Gem Medical Aid, the Healthy Choice for SA Government
Aid is a closed medical aid scheme aimed at medical treatment and healthcare for employees of the
The idea behind Gems is that all employees will have the same access to benefits,
catering for employees with lower income as well.
Each member will have the following benefits, irrespective
of which plan you belong to:
Access to private facilities for a broad spectrum of medical care. You can choose
Claims are paid promptly every 14 days.
Communications with members on a regular basis.
Customer service is efficient and done in a friendly
DMP for managing costs and treatments for chronic
Emergency medical treatment is covered in most parts of South
HIV/Aids DMP, or Disease Management Program gives health care on a confidential
Medical information is kept private and is seen as confidential
Medical services in an emergency.
Monthly payments are affordable and calculated according to your
There are five
different Gems medical aid plans government employees can choose from, with different gemstone
Sapphire medical scheme members can choose from
the network general practitioners, dentists, optometrists and pharmacists for their medical care visits. These
visits are unlimited and you will not need to pay any additional fees. Should you need to visit a specialist, the
general practitioner in the network, will refer you to the specialist. A wide variety of doctors belong to this
Beryl medical plan also has the option of choosing
the doctor, dentists, optometrist or pharmacist from the approved network. If you go to one of the network
professionals, the approved medical aid rate for medical treatment and visits are covered. In addition to the
general cover for all members are the following:
· Day-to-day care
Cover for chronic medications
· Oncology management
Ruby is ideal for the person who has a chronic
medical illness. GEMS Personal Healthcare support group consists of professionals that are qualified to assist you
in managing your chronic illness. Included in the Ruby plan are a hospital plan and a Savings
Emerald plan members also use the approved network
of medical professionals, thereby avoiding paying any additional costs. However, you are not obligated to visit
medical professionals from the approved network.
Authorization prior to admittance, a visit or
treatment is necessary for the following treatments and procedures:
Onyx plan members are not obligated to visit the
medical professionals in the network group. However, should they visit professionals outside of the network; they
can be held responsible for additional costs. Onyx plan has specific management programs that assists member who
have chronic medical diseases. The team consists of medical professionals who can assist the patient in handling
and managing their chronic medical disease. There are nursing staff that will help with healthcare and education on
disease such as asthma, cardiovascular disease, diabetes and mental illnesses. Assistance is also given according
to the prescribed treatment for the disease.
Gem medical aid is the perfect scheme for
government employees requiring good medical and health care at affordable rates. © Medical Aid Plan.