What Genesis Medical Scheme does

Genesis Medical Scheme is a not-for-profit, member-owned medical aid scheme registered in South Africa under the Medical Schemes Act in May 1995. Operating from Cape Town with 101-250 employees, the scheme provides private healthcare funding to South African individuals and families, offering three subscription products: MED-100 (entry-level hospital plan at R1,680 per adult per month covering in-hospital care at 100% of Scheme Tariff), MED-200 (R2,355 per adult per month covering 200% of Scheme Tariff with additional diagnostics), and MED-200 Plus (R3,400 per adult per month combining 200% Scheme Tariff hospital cover with a R10,800 per adult annual Self Managed Fund for day-to-day expenses). The scheme differentiates on freedom of choice — members can use any private hospital and doctor in South Africa, with no network restrictions — and on price discipline, claiming the lowest 2026 contribution increase in South Africa at 4.7%.

The technology stack centers on a digital member management platform comprising a password-protected web portal (live.gmed.co.za), a smartphone application available on iOS, Android, and Huawei, and electronic membership cards accepted by major hospital groups including Mediclinic, Netcare, National Hospital Network, and Life Health Care. Members can view claims, manage Self Managed Fund balances, update banking details, and retrieve tax certificates entirely through self-service channels. Distribution is dual-channel: direct-to-consumer via online application, phone sales lines, and paper forms, supplemented by a broker network with a dedicated portal for member listings and commission statements. Revenue is generated entirely through recurring monthly contributions debit-ordered on the 1st of each month, with all adult members on each option paying identical rates regardless of age or health status. The scheme is regulated by the Council for Medical Schemes, maintains solvency reserves well above the statutory 25% minimum, and has secured a 2017 Constitutional Court judgment in its favor.

Name

Genesis Medical Scheme

Legal name

Genesis Medical Scheme

Website

https://genesismedical.co.za

Company type

Private

Founded year

1995

Operating status

Operating

Headcount range

101–250 employees

Short description

Genesis Medical Scheme is a South African not-for-profit medical aid scheme founded in 1995, offering three subscription hospital and comprehensive plans (MED-100, MED-200, MED-200 Plus) to individuals and families, with freedom of provider choice and below-inflation contribution increases.

Ownership category

akta.pro rank

Product category

Medical Aid / Health Insurance

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411), Health and Welfare Funds (52512), Health and Welfare Funds (525120)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro primary industry

Medicare Advantage (MA) Plans (FSAIAGAA)

akta.pro secondary industry

Level-Funded Group Health Plans (FSAIAFAC)

Keywords

• Medical aid scheme
• Hospital cover plans
• Healthcare insurance
• Day-to-day benefits
• Medical scheme membership

Headquarters

HQ city

Cape Town

HQ country

South Africa

HQ region

Africa

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Operations, Personnel, Marketing or Sales, Technology or R&D, Infrastructure, Others

Revenue model

1. Monthly Member Contributions: Genesis Medical Scheme generates revenue through monthly subscription contributions paid by members. Contributions are structured based on the selected benefit option (MED-100, MED-200, or MED-200 Plus) rather than income bands. All adult members pay the same monthly contribution regardless of age or health status on each option.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

Genesis Medical Scheme is a not-for-profit, member-owned South African medical aid scheme that sells three healthcare insurance plans (MED-100, MED-200, and MED-200 Plus) providing in-hospital coverage and varying day-to-day benefits. Members pay flat-rate monthly contributions per plan (not income-based) and gain access to any private hospital and doctor in South Africa without network restrictions, supported by an electronic membership card system and a self-service smartphone app.

Product overview

Genesis Medical Scheme offers three medical aid products: MED-100 and MED-200 (hospital plans with varying coverage levels at 100% and 200% of Scheme Tariff respectively), and MED-200 Plus (comprehensive plan with Self Managed Fund for day-to-day expenses). All plans provide in-hospital coverage, freedom of choice to use any private hospital and doctor in South Africa, and substantial dentistry benefits. The scheme is supported by a smartphone app providing electronic membership cards and self-service functionality.

