About Gems Medical Aid
Gems Medical Aid is
one of a number of closed medical aid schemes in South Africa. It was launched on 1st January 2005, borne out of
the need to serve a particular group of members – public service employees. The establishment of this scheme
stems from a Cabinet approved framework back in 2002 that came up with the idea for a closed scheme to serve
public service employees at all levels of government.
By its nature, Government Employees Medical Scheme (or GEMS) is one of the fastest
growing medical schemes in the country as it is open to a pool of millions of potential members in public
Apart from serving government employees
at all levels and in all government structures, GEMS also has its doors open wide to pensioners irrespective
of the level of government they hail from.
However, GEMS membership must not be
misunderstood. Membership to GEMS by government employees is not automatic or compulsory. All workers in public
service are at liberty to seek alternative medical scheme services. Be that as it may, GEMS medical aid is a competitive one on the market and
members are exposed to equally good service and benefits that they, actually, might not get at the same rates as
they would with GEMS.
What is medical
Medical aid is a facility that takes care of a
member’s medical or health care expenses they would otherwise not afford to pay from their pocket at one go.
Medical schemes design plans that they offer their potential members to choose from. This is done with a needs
assessment and affordability.
GEMS comes up as the ideal option for the huge
majority of government employees. It is the natural option, or alternative.
Like other schemes, GEMS does have plans that
provide cover to clearly defined groups.
This plan covers healthcare provided by
practitioners or healthcare service providers that are registered with the scheme. Seeking services from non-scheme
registered providers entails that the member would pay the account from their own pocket. To add on to that,
members are expected to verify and confirm that the practitioner attending to them is accredited to the scheme. The
scheme reserves the right to approve any specialist visits.
Apart from having access to services for the
treatment or management of chronic illnesses or condition, the Beryl plan is quite similar to the Sapphire plan.
Day-to-day medical expenses are taken care of on an aptly set-up savings plan.
This is the plan that is best designed for members
faced with chronic conditions or illness. Although this plan has a hospital plan as well as a savings one,
admission to hospital requires prior approval from the scheme. As with the Sapphire and Beryl plans, members can
only make use of accredited healthcare providers and practitioners. Otherwise, members must foot the bills
The Emerald plan
This plan, like the Ruby plan, also demands use of
only scheme approved healthcare providers. The plan also provides for programmes specially designed to address
chronic conditions and illnesses, including cardiovascular disease,asthma and even mental
Equipped with one of the best hospital plans, the
Onyx plan is a comprehensive cover that takes care of a member’s full cover for in-and-out-of-hospital treatments.
Despite being restricted to prior approval, full access to specialist services is available to all
Aid is a scheme that offers government employees an affordable option to quality medical aid.©
Medical Aid Plan.
To get your medical aid plan quote by