GEMS Emerald Value Medical Plan

GEMS Medical Scheme was registered in 2005 to meet the health care needs of government employees. This particular medical aid is committed to providing useful information so that people can make solid choices about their health care cover. GEMS Emerald Value is something to consider.

GEMS is a large medical scheme in South Africa with more than 1.8 million beneficiaries. So some of the good things going for this medical plan is that it offers excellent scheme security, it is affordable, and it covers every family member.

GEMS Emerald Value

They help their colleagues in the language of their choice and can provide free consultations in your home or workplace. When comparing benefits and contributions, the medical scheme compares will to the industry average. Also, we take a look at one of the medical plans – the GEMS Emerald Value Medical Plan –

So let’s look at one of the medical plans – the GEMS Emerald Value Medical Plan:

Emerald is a traditional option, providing comprehensive cover. The primary member will pay R1 996 on this plan during 2016.  So people love knowing that it offers access to care at the provider of your choice. Of course, this is subject to benefits and Scheme Rules.

Nominate an FP

There is the Ruby, Emerald and Onyx (REO) Network. That is made up of general- or family practitioners, pharmacies and specialists who agree to charge the Scheme Rate and follow the managed care rules. Emerald Plan members are encouraged to nominate an FP on the GEMS REO FP network. This person will consult for all your doctor visits so that you don’t have to pay out-of-pocket expenses.

If you’ve got any queries, you can call  the GEMS Call Centre on 0860 00 4367
Also, you’ll need to get pre-authorisation for all hospital visits, ambulance transportation, out-patient visits,  MRI scans, etc. As well as specialised dentistry.

So let’s have a look at just some of the benefits you can enjoy with the Emerald Plan –

In-Hospital Benefits

Prescribed minimum benefits (PMBs) – unlimited
– Yearly hospital benefit – includes accommodation in general- or high care ward
– Blood transfusions – unlimited
– Breast reduction – unlimited
– Maternity – subject to registration on the maternity programme
– Dental services – limited to R4 402 for each beneficiary
– Mental health
– Emergency services
– Oncology – medicines and materials – limited to R315 779 per family each year
– Prostheses – temporary and permanent
– Organ and tissue transplant
– Pathology – unlimited
– Radiology
– Physiotherapy – limited to R4 258 per beneficiary each year
– Specialist service – unlimited consultations

Out of Hospital Benefits

– Audiology
– Emergency Assistance
– Dental Services
– FP services
– Maternity Care
– Mental Health
– Circumcision to prevent HIV infection
– Prostheses
– Optical services
– Orthopedic services
– Physiotherapy
– Specialist Services

Meeting Members Needs With GEMS Emerald Value

So are you searching for quality health care? GEMS is a medical scheme which is looking at ways to deal with lifestyle diseases. Also, they are constantly re-aligning their products and services to meet the needs of their members.

On the Emerald Plan as well as the other plans, they have introduced new benefits such as influenza vaccines, pneumococcal vaccinations, pap smears, mammograms and blood tests for prostate cancer for instance. They’re looking out for the health of their members. So this is a top-notch medical aid scheme for government employees.