0%)
3(0%)
2(11.1%)
1(77.8%)
Recent reviews (9)
Used this business recently? Share your experience to help others decide.
Used this business recently? Share your experience to help others decide.
Share Your ExperienceLB
Lily B
1 reviews | Active since Jan 2020
30 Jan 2026, 08:53
Limited cover for mental health PMB
I would like to express my utmost disappointment with Genesis medical scheme regarding cover of my stay in Kenilworth Akeso mental health facility. Genesis has said that if I want the standard 21 day PMB cover for mental health, I need to go to a DSP. However, as far as I can see all of the DSPs anywhere near me in Cape Town are public health care facilities. As a result, Genesis is only paying R54000 which covers 6 days in Kenilworth Akeso. I am outraged. If I wanted to go to a public health care facility, I could pay for it myself, as they are catered to one’s income level. Furthermore, my psychiatrists have never heard of another medical aid scheme pulling a stunt like this - they are used to all medical aid schemes covering the standard 21 days in a mental health clinic. Furthermore, if I had a physical injury, there would be no doubt that I could be admitted to a private hospital and be covered by Genesis. Mental health is just as important to my mortality. I have been a loyal customer of theirs and expect better, non-discriminatory treatment. I would like to fully benefit from the Kenilworth Akeso program which is three weeks, in order to have a chance at recovery. I will be spreading the news of their disappointing decision far and wide and ensure that everyone I have recommended Genesis to is aware that they should not choose Genesis.
Helpful (0)
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Lily B
1 reviews | Active since Jan 2020
30 Jan 2026, 08:53
Limited cover for mental health PMB
I would like to express my utmost disappointment with Genesis medical scheme regarding cover of my stay in Kenilworth Akeso mental health facility. Genesis has said that if I want the standard 21 day PMB cover for mental health, I need to go to a DSP. However, as far as I can see all of the DSPs anywhere near me in Cape Town are public health care facilities. As a result, Genesis is only paying R54000 which covers 6 days in Kenilworth Akeso. I am outraged. If I wanted to go to a public health care facility, I could pay for it myself, as they are catered to one’s income level. Furthermore, my psychiatrists have never heard of another medical aid scheme pulling a stunt like this - they are used to all medical aid schemes covering the standard 21 days in a mental health clinic. Furthermore, if I had a physical injury, there would be no doubt that I could be admitted to a private hospital and be covered by Genesis. Mental health is just as important to my mortality. I have been a loyal customer of theirs and expect better, non-discriminatory treatment. I would like to fully benefit from the Kenilworth Akeso program which is three weeks, in order to have a chance at recovery. I will be spreading the news of their disappointing decision far and wide and ensure that everyone I have recommended Genesis to is aware that they should not choose Genesis.
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Replies (0)MP
Merle P
1 reviews | Active since Jan 2020
15 Jan 2026, 09:50
NON PAYMENT OF EMERGENCY CODES FOR EMERGENCY OPERATION TO HAND
I had a near fatal fall and fractured/broke my left distal radius, it was severely displaced, the bone was pushed into place at orthopedic trauma hospital and cast fitted. It was an emergency that required immediate surgery but because of the severity of the fracture the swelling made it impossible for surgery immediately which was only performed 2 days later but it was still an emergency as failure to operate would result in total loss or function of hand, Genesis refuse to pay the emergency codes on ALL the bills including orthopedic trauma doctor, aneathatist, theatre etc etc despite the doctor sending a motivational letter to Genesis ...they still refuse to pay.
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Merle P
1 reviews | Active since Jan 2020
15 Jan 2026, 09:50
NON PAYMENT OF EMERGENCY CODES FOR EMERGENCY OPERATION TO HAND
I had a near fatal fall and fractured/broke my left distal radius, it was severely displaced, the bone was pushed into place at orthopedic trauma hospital and cast fitted. It was an emergency that required immediate surgery but because of the severity of the fracture the swelling made it impossible for surgery immediately which was only performed 2 days later but it was still an emergency as failure to operate would result in total loss or function of hand, Genesis refuse to pay the emergency codes on ALL the bills including orthopedic trauma doctor, aneathatist, theatre etc etc despite the doctor sending a motivational letter to Genesis ...they still refuse to pay.
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Replies (0)MK
Monica K
1 reviews | Active since Jan 2020
15 Dec 2025, 17:14
Poor Contribution Management
Don't use this medical aid when you plan to retire. André Roos had no empathy for my 60 year old retired father who was a loyal Genesis member all of his young years! My father died in hospital because Genesis terminated his contract when he was being transferred from a salary to a pension payout. Poor management contribution with no empathy towards retirement persons like Genesis manager André, will cost you your life when you need it most in your 60's Will never recommend. Remember you will all get old and suffer from your wrong attitudes. Not loyal to loyal members!
