FAQ’s

GENRIC is an exempt Medical Insurance, fully compliant with the Demarcation Regulations. It is governed by the short-term and long-term insurance legislation and reports to the Council for Medical Schemes.

Medical insurance is based on events and stated benefits and is regulated under the Long-term and Short-term Insurance Acts. Medical aid is based on procedures and tariff codes and is regulated by the Council for Medical Schemes.

Yes, you may, but you need to understand that medical aid and medical insurance offer different benefits and cover.

Yes. We will contact you to confirm bank account details and to obtain authorisation from you to debit your account.

Yes, you may.

Cover is only available within the borders of South Africa, Lesotho and Eswatini (Swaziland). You will need to return to South Africa to receive treatment.

Yes. Our primary care policy can sit alongside a hospital plan or medical aid. Insurance aims to put you back in the same position as before the event, so claims already paid by a medical scheme will not be paid again.

Check your policy to see if waiting periods apply. Waiting periods may apply on newly incepted policies and/or additional dependants, except in the event of an accident. They are a period when you cannot claim for certain benefits.

An adult is a person over the age of 21 who is the immediate family of the policyholder and eligible for membership.

A child is a person under 21 and the immediate family of the policyholder. Cover as a child can be extended to age 27 if they are full-time students. Documented proof of full-time studies is required annually.

Immediate family includes children by birth, adoption, stepchildren or grandchildren in the policyholder’s care; parents, step-parents and grandparents for whom the policyholder is liable; siblings including half-siblings; a spouse as defined in the policy; and any other relative who, at the insurer’s discretion, qualifies.

A spouse is a significant other, partner or non-marital partner of the principal member in a marriage or customary union recognised in South African law, a religious union, or a same-sex or heterosexual union intended to be permanent.

Your newborn will be covered from the moment of birth, provided you complete registration within 90 days.

GENRIC has a network of doctors. You need to visit one of them to qualify for benefits. Use the GP and dental network lookup to find a provider near you.

Certain options allow 2 out-of-network GP benefits. You pay cash and claim back. Complete a claim form and keep your receipts.

If your plan has the casualty room benefit, contact pre-authorisation on 031 303 3928 (office hours) or 086 000 2402 (24/7 emergency).

Locate a network GP where you are. If you cannot see a network GP and pay up front, we will reimburse you up to the out-of-network benefit on your option.

Email admin@medsureglobal.com with your doctor’s name, practice number and contact details. We will request that they join the GENRIC network. The same applies to dentists.

If your network GP believes you need a specialist, they must write a referral. No pre-authorisation is required, subject to benefit entitlement. There is no specialist network.

Optical benefits are accessed at Specsavers: 1 consultation and 1 set of frames with single vision lenses per member every 24 months, limited to R1 550. Bifocals or multifocals may attract a member co-payment.

If you used a non-network provider or specialist and paid cash, complete and sign the claim form and email it to claims@medsureglobal.com with clear copies of all accounts. Submit within 90 days. For help call 031 303 3928 or WhatsApp 066 122 1528.

Call 031 303 3928 during office hours or 086 000 2402 for 24/7 emergencies. We will assist with authorisation and finding an appropriate facility.

A sudden, unexpected, unusual, specific event at a particular time and place that results in visible, violent, external and traumatic physical injury. Seek medical care within 12 hours and report the event within 30 days.

2 months on out-of-hospital benefits unless otherwise stated; 3 months on in-hospital illness benefits; 6 months on optical, dental and chronic medication benefits.

Myringotomy and grommets, adenoidectomy, tonsillectomy, hysterectomy (except where malignancy is proven), and spinal, back, neck and joint related procedures except in the case of an accident.

A 12-month waiting period applies to all pre-existing conditions, diseases or illnesses, and to pregnancy and confinement. Failure to disclose a pre-existing condition could render the policy cancelled. A 3-month waiting period applies to the accidental death benefit. A 12-month waiting period applies to pre-existing cancer-related treatments.