Updated 03.07.2023

GEMS Medical Aid Scheme – Everything You Should Know

GEMS stands for Government Employee Medical Scheme. Therefore, if you are a government employee you can join the Gems medical aid scheme. This is a great medical aid scheme that has been specifically designed for employees in government. Unfortunately, though, there are certain employees who can’t join GEMS, but I will get to that later on in the article. 

If you would great health care at a low price, then joining GEMS could be for you. 

Keep reading for everything that you need to know about GEMS medical aid scheme.

Who can join the GEMS medical aid scheme?

GEMS medical aid scheme is specifically for government employees in South Africa. You may join GEMS if you work in:

  • A National Department listed in Schedule 1 of the Public Service Act.
  • A Provincial Department listed in Schedule 2 of the Public Service Act
  • A Provincial Administration listed in Schedule 2 of the Public Service Act
  • Organizational components listed in schedule 3 of the Public Service Acts
  • An employer group approved by the medical aid scheme.

Unfortunately, you won’t be able to join GEMS if you are part of the SANDF, NIA, SASS or SAPS.

If you meet the above conditions you can apply to join GEMS on their website. They have an online application form that you can fill out. Their brochure is also available on their website with all their pricing info.

Why join GEMS medical aid?

GEMs are firstly affordable. They offer a low contribution increase which means that you will still be able to afford your medical aid cover through the years.

Besides affordability GEMS is also accessible. They offer quality healthcare through a variety of networks. GEMS also ensure great benefits for all their customers. They have invested billions of Rands into claims for their beneficiaries and interestingly only 18% of their client’s runout of claims before the end of the year. This is a low percentage in comparison to other medical aid schemes. GEMS also offers 6 different types of options. On the GEMS website, they have a contribution calculator, which is great for helping you see how much money you would need to contribute towards your medical aid. The contribution calculator is affected by the number of dependents you have, your salary and the option which you will select. Their website is so easy to use, which makes using GEMS a breeze.

What are GEMS medical aid options?

  • Sapphire (TANZANITE ONE)

Sapphire, is the lowest cost medical aid cover. Starting at R403 a month. It covers up to 100% employer subsidy. The Sapphire Option also covers maternity care at a private hospital. There are also no co-payments at GEMS network providers. 

  • Beryl

The Beryl options start at R605 a month. This option covers in and out of hospital benefits as well as a network of healthcare providers. You also have the option of private or public health care facilities.

  • Ruby

The Ruby option is the third option on the medical aid scheme. This option starts at R860 and offers in and out of hospital benefits. You can also have PMSA, hospital plan and Block Benefits on this option. You are also offered a network of health care providers.    

  • Emerald Value

 The starting price of the Emerald Value option is R809. This plan offers in and out of hospital comprehensive cover at affordable rates. You will also receive a nominated GP in this plan to help you with your care. You will also be able to have specialist referrals from your GP on this option.      

  • Emerald

The Emerald option starts at R916. With this plan, you will be offered comprehensive in and out of hospital cover. You can also choose the provider of your choice and you will also receive day to day benefits. 

  • Onyx

The last option that is available, is the top of the range benefit option. The Onyx plan starts at R1229. With this plan, you will receive extensive in and out hospital cover, day to day benefits as well as specialist visits. Contraception is also covered in this plan, as well as basic radiology.

GEMS Offers a Variety of Health Programs and Extras!

GEMs offers a variety of wellness programs that are developed to help improve the health of those in the public service sector. These programs are aimed at helping those who work in the government to make positive lifestyle changes that will impact their health in a positive way. These awesome health programs are also used to help screen for various illnesses such as diabetes, high blood pressure, and HIV. GEMS will also provide support and guidance to help maintain your health, whether it be physical, psychological or social. They also provide HIV counseling, head, neck and shoulder massages, oral health education as well as cholesterol testing. All the results will be discussed with the patients and advice will be given on how to proceed from thereon.

There is also a wonderful maternity program that is fantastic for expectant mothers to be.

GEMS also offers emergency services, that can be contacted 24 hours a day, 7 days a week. This also includes a medical response by ambulance or by helicopter to the scene of an emergency.

You can also qualify for PMB.

In conclusion

GEMS is a fantastic medical aid scheme for those who work in government. Offering a variety of affordable cover, there is a plan for everyone. You will also be able to enjoy a variety of health programs that are designed especially for those in government in order to help you cope better with the stress of your job and to help you live a healthy and happy life.

GEMS Medical Aid Contact Details

Contact Number: 0860 00 4367
Email: enquiries@gems.gov.za

Search for GEMS walk-in centre here: https://www.gems.gov.za/en/corporate/contact-us 

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