Differentiator

Problem solved

Functional benefit

Products and services

• MED-100 Hospital Plan Entry-level hospital plan for South African individuals and families, providing in-hospital treatment cover at 100% of Scheme Tariff at any private hospital, with basic dentistry, screening tests, and limited out-of-hospital dental benefits. Priced at R1,680 per adult and R525 per child dependant per month (2026 rates).
• MED-200 Hospital Plan Mid-tier hospital plan providing in-hospital coverage at 200% of Scheme Tariff, plus out-of-hospital benefits for X-rays, MRI/CT scans, and diagnostic endoscopy (colonoscopy and gastroscopy), together with enhanced dentistry. Priced at R2,355 per adult and R675 per child dependant per month (2026 rates).
• MED-200 Plus Comprehensive Medical Aid Plan Comprehensive plan combining in-hospital coverage at 200% of Scheme Tariff with a R10,800 per adult Self Managed Fund (SMF) annually for member-controlled day-to-day medical expenses, generous dentistry, and diagnostic scope cover. Priced at R3,400 per adult and R675 per child dependant per month (2026 rates).
• Genesis Smartphone App Free smartphone application for members and their dependents available on iOS, Android, and Huawei stores, providing electronic membership cards accepted by major hospital groups and pharmacies, 24/7 access to claims, SMF balance, contribution details, and personal membership information.

Quantifiable outcome

• 4.7% contribution increase for 2026 - lowest in South Africa
• +3 more outcomes

Named customers6 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Four partnerships are on record, tiered core and minor.

• ER24coreStrategic or Co-development PartnerER24 is Genesis Medical Scheme's preferred emergency evacuation and transport provider. Available 24/7 for emergency pre-hospital treatment, evacuation, and inter-hospital transfers within South Africa. Also provides 24/7 medical helpline service for medical-related enquiries. Members receive 100% cost coverage when using ER24 for emergencies.
• MediclinicminorGTM or Marketing PartnerMediclinic Client Alliance Programme allows Genesis members to access health management programs including Mediclinic Baby (pregnancy support, baby benefits, antenatal classes) and Mediclinic Prime (health screening, wellness support, hospital admission assistance). Programs provide additional value beyond standard medical aid coverage.
• Council for Medical Schemes (CMS)coreOthersGenesis Medical Scheme is regulated by the Council for Medical Schemes under the Medical Schemes Act. CMS conducts member awareness surveys and sets regulatory requirements including minimum 25% solvency levels that Genesis exceeds.
• NedbankcoreOthersNedbank serves as Genesis Medical Scheme's banking partner for member contributions and claim payments. Branch code 16-21-45, Account number 1621 111 563, Account name: Genesis Medical Scheme.

Scale indicators5 records

Recent moves6 records

Expansion highlights2 records

Direct peers

• Fedhealth Medical Scheme: Mid-sized open medical scheme in South Africa offering hospital and savings-plan options on subscription. Comparable in size, target member profile, and broker-led distribution approach.
• Discovery Health Medical Scheme: Largest open medical scheme in South Africa offering hospital and comprehensive plans on a monthly subscription model. Direct competitor across member segments, with a substantially larger member base and broader product ecosystem (including Vitality wellness).
• Medihelp Medical Scheme: Long-standing South African medical scheme offering a comparable mix of hospital and comprehensive plans with monthly contributions. Direct competitor for individual and family medical aid buyers in the same mid-market segment.
• Compcare Wellness Medical Scheme: Smaller South African medical scheme with similar hospital and comprehensive plan offerings. Direct competitor for cost-conscious individual and family buyers seeking affordable cover.
• Bonitas Medical Fund: One of the largest open medical schemes in South Africa offering hospital and comprehensive plans with similar monthly subscription pricing. Competes head-to-head with Genesis on affordability and benefits breadth.
• Momentum Medical Scheme: Established open medical scheme offering hospital and comprehensive plans to individuals and employer groups. Comparable in product structure, target market, and distribution through brokers and direct channels.

Broad incumbents

• Sanlam Health Solutions: Broader South African financial services group offering health insurance products within a diversified life, investment, and short-term insurance portfolio. Comparable adjacent incumbent operating at scale rather than as a dedicated medical scheme.
• Old Mutual Health Solutions: Broader South African financial services group offering health insurance products alongside life, investment, and wealth solutions. Adjacent incumbent with overlapping capabilities but wider portfolio focus rather than specialised medical-scheme niche.

Emerging players

• KeyHealth Medical Scheme: Smaller South African medical scheme focused on affordable hospital and comprehensive cover. Comparable to Genesis in scale and positioning as a value-oriented scheme, though narrower product range.
• Sizwe Hosmed Medical Scheme: Smaller open medical scheme in South Africa offering hospital and comprehensive plans. Overlaps with Genesis on individual/family subscription model and value-segment positioning.

Market position

Strengths5 records

Weaknesses1 record

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/genesismedical
• Facebookfacebook.com/genesismedical
• Instagraminstagram.com/genesismedical.sa
• LinkedInlinkedin.com/company/genesis-medical-scheme

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Genesis Medical Scheme