GEMS Medical Aid is a government health plan for its workers. The government employee medical scheme is meant to be affordable and one that most, if not all government workers can opt for as opposed to private covers.
The need for a reliable medical cover cannot be overemphasized. With health emergencies occurring unexpectedly, these unplanned expenses can take a toll on the family since they cannot be pushed forward. While this is a reality that many South Africans are faced with, there is a certain fear attached to insurance covers. Questions such as who may join GEMS are, therefore, not uncommon. Everyone needs to know if this is a plan that can work for them and help them out when the situation is truly dire.
So, who can join the scheme?
Well, anyone can join as long as they are permitted by the terms and conditions. Usually, the following are the most popular members of GEMS. You must be an employee of the following departments:
- Organisational components listed in Schedule 3 of the Public Service Act
- A National Department listed in Schedule 1 of the Public Service Act
- A Provincial Administration listed in Schedule 2 of the Public Service Act
- A Provincial Department listed in Schedule 2 of the Public Service Act
- Any employer group approved by the Scheme (a list of these employers is available in Annexure A of the Scheme Rules).
Just as there are members that are allowed to join the scheme, the following are not permitted to be covered under the program:
- The National Intelligence Agency (NIA)
- The South African National Defence Force (SANDF)
- Uniformed members of the South African Police Service (SAPS)
- The South African Secret Service (SASS)
- Any department where the conditions of service do not allow you to join GEMS.
How to join GEMS?
As you look to explore the different GEMS Medical Aid options 2021 has to offer; you need to get the basics right. It is necessary to know how to join. You will have to make an online application first. The online process begins by answering certain questions that determine whether or not you are qualified for membership. You will need to supply your employment details and answer a few questions for you to be ascertained. You may have to fill in more GEMS Medical Aid forms to complete your application.
GEMS Medical Sid schemes options
Even as you get the GEMS Medical Aid contact details for further clarifications, it is important for you to know and understand the different packages and benefits available on offer. You need to note that all GEMS Medical Aid claims can be made only after you have complied with certain requirements. It is advisable, therefore, to know what is expected of you from the start. The benefits will be outlined based on the different GEMS Medical Aid plans 2021 available.
1. Tanzanite One – from R882
It is an entry-level benefit option. Previously known as Sapphire, Tanzanite One covers more areas. Merits on this plan as of 2021 include coverage in the following areas:
- Comprehensive cover for both in-hospital and out-of-hospital benefits
- All salary level 1-5 members can have a subsidy of up to 100% from an employer
- Access to a network of private hospitals
- Unlimited GP and specialist consultations
- Access to over the counter (OTC) medication
2. Beryl – from R1,231
The Beryl option is an entry-level benefit option. The gains here include:
- Comprehensive in and out-of-hospital benefits
- Public and private facilities
3. Ruby – from R1,915
The Ruby option is a mid-level benefit option. It gives patients such benefits:
- PMSA that consists of 20% of your contribution, hospital plan and block benefits
- Comprehensive in-and-out-of-hospital benefits
- Network of healthcare providers
4. Emerald Value – from R1,859
The Emerald Value option is a high-level benefit option. It offers:
- Comprehensive in and-out-of-hospital cover at more affordable rates
- Get specialist referrals from your nominated GP
- Nominate a GP to coordinate your healthcare needs
5. Emerald – from R2,172
The Emerald option is a high-level benefit option. This plan offers such gains:
- Comprehensive in-and-out-of-hospital cover
- Day-to-day block benefits
- Healthcare provider of your choice
6. Onyx – from R3,733
The Onyx option is a high-level benefit option. If can prove you with such benefits:
- Day-to-day block benefits
- Extensive in and out-of-hospital cover
- Top of the range benefit option
The types of out-of-hospital and in-hospital benefits are similar across all the plans offered. The difference comes in the details of what is offered on each package. This means that users must be keen when settling for a plan that works for them. In addition to that, you can compare different option or get a more detailed description of each option on the website.
With so many options available for different users, civil servants need to evaluate themselves before picking a plan that works for them. The best way to get details on contributions and any clarifications on gains would be to contact GEMS Medical Aid directly. Whatever you choose, you can be assured that no medical emergencies will put unnecessary pressure on your finances.
DISCLAIMER: This article is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional advice or help and should not be relied on to make decisions of any kind. Any action you take upon the information presented in this article is strictly at your own risk and responsibility!