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Sapphire Beryl Ruby Emerald Onyx


Emerald is a traditional option designed to provide comprehensive cover that offers access to care at the provider of your choice, subject to benefits and Scheme Rules.

Important things to remember about the Emerald option

  • There is a specific Ruby, Emerald and Onyx (REO) Network that is made up of Family Practitioners, (also known as general practitioners or GPs), specialists and pharmacies who have agreed to charge the Scheme Rate and follow the managed care rules applicable to the GEMS Network relevant for these options. To find a GEMS Network doctor in your area, call the GEMS Call Centre on 0860 00 4367 or visit the GEMS website at and click on the GEMS Network logo.
  • You are required to nominate a Family Practitioner (FP) on the GEMS REO FP network, who you will consult for all your doctor visits. To assist you with the process of Family Practitioner (FP) nomination, GEMS will allocate you and your dependants a GEMS Network doctor who you currently visit. You and your dependants will receive communication confirming which Network FP has been allocated to you. If you would like to change the allocated FP or if you were not allocated an FP, please phone the Call Centre. You can change your nominated FP as many times during the course of 2015. Once the FP nomination claims rules are applied, the nominated FP may be changed only once every six (6) months.
  • Although the Specialist Referral claims rules will not apply in 2015, GEMS REO members are advised to visit their nominated FP. Going forward, once the Specialist Referral rules are activated, specialist claims without a referral will attract a 30% co-pay. A specialist referral number via the call centre is not required, but the nominated FP's practice number must be submitted with the specialist's claim in order for it to be paid in full.
  • You need to get pre-authorisation for all hospital visits, out-patient visits to a hospital, MRI scans, CT scans or radio-isotope studies, in-hospital physiotherapy, ambulance transportation and specialised dentistry.

Your 2015 Emerald benefits

Click here to view your 2015 Emerald Benefit Guide.

Disease Management Programmes

What medicine does GEMS pay for (Formulary)?

What does GEMS not pay for?

Click here to see what GEMS does not pay for.


Cost of membership for 2015

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 BandMember
R0 - R10 330
R1 827R1 291R669
R10 331 - R17 840R2 023R1 450R751
R17 841 +R2 267R1 612R837


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 might 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 and we did not take account of this change in time for the next 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.

Benefit Options > Sapphire Beryl Ruby Emerald Onyx

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