Gems Medical Aid is here for the workers of South Africa.
Designed for government employees only, Gems medical aid has first-class healthcare at rates a working man can afford.
The scheme came about because many workers could not pay for rising medical costs. Also, there was little integration with the public health system.
Gems medical aid and Healthcare benefits
Gems aim to provide equal access to healthcare for public service employees and lower income earners. The scheme supports the public health network and work done by the Department of Health.
You need to make sure that you follow the scheme’s rules and systems in order to gain the most from being a member.
Only certain people may join Gems medical aid, these include:
- National and Provincial departments
- Provincial Administration
- People who belong to an employer group approved by the scheme
On joining, you and your dependents get a membership card. You must show the card to healthcare providers such as chemists, dentists and hospitals when required.
Gems medical Aid has Five plans:
1. Sapphire – This plan puts you in touch with the Gems network of providers at scheme rates. There are no extra costs involved. A Gems Network logo is displayed at all providers who belong to the network.
2. Beryl – Members have access to a network of dentists, optometrists and GPs. Any visit to specialists must be on referrals from a GP. Pathology and radiology tests are carried out within the Gems rules.
3. Ruby – Certain care programmes in order to help manage chronic diseases are part of this cover. This means you receive support and advice from professionals dealing with diabetes, asthma and mental wellness.
The plan includes a medical savings account to manage day-to-day costs. You do not have to use the network of doctors but doing so will help to avoid extra costs.
4. Emerald – A health care support and education plan plus the choice of doctors. However, seeing a GP outside of the network will result in extra costs. A hospital stay needs pre-approval. Included are out-patient visits, scans, physiotherapy and ambulance transportation.
5. Onyx – This plan helps to manage chronic diseases and other disease management issues. You have the option of using doctors outside of the network at your own expense.
Gems medical aid is ideal for Government employees seeking top quality medical aid for themselves and their families at reasonable rates.