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Emerald Value


The new Emerald Value option, which includes a hospital network, offers the same rich benefits as the existing Emerald option, but at a more affordable rate.

Important things to remember about the Emerald Value option

  • You must nominate a General Practitioner, who must be on the GEMS Network, as your first-line when seeking medical care and who you will consult for all your doctor visits. A 30% co-payment will apply to all GP claims received from a non-nominated GP.
  • You must use a hospital, of your choice, from the Emerald Value Hospital Network for your in-hospital needs. View the Emerald Value Hospital Network list for the list hospitals.
  • Specialist referral must be obtained from your nominated GP for all specialist requirements.
  • Provision is made in the event that you may require healthcare while travelling, or require specialised care that may not be available through your nominated healthcare providers, to ensure that your needs are taken care of. As part of this, you are allocated three visits to a non-nominated GP per family per year for emergencies only, i.e. in cases where you cannot get to your nominated GP.

Your 2017 benefits

View your 2017 Emerald benefit guide.

Frequently Asked Questions

Click here to view Frequently Asked Questions about the Emerald Value Option.

Disease Management Programmes

Forms

Cost of membership for 2017

Contributions (how much you pay each month to be a member of GEMS)

As always, GEMS aims to bring you the best possible healthcare benefits to suit your needs. Offering you more choices is what our commitment to you is about.

The contributions in the table below do not include employer subsidies. In some cases, you might qualify for a subsidy from your employer. A subsidy is an amount your employer pays towards the cost of being covered by GEMS. If you qualify for a subsidy, the employer will pay a portion of the contribution each month and you will pay the rest. You must find out about the subsidy from your employer.

If you have any questions about your subsidy, you should discuss them with your Human Resources (HR) Department. A useful contribution calculator will help you to work out your monthly contributions, if you are employed in the public service.

Salary Band Member
Adult Child
R0 - R11 892 R2 066 R1 498 R757
R11 892.01- R20 538 R2 287 R1 682 R849
R20 538.01 + R2 563 R1 870 R946

Note:

Salary column: This reflects the monthly salary amount before tax or other benefits are deducted.

Member column: This column shows how much the principal member, who is the public service employee registered with GEMS, has to pay.

Adult column: This oclumn shows how much you have to pay for your adult dependants.

Child column: This column shows how much you have to pay for a child dependant. GEMS covers children up to the age of 21, unless the child is mentally or physically disabled or is below 28 years of age and is a student registered at a recognised educational instutution.

Contribution statements

We send a contribution statement to members who owe money to GEMS on a monthly basis. We also send a contribution statement to all members on a quarterly basis. The contribution statement sets out your monthly contribution payment and any money that you owe to GEMS. This statement helps you to check that your contributions are always up-to-date.

Managing arrear contributions

You might be behind in your payment to GEMS if any of the following happen:

  • Your employer has not deducted your monthly contribution costs from your salary. This may happen to new members when the membership start date is captured after the date of the monthly deductions for that particular month. This might also happen if you move between departments.
  • Your salary increase was backdated and this increase moved you into a higher contribution category.
  • You added a dependant, but the additional contribution for this new dependant was not taken into account on time for the next contribution payment.
  • Your contract ended and your new contract was not active in time for the next payment.

GEMS will send you a letter confirming the amount that you owe us. You will also receive a monthly contribution statement if your payments are behind.

If you need help with paying the contributions you owe, please contact the Scheme or ask your HR Department to help you with the repayment terms.

Remember: Your annual contribution increases are effected in January and may be increased with your annual salary increase. It is your responsibility to ensure that your contributions are paid monthly and are up to date.

Benefit Options Enquiries >

0860 00 4367 (Call Centre) enquiries@gems.gov.za More Contacts >