GEMS – simply the best Medical Scheme for Government Employees At GEMS we are always looking out for our members’ best interests. From providing cover for your extended family to speaking to you in your own language, we know what’s best for your health! If you are a qualifying Government Employee, here are more great reasons to choose GEMS: 1. GEMS is affordable Your employer subsidises your GEMS contribution by up to 75%. If your income is within salary levels 1 to 5 and you choose the Sapphire option, you could qualify for a 100% subsidy! Subsidy limits increase by medical price inflation (MPI) every year.
2. GEMS offers you ‘Big Scheme’ security GEMS is the biggest restricted medical scheme and the second largest scheme in South Africa. Less than 5% of contributions are spent on non-healthcare services, compared to an industry average of 9%.
3. GEMS benefits are accessible You can cover your extended family. No waiting periods for l principal members who join the Scheme for the first time; l beneficiaries who join at the same time as the principal member; and l new-born babies and newly-adopted children added as beneficiaries for the first time.
4. GEMS is not too big to serve its members GEMS provides you with free face-to-face consultation services at your workplace. You can ask for assistance in the language of your choice.
5. GEMS is there for you in an emergency Our committed network of emergency medical services staff is ready to help you in times of crisis, no matter where you are in South Africa.
6. GEMS is easy to reach Our Self-help Kiosks bring personalised service to you at the touch of a button. Conveniently located at your local GEMS walk-in centre, selected Government buildings as well as a pharmacy near you!
7. GEMS protects your funds through selective underwriting Underwriting protects GEMS against anti-selective behaviour, fraud, waste and abuse, thereby protecting your funds. Unlike other medical schemes that apply underwriting to all members, GEMS applies underwriting to the following categories of members only: l Principal members who resign from the Scheme with their dependants (without also resigning from the Public Service) and then re-join the Scheme. l Dependants who are resigned from the Scheme and who are then re-registered by the principal member at a later date. l Dependants who join GEMS on a different date from the main member (excluding new-born babies and newlyadopted children).
8. GEMS gives you value-added services across all benefit options In-hospital, Prescribed Minimum Benefits are covered at 100% of scheme tariff. No co-payments when you make use of GEMS network providers.
What’s new and happening in 2017? A new app to help you manage your GEMS membership from A to Z An electronic Patient Health Record allowing you to track the usage of your benefits Roll-out of more Self-help Kiosks for added convenience Additional Client Liaison Officers (CLOs) Lifestyle Rewards Programme for great added value and benefits Enhanced GEMS Fitness Programme New Disease Management Programme Working towards a healthier you