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Monica K
1 reviews | Active since Jan 2020
15 Dec 2025, 17:14
Poor Contribution Management
Don't use this medical aid when you plan to retire. André Roos had no empathy for my 60 year old retired father who was a loyal Genesis member all of his young years! My father died in hospital because Genesis terminated his contract when he was being transferred from a salary to a pension payout. Poor management contribution with no empathy towards retirement persons like Genesis manager André, will cost you your life when you need it most in your 60's Will never recommend. Remember you will all get old and suffer from your wrong attitudes. Not loyal to loyal members!
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Mari R
1 reviews | Active since Jan 2020
22 Jul 2025, 19:51
Disappointing and inhumane
Joining Genesis was the biggest mistake of my life. They made countless promises but showed zero compassion when it mattered most. My one-year-old was hospitalised and placed on oxygen with RSV—an obvious emergency. Yet Genesis refused to cover the emergency claims. I asked multiple times why certain claims were rejected and received only contradictory answers. I eventually filed a complaint. Around the same time, a non-disclosure investigation was opened. I provided full explanations, which Genesis accepted. They confirmed in writing that I remained covered. I understood they had the right to cancel my membership, and had they done so then, I would have accepted it. But they ruled in my favour, and I trusted their word. A week after my complaint about the emergency claim, they suddenly reopened the non-disclosure issue—clearly in retaliation. They claimed I hadn’t provided reasons after I asked what they mean because they already asked regarding the same case and ruled in my favour, previously confirming the matter was finalised. My membership was cancelled, and I was told I couldn’t dispute it as I was no longer a member. I take responsibility for the initial mistake in non-disclosure, but changing their decision after a complaint is *********. They had all the facts the first time and made a clear, unconditional ruling. Only after I questioned their emergency cover did they reverse it. No one even had the decency to speak to me and explain anything to me, no humanity - just long letters throwing acts and irrelevant cases in my face. Sadly, I now see many similar complaints—emergencies not covered, cold responses, and no accountability. Genesis shows no humanity when people need it most. The non-disclosure was never my issue - the ruling in my favour and then going back on their words because of a service complaint is.
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Mari R
1 reviews | Active since Jan 2020
22 Jul 2025, 19:51
Disappointing and inhumane
Joining Genesis was the biggest mistake of my life. They made countless promises but showed zero compassion when it mattered most. My one-year-old was hospitalised and placed on oxygen with RSV—an obvious emergency. Yet Genesis refused to cover the emergency claims. I asked multiple times why certain claims were rejected and received only contradictory answers. I eventually filed a complaint. Around the same time, a non-disclosure investigation was opened. I provided full explanations, which Genesis accepted. They confirmed in writing that I remained covered. I understood they had the right to cancel my membership, and had they done so then, I would have accepted it. But they ruled in my favour, and I trusted their word. A week after my complaint about the emergency claim, they suddenly reopened the non-disclosure issue—clearly in retaliation. They claimed I hadn’t provided reasons after I asked what they mean because they already asked regarding the same case and ruled in my favour, previously confirming the matter was finalised. My membership was cancelled, and I was told I couldn’t dispute it as I was no longer a member. I take responsibility for the initial mistake in non-disclosure, but changing their decision after a complaint is *********. They had all the facts the first time and made a clear, unconditional ruling. Only after I questioned their emergency cover did they reverse it. No one even had the decency to speak to me and explain anything to me, no humanity - just long letters throwing acts and irrelevant cases in my face. Sadly, I now see many similar complaints—emergencies not covered, cold responses, and no accountability. Genesis shows no humanity when people need it most. The non-disclosure was never my issue - the ruling in my favour and then going back on their words because of a service complaint is.
0
Replies (0)VC
Vonne C
1 reviews | Active since Jan 2020
22 Jul 2025, 12:25
Genesis Medical Scheme not wanting to help after my PMB cancer win at the CMS so they trough me out and i am not the only one.
Dear Ian Hughes and Katherine W my name is Vonne Conradie and I would love to make contact with you. Please find me on Facebook. My story was published in Die Rapport and it is exactly the same as yours. I would also love to speak to the Citizen, The Sunday times and Carte Blanche as well.
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Vonne C
1 reviews | Active since Jan 2020
22 Jul 2025, 12:25
Genesis Medical Scheme not wanting to help after my PMB cancer win at the CMS so they trough me out and i am not the only one.
