Emerald

Using YOUR benefits ›

Disease management programmes
GEMS offers its members specific care programmes to support the management of various chronic diseases and conditions. If you suffer from asthma, bipolar mood disorder, cardiovascular disease and diabetes type 1 and type 2, for instance you will benefit from joining the disease management programme for your specific condition. Benefits of these programmes include education, advice and support by trained nurses, review of the medicine currently being used and support of the doctor/patient relationship. If you, or a family member, have a severe chronic condition or you may have been hospitalised as a result, joining the relevant programme will be of great benefit to you.

Click here for more information about ›

• Chronic medication
• HIV/AIDS Management
• Oncology Management
• Optometry Management
• Dental Management
• Hospital Management
• Maternity Programme

What medication does GEMS pay for (Formulary)?

• 2010 Comprehensive Formulary - Emerald and Onyx

You can also visit the Formulary Check service to conduct a search.

What does GEMS not pay for?

Click below to access the Exclusions and Limitations.

• Exclusions and Limitations Part 1
• Exclusions and Limitations Part 2

Forms ›

• Application Form>
• Chronic Medication Application form>
• HIV Disease Management Form>

Benefits 2010 ›

• Download the Benefits schedule for 2010 ›

Cost of membership for 2010 ›

As always, GEMS strives to bring you the best possible healthcare benefits to suit your needs. Offering you more choices is what our commitment to you is all about. There is a perfect benefit option for you and your family's healthcare needs and
your pocket!

These are the total monthly contributions for each option and do not reflect any applicable employer subsidy. Where an employee is eligible for a subsidy, the employer will pay a portion of the contribution reflected in the table and the employee the balance. Feel free to discuss your subsidy with your HR Practitioner.

Salary Band	Member	Adult	Child
R0 – R8000	R1152	R816	R424
R8001 - R10 500	R1256	R900	R468
R10501+	R1396	R992	R516

Contribution statements

A contribution statement is issued to each member on a monthly and quarterly basis and summarises your monthly contribution payments and outstanding payments. This statement helps you to ensure that your contributions are always up-to-date.

Managing arrear contributions

Arrears can be caused by the following:

Your medical deduction has not been implemented.

Your salary increase was backdated and this increase moved you into a higher contribution category.

You added a dependant and this change was not implemented on time.

You moved to another department that has not implemented your medical deductions yet.

Your contract expired and your new contract has not been captured.

GEMS will send you a letter confirming the amount of your medical contribution arrears. You will also receive a monthly contribution statement if your account is in arrears.

Note: You can approach your HR Practitioner to assist you with the repayment terms of any arrears.

Understanding the different codes on your salary statement

An increase in your salary could make you eligible to pay the contribution applicable to a higher salary band.

Various salary codes are used for medical scheme deductions that may appear on your salary advice. Below is an explanation of what they mean:

• 0005 - Normal medical scheme deduction. This amount would be the monthly contribution.
  
• 0006 - Arrear deduction implemented via GEMS. This amount is for medical arrears that were incurred within a three month period. The employee payroll automatically calculates the amount that the employee can afford and will either deduct the arrears once-off or spread the arrears over a few months.
  
• 0189 - Manual arrear implementation via HR Practitioner. This amount is for any arrears that cannot be implemented automatically via the employee payroll (more than three months) and is manually implemented by your HR Practitioner.