Dear Ian Hughes and Katherine W my name is Vonne Conradie and I would love to make contact with you. Please find me on Facebook. My story was published in Die Rapport and it is exactly the same as yours. I would also love to speak to the Citizen, The Sunday times and Carte Blanche as well.
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Replies (0)KW
Katharine W
1 reviews | Active since Jan 2020
22 Jul 2025, 09:26
Genesis still not authorising treatment for PMB condition
ATTN: CHIEF PRINCIPAL OFFICER MNGR ONCOLOGY DEPT 21/7/25 Dear Sir/Madam Following my daughter's post on Friday last week, I think it fair to let you know that in view of the intransigence of your Oncology Dept in flatly refusing to countenance payment for a Non-DSP treatment -on my behalf, despite the unarguable fact that it is a PMB and that proof has been provided that it cannot reasonably be treated in a State facility, an article is being prepared for publication in both The Citiizen and The Sunday Times newspapers covering that history and will be ready for publication in a few days. This article will not only cover my own case and Genesis’s disgraceful and ******* rejection of my PMB claim to be treated by a non-DSP provider, but will draw on other members’ testimonies as published in HELLO PETER I(Vonne Conradie) of their treatment by Genesis under almost identical circumstances as my own. Moreover, we have also learned of earlier Court decisions, which Genesis has similarly lost and which substantially underlines the fact that Genesis is an incorrigible violator of the above law. This cannot be allowed to stand. My health is at a critical crossroads. At Carte Blanche’s request all the information gathered for this article will be sent to them for further in-depth investigation. IAN HUGHES 0825538154 MNO: 05002746
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Katharine W
1 reviews | Active since Jan 2020
22 Jul 2025, 09:26
Genesis still not authorising treatment for PMB condition
ATTN: CHIEF PRINCIPAL OFFICER MNGR ONCOLOGY DEPT 21/7/25 Dear Sir/Madam Following my daughter's post on Friday last week, I think it fair to let you know that in view of the intransigence of your Oncology Dept in flatly refusing to countenance payment for a Non-DSP treatment -on my behalf, despite the unarguable fact that it is a PMB and that proof has been provided that it cannot reasonably be treated in a State facility, an article is being prepared for publication in both The Citiizen and The Sunday Times newspapers covering that history and will be ready for publication in a few days. This article will not only cover my own case and Genesis’s disgraceful and ******* rejection of my PMB claim to be treated by a non-DSP provider, but will draw on other members’ testimonies as published in HELLO PETER I(Vonne Conradie) of their treatment by Genesis under almost identical circumstances as my own. Moreover, we have also learned of earlier Court decisions, which Genesis has similarly lost and which substantially underlines the fact that Genesis is an incorrigible violator of the above law. This cannot be allowed to stand. My health is at a critical crossroads. At Carte Blanche’s request all the information gathered for this article will be sent to them for further in-depth investigation. IAN HUGHES 0825538154 MNO: 05002746
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Esmay G
1 reviews | Active since Jan 2020
20 Jul 2025, 12:40
Sterling job Genesis Medical Scheme
I have had dealings with Genesis Medical Scheme for the last 12 years. Best Medical Scheme ever. You get treated like a person not just a number. After a while you become part if the Genesis Medical Scheme family. Your query gets sorted super quick, you then you start talking like friends , asking about family etc. Being a smaller Scheme you definately get personal attention. Speaking to a fami**** voicecifter and you dont have to repeat yourself all the time. I would recommend Genesis Medical Schemec to young and older generation. Esmay Grove
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Esmay G
1 reviews | Active since Jan 2020
20 Jul 2025, 12:40
Sterling job Genesis Medical Scheme
I have had dealings with Genesis Medical Scheme for the last 12 years. Best Medical Scheme ever. You get treated like a person not just a number. After a while you become part if the Genesis Medical Scheme family. Your query gets sorted super quick, you then you start talking like friends , asking about family etc. Being a smaller Scheme you definately get personal attention. Speaking to a fami**** voicecifter and you dont have to repeat yourself all the time. I would recommend Genesis Medical Schemec to young and older generation. Esmay Grove
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Replies (0)KW
Katharine W
1 reviews | Active since Jan 2020
17 Jul 2025, 14:52
Genesis denying us urgent PMB cancer treatment for my father
Genesis denying us urgent PMB cancer treatment for my father I am writing this as the daughter of a Genesis Medical Scheme member who has been diagnosed with a Prescribed Minimum Benefit (PMB) cancer condition requiring urgent chemotherapy and radiation treatment. We have been assured that with timely treatment my father should make a full recovery. Despite the clear urgency of his condition, Genesis has: • Refused to provide or accept an application for access to treatment for a PMB at a private hospital • Ignored multiple emails and follow-ups • Provided conflicting and evasive responses • Insisted that my father must pay privately for treatment, even though PMB law clearly protects him. Most disturbingly, Genesis has ignored a formal letter from the treating doctor at Chris Hani Baragwanath Hospital, which states: “The oncology department is overwhelmed with a high burden of patients and the acceptable delay for his treatment will be exceeded. The patient does have medical insurance. This is a very clearly prescribed minimum benefit and it is therefore the duty and the responsibility of the medical insurance scheme to cover the cost and this should be done in the private sector.” Despite this, Genesis continues to delay any meaningful response. The Assistant Manager – Oncology has either ignored our emails or responded without answering direct questions, seemingly intent on stalling the process. At this point, it feels like they are hoping my father’s condition deteriorates before they are forced to act. To make matters worse, my father has even managed to secure treatment at Netcare Linksfield Clinic at the same rates charged by Chris Hani Baragwanath Hospital, meaning there would be no cost impact to Genesis – and yet they still refuse to authorise treatment. This is not just poor service, it’s a shocking failure of duty, ethics, and compassion. Genesis is knowingly denying (or at the very least delaying) access to life-saving treatment, despite clear medical advice and the provisions of Regulation 8(3) of the Medical Schemes Act, which requires schemes to cover PMB treatment in full when DSPs are unavailable or cause unreasonable delay. What makes this even more outrageous is that Genesis has previously been taken to court over this exact issue and lost. The Constitutional Court dismissed Genesis’s appeal, confirming that medical schemes cannot use their rules to override the law. We are escalating this matter to the Council for Medical Schemes (CMS). Their treatment of our family during this crisis has been nothing short of disgraceful. Genesis, your members are not just policy numbers. They are people - parents, grandparents, and loved ones - who deserve timely care and dignity. How many times to you need to be taken to court before you accept your legal responsibilities?
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Katharine W
1 reviews | Active since Jan 2020
17 Jul 2025, 14:52
Genesis denying us urgent PMB cancer treatment for my father
Genesis denying us urgent PMB cancer treatment for my father I am writing this as the daughter of a Genesis Medical Scheme member who has been diagnosed with a Prescribed Minimum Benefit (PMB) cancer condition requiring urgent chemotherapy and radiation treatment. We have been assured that with timely treatment my father should make a full recovery. Despite the clear urgency of his condition, Genesis has: • Refused to provide or accept an application for access to treatment for a PMB at a private hospital • Ignored multiple emails and follow-ups • Provided conflicting and evasive responses • Insisted that my father must pay privately for treatment, even though PMB law clearly protects him. Most disturbingly, Genesis has ignored a formal letter from the treating doctor at Chris Hani Baragwanath Hospital, which states: “The oncology department is overwhelmed with a high burden of patients and the acceptable delay for his treatment will be exceeded. The patient does have medical insurance. This is a very clearly prescribed minimum benefit and it is therefore the duty and the responsibility of the medical insurance scheme to cover the cost and this should be done in the private sector.” Despite this, Genesis continues to delay any meaningful response. The Assistant Manager – Oncology has either ignored our emails or responded without answering direct questions, seemingly intent on stalling the process. At this point, it feels like they are hoping my father’s condition deteriorates before they are forced to act. To make matters worse, my father has even managed to secure treatment at Netcare Linksfield Clinic at the same rates charged by Chris Hani Baragwanath Hospital, meaning there would be no cost impact to Genesis – and yet they still refuse to authorise treatment. This is not just poor service, it’s a shocking failure of duty, ethics, and compassion. Genesis is knowingly denying (or at the very least delaying) access to life-saving treatment, despite clear medical advice and the provisions of Regulation 8(3) of the Medical Schemes Act, which requires schemes to cover PMB treatment in full when DSPs are unavailable or cause unreasonable delay. What makes this even more outrageous is that Genesis has previously been taken to court over this exact issue and lost. The Constitutional Court dismissed Genesis’s appeal, confirming that medical schemes cannot use their rules to override the law. We are escalating this matter to the Council for Medical Schemes (CMS). Their treatment of our family during this crisis has been nothing short of disgraceful. Genesis, your members are not just policy numbers. They are people - parents, grandparents, and loved ones - who deserve timely care and dignity. How many times to you need to be taken to court before you accept your legal responsibilities